Hand Injuries and Pain in Happy Valley

Hand injuries and pain are common with all types of jobs, ages, and activity levels, however certain jobs and activities may give you higher risks for a certain type of hand injury. The bones, muscles and ligaments in the hand are more delicate than other areas of the body and are used near constantly in our daily lives. The hand is described as the palmer and dorsal (back) surfaces with the flexor tendons and muscles on the palmar side and extensor tendons on the dorsal side. The majority of the muscles that flex and extend your fingers are actually in your forearm but there are smaller muscles around the bones of your hand called “intrinsic muscles” that help perform fine motor, stability in addition to bringing your fingers together (adduction) and apart (abduction).

Carpal Tunnel Syndrome – People who work on a computer or use computers or gaming consoles will likely have a higher risk for carpel tunnel syndrome. This is where tissues on the palm side of your hand become inflamed in a small passageway in the palm causing pain, numbness and even weakness in very specific patterns. The median nerve also passes through the carpel tunnel, which usually gives the first symptoms of this condition, pain and possible numbness along the thumb, pointer, middle and part of the ring finger of the hand on the palmer side only.

De Quervain’s Tenosynovitis – Despite the impossibly complicated name it is just an inflammation and thickening of the tendon that extends (“thumbs up” position) the thumb as it passes through a passageway at the base of the thumb. It is usually more painful to lift your thumb than to flex or grasp an object.  Fittingly, one of the tests to diagnose De Quervain’s Tenosynovitis is called “Finkelstein test.” It is also surprisingly simple considering the name. First, grasp your thumb with your other fingers to make a fist with your thumb on the inside. Second, rock your wrist toward your pinkly like you are very slowly hitting a nail with a hammer. If this produces pain that is isolated at the base of your thumb then you may have De Quervain’s.  The good news is this type of injury is commonly treated with nothing more than Physical Therapy focused on decreasing the inflammation of the tendon and improving the sliding surfaces in the passageway for that tendon.

Mallet Finer – This is one specific kind of extensor tendon injury and is treated with careful bracing. After the tendon is sufficiently healed exercise programs are focused on tendon strength rather than muscular strength to prevent the same injury in the future and further repair the damaged tissues. Range of motion can also be corrected through physical therapy, a common issue following prolonged bracing. It is important to first assess if an x-ray is needed as in some cases a small piece of bone can break off of the hand and may not heal properly without surgical reattachment.

Boutonniere Deformity – Similarly to mallet finger this is damage to a long tendon on the dorsal (back) side of the hand. It results in the joint by the fingertip to be stuck in a “bent back” position (hyper extended) and the middle joint of the finger to be stuck in a bent position. This is results in an inability to curl the finger into one arc when opening your hand, like to grab a coffee mug. Like mallet finger, boutonnieres deformity is treated initially with bracing, followed by range of motion exercises and tendon strengthening.

Arthritis – Osteoarthritis (OA) and rheumatoid arthritis (RA) are also common in the hands as we age. Although OA and RA have very different mechanisms they both benefit from careful exercise progressions that help stabilize the joints and protect the delicate connective tissues. OA is the breakdown of the sliding surfaces in the joints resulting in pain and loss of tolerance to motion of the fingers. RA is an autoimmune condition that damages the connective tissues of the joints and should be treated in conjunction with a rheumatologist.

If hand & wrist symptoms have been interfering with your life, call us today to get started on a plan of care that works for you. Ascent Physical Therapy is conveniently located off Sunnyside Road in Happy Valley. We also love treating our neighboring communities of Damascus, Gresham, Clackamas, and Sandy at our top rated physical therapy clinic!