Ganglion Cysts

Ganglion cysts are very common lumps within the hand and wrist that occur adjacent to joints or tendons. The most common locations are the top of the wrist, the palm side of the wrist, the base of the finger on the palm side, and the top of the end joint of the finger. The ganglion cyst often resembles a water balloon on a stalk, and is filled with clear fluid or gel. The cause of these cysts is unknown although they may form in the presence of joint or tendon irritation or mechanical changes. These cysts may change in size or even disappear completely, and they may or may not be painful. These cysts are not cancerous and will not spread to other areas.

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Reflex sympathetic dystrophy (RSD), also known as chronic regional pain syndrome, is characterized by pain, swelling and abnormal sympathetic nerve activity in the affected hand or extremity.The pain is out of proportion to the injury that triggered it. RSD is usually associated with an injury, which can sometimes be as minor as a paper cut or small bruise. It causes nerves to misfire and send frequent or constant pain signals to the brain. The sympathetic nerves become overactive, causing intense burning or aching pain, along with swelling and changes in skin color, moisture, and temperature.The earlier the diagnosis of RSD is made and treatment started, the better the chance of full recovery. The treatment is varied and depends on both the severity of the symptoms and the duration of the problem. Read more...

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand . Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers.
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Dupuytren’s disease is an abnormal thickening of the fascia (the tissue just beneath the skin of the palm). It often starts with firm lumps in the palm. In some patients, firm cords will develop beneath the skin, stretching from the palm into the fingers. Gradually, these cords may cause the fingers to bend into the palm . Although the skin may become involved in the process, the deeper structures—such as the tendons—are not directly involved. Occasionally, the disease will cause thickening on top of the finger knuckles (knuckle pads), or nodules or cords within the soles of the feet (plantar fibromatosis).The first sign of the disease is often a 'lump' or nodule in the palm of the hand, commonly at the base of the ring or little finger. Another sign may be an indentation in the skin, known as a dermal pit, which occurs due to a contraction of the connective tissue fibres. Later, a longitudinal fibrous band, known as a cord, may form, extending from the palm into the finger(s). This cord can pull the finger joints into a flexed (bent) position. Read more...

DeQuervain’s Tendonitis

De Quervain’s tendonitis or tenosynovitis is a condition brought on by irritation or inflammation of the wrist tendons at the base of the thumb . The inflammation causes the compartment (a tunnel or a sheath) around the tendon to swell and enlarge, making thumb and wrist movement painful. Making a fist, grasping or holding objects—often infants—are common painful movements with de Quervain’s tendonitis.
The cause of de Quervain’s tendonitis is an irritation of the tendons at the base of the thumb, usually caused by taking up a new, repetitive activity. New mothers are especially prone to this type of tendonitis: caring for an infant often creates awkward hand positioning, and hormonal fluctuations associated with pregnancy and nursing further contribute to its occurrence.
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The condition commonly known as “trigger finger” or “trigger thumb”, involves the pulleys and tendons in the hand that bend the fingers. The tendons work like long ropes connecting the muscles of the forearm with the bones of the fingers and thumb. In the finger, the pulleys are a series of rings that form a tunnel through which the tendons must glide, much like the guides on a fishing rod through which the line (or tendon) must pass. These pulleys hold the tendons close against the bone.
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