A number of conditions can affect the hand and wrist, leading to disabling symptoms such as pain and reduced function of the hand. Dupuytren’s contracture, trigger finger, and carpal tunnel syndrome can have similar symptoms, but they are caused by different factors and may require different treatments.
How Does Dupuytren’s Contracture Happen?
Dupuytren’s contracture is a hand condition that affects the layer of tissue directly underneath the skin in the palm of the hand. It involves an abnormal thickening and knotting of this tissue, and it eventually creates strong cords of tissue. Over time, these cords can pull and bend one or more fingers inward, toward the palm of the hand, creating a deformity in the hand. The pinkie and the ring finger are usually most affected.
Although Dupuytren’s contracture is not usually painful per se, it can cause loss of hand function. The affected fingers cannot be straightened out completely, which can make simple everyday activities difficult – such as grasping objects or shaking someone’s hand.
What Causes Dupuytren’s Contracture?
The causes of Dupuytren’s contracture are still not fully understood, but there is some evidence to suggest that it may be associated with abnormal biochemical processes in the palmar fascia (a thin sheet of connective tissue located just beneath your skin).
It is also believed that there are certain factors which can increase a person’s susceptibility to developing the disease, which include:
- Being age 50 or older
- Being male
- Having a family history of the condition
- Having diabetes
- Being of Northern European descent
- Using tobacco and alcohol
There is currently no way to stop the progression of Dupuytren’s disease, but treatments such as enzyme injections can help to alleviate it and give you the use of your finger back. Surgery, such as a fasciotomy, may be recommended to break up the knotted tissue under your skin.
How Is Trigger Finger Different?
Trigger finger, also known as stenosing tenosynovitis, causes a tendon (the strong, thick, semi-flexible tissue that connects a muscle to a bone) in a finger to catch or get stuck in a bent position. This can make it very difficult or impossible to straighten out the affected finger. It can occur in one or more fingers or the thumb at the same time, but it can also occur in different fingers at different times.
Tendons glide through a tendon sheath, which allows for smooth, easy movements. However, if a tendon is inflamed and swollen, or if it develops a nodule, it can have difficulty fitting through the tendon sheath and moving properly. Trigger finger can cause pain, discomfort, and swelling, and a popping or catching feeling may be experienced when trying to straighten out the affected finger.
The cause of trigger finger is not always clear, but it is more common in people whose work or hobbies involve repetitive gripping actions, which can irritate the tendon sheath over time. Other factors that increase the chances of developing the condition include being female, aged 40-60, certain health problems (such as diabetes or rheumatoid arthritis), and having complications following carpal tunnel syndrome surgery.
Treatment for the condition can vary, but it usually begins by resting that hand, taking pain-relief medication, and wearing a splint for support. Surgery can be performed to create a larger tunnel for the tendons to slide through, and this invasive treatment may be recommended if other treatments have failed to work or if the finger remains stuck in a bent position.
What Happens in Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common hand condition that is caused by pressure on the median nerve in the wrist. The median nerve runs from the forearm through the carpal tunnel in the wrist near the palm, and it carries nerve signals for sensation and muscle movement throughout the hand except the pinkie finger.
If the nerve becomes compressed or entrapped, it cannot function properly. This can lead to debilitating symptoms such as numbness, tingling, and weakness in the hand, wrist, and arm. This can make activities that involve grasping and gripping actions difficult or impossible.
There is no single cause of carpal tunnel syndrome, but it is more common in women and those aged between 30 and 60. Other factors that may increase your susceptibility of developing the condition include:
- Structural factors such as a wrist deformity, fracture, or dislocation
- Medical conditions such as diabetes, rheumatoid arthritis, or thyroid disorders
- Certain medications
- Work activities or hobbies involving prolonged or repetitive flexing or compression of the wrist
- Fluid retention
Carpal tunnel syndrome can usually be relieved by resting the area, taking pain-relief medicine, and wearing a splint to support the wrist in a neutral position. Carpal tunnel release surgery may also be recommended if nonsurgical options do not work or if the condition becomes worse.
Hand and Wrist Care in Greater Chesapeake
If you have pain, weakness, or limited function in your hand or wrist area, the orthopedic physicians at Greater Chesapeake Hand to Shoulder are here for you. Our Maryland surgeons can diagnose and treat a broad range of conditions affecting the hand, wrist, elbow, and shoulder.