Carpal Tunnel Syndrome
Carpal tunnel syndrome causes tingling, weakness, cramping and pain radiating from the palm of the hand through the wrist and into the forearm. This is the path of the median nerve and problems occur when this nerve becomes compressed passing through the wrist canal.
Compression often results when tendons, also running through the carpal tunnel, become inflamed. This leads to crowding, irritation and pressure on the nerve, which sends out pain signals in response.
Compression is more likely in people with genetically smaller wrists and/or a wrist injury and swelling. Other causes include: use of heavy vibrating tools; fluid retention due to the hormonal changes of pregnancy or menopause, a tumor or some combination of causes.
The talented New Jersey plastic surgeons at Cohen/Winters use straightforward, outpatient procedures to widen the tunnel and alleviate symptoms, often permanently.
Basal Joint Arthritis
This common form of arthritis of the hand makes moving the thumb painful and difficult. People affected by basal joint arthritis have trouble with daily tasks like picking up a pen or a cell phone, retrieving something from a shelf, carrying a bag of groceries or gripping the steering wheel.
The wear and tear the average person puts on the joint at the base of the thumb is incredible, putting almost everyone at risk of developing basal joint problems.
Injury and aging are also factors that combine to bring on osteoarthritis of the thumb. If left untreated, basal joint arthritis can cause the thumb to permanently contract toward the palm.
We need our thumbs for almost everything, so when thumb joint arthritis makes moving the hand painful and limited, hand surgery can help. Hand microsurgery can rebuild and strengthen the base of the thumb to restore proper function.
Trigger Finger
Trigger finger (or trigger thumb) is tendon problem causing finger or thumb stiffness, pain and also jerky movements of one or more fingers. This occurs when finger tendons develop nodules (bumps or swollen areas), which “catch” when sliding though the tendon’s protective sheath.
The tendon “sticks” or “catches” on a pulley which holds the tendon sheath in position. When the tendon gets “unstuck” it slides through pulley and sheath abruptly, causing the finger or thumb to straighten out suddenly.
Middle aged and older adults get trigger finger most often, but children can also be affected. Individuals with rheumatoid arthritis or diabetes are more vulnerable. In some cases, the trigger finger gets locked into the curled position. Trigger finger causes pain and makes carrying items or picking them up difficult or impossible.
Tendonitis (Tendinitis)
Strong, fibrous tendons attach muscle to bone throughout the body and are surrounded by a lubricating sheath and held in place by pulleys. Tendonitis of the wrist (also called de Quervain’s tendinitis) is caused by a swollen tendon and/or tendon sheath running from the back of the thumb through the side of the wrist.
Tenosynovitis is a closely related condition, where the nerve irritation is due to swelling in the sheath’s lining (called the synovium). Swelling may be caused by overuse and/or injury.
Women are more susceptible due to hormonal changes throughout life. Older people are more prone to tendonitis, as are people who use their wrists repetitively in work or sports activities. Wrist tendonitis causes pain, swelling, numbness and stiffness in the wrist and thumb when nearby muscles are used and often when at rest.
Pain may spread up the forearm if left untreated and tendon tears or ruptures can occur. Tendon repair surgery may be the best option to restore full range of motion and eliminate pain. When performing this outpatient procedure, the NJ plastic surgeons at Cohen/Winters always make sure to place the incision in an inconspicuous spot in one of the natural creases of the hand.
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