Get to grips with hand conditions from arthritis to ganglions

By Mr Giles Bantick, consultant plastic and hand surgeon at The London Hand and Wrist Unit at The Wellington Hospital, The Lister Hospital, Chelsea Outpatient Centre and Chiswick Medical Centre.

How do you know if you have carpal tunnel syndrome (CTS) ? The typical symptoms are tingling and numbness in your hand and fingers and pain in the hand and arm, particularly at night. There are a number of known causes for CTS; it is common in women during the latter stages of pregnancy, and can be caused by repetitive hand movements, such as using a computer keyboard. CTS is a common problem; however, often there is no specific cause. 

CTS occurs when the median nerve, one of the main nerves to the hand, becomes squashed in the carpal tunnel – the space between the wrist bones and a thick ligament called the flexor retinaculum.

The diagnosis of CTS can usually be made based on the history of the problem. Sometimes an electrical test is required to confirm the diagnosis, as there are several other causes of pins and needles, numbness and pain in the hands.

Dupuytren's disease is a common hand condition which particularly affects people of northern European background. It is believed this condition was originally brought to the UK during Viking invasions between the eighth and 11th centuries. It is also common in people with diabetes.

The first signs of Dupuytren’s is usually lumps in the palm and fingers. Tight bands can develop later, and the fingers can be pulled into the palm of the hand (Dupuytren’s contracture). This condition is not usually painful.

Dupuytren’s contractures can be treated either with collagenase injections in the outpatient clinic, or with surgery.

Trigger finger (or thumb) happens when your finger gets stuck as you make a fist and extend your finger and is usually painful. This occurs because the tendon in your finger becomes inflamed, and sticks under a ligament at the base of the finger and in the palm.

This painful condition may occur after doing a repetitive or heavy activity with the hand, however there is not always an obvious cause. Trigger finger can progress to a locked finger, where it is no longer possible to straighten or bend your finger at all.

While mild cases of trigger finger can be resolved with rest, if the problem persists for more than a few weeks, treatment should be considered. Most cases are effectively treated with a steroid injection, and this can be done in the outpatient clinic at Chiswick Medical Centre.

The cause of ganglion cysts is not known. Ganglions are the most common type of lump that appears around the hand and wrist. A ganglion is a jelly-filled cyst, and is thought to result from minor ligament injury. They are mostly found around the wrist, on the back of the hand or at the base of the finger.

Ganglions are sometimes painful. They can interfere with the everyday use of your hand, and are viewed as unsightly.

The diagnosis of ganglion can usually be made during an examination, but in some cases an ultrasound scan may be required. Treatment options are to draw the contents of the ganglion out (aspiration), which can be done in the outpatient clinic, or surgery.

Arthritis is common in the small joints of the hand and fingers. Osteoarthritis, a common form of arthritis, is the result of wear and tear of the smooth cartilage of the joints. Arthritis causes painful, swollen joints and restricted movement. Sometimes arthritis can occur months or years after a joint injury or fracture. There are a variety of effective treatments for arthritic joints in the hands, ranging from hand therapy (specialist physiotherapy) to steroid injections and surgery in advanced cases.

The state-of-the-art facilities at Chiswick Medical Centre enable us to promptly investigate and effectively treat the whole spectrum of hand problems and hand injuries. The Centre has X-ray, MRI scan, CT scan and ultrasound scan imaging equipment.

Many hand conditions can be treated without surgery, often in the outpatient clinic. We have access to the hand therapy team (specialist physiotherapists) based at The London Hand and Wrist Unit. If surgical treatment is required, this can be arranged at one of several HCA UK hospitals in London.

At Chiswick Medical Centre we understand the importance of our role in the local community – to offer exceptional healthcare to the whole family, across the full range of medical specialties.

 

If you, or any one of your family members has a hand injury or hand problem, please do not hesitate to book an appointment with us at Chiswick, where we will ensure you receive exceptional care.

For more information please contact Chiswick Medical Centre, part of HCA UK, on 020 8712 1806.