The hands are vital parts of the human body and without them, very little essential and social activities can be performed such as feeding, being productive to be able to make a living and support dependents, and interactions with others. Losing the ability to use one’s hand can be a very emotional and debilitating problem that can lead to increased stress and anxiety that may result in the development of mental health issues such as depression. Therefore, the proper diagnosis and management of conditions affecting hands is extremely important.
The following are conditions that can result in the hands becoming unable to function properly and how they are managed.
- Progressive thickening of the tissue in the palm of the hand results in shortening of this tissue and causes flexing contractures of the fingers (makes the fingers close).
- The most commonly affected fingers are the fourth and fifth digits and this can be quite a disabling condition.
- Management includes physical and occupational therapy and surgical intervention in severe cases.
- Referred to in medicine as stenosing tenosynovitis.
- Trigger finger causes a similar issue to Dupuytren’s contracture. The difference though is that where the latter involves pathology of the tissue covering the palm of the hand, trigger finger is caused by thickening of the tissue that covers the tendons which allow the fingers to close.
- The condition is characterized by the affected finger seeming like it is stuck in a trigger-pulling position. Since it is difficult for the finger to be straightened, when it becomes unlocked it resembles the pulling of a trigger.
- Management includes trigger finger surgery and when the thumb is involved is referred to as trigger thumb surgery.
- These surgeries may be performed through minimally invasive access or open procedures if the cases are severe.
Carpal tunnel syndrome
- This condition is associated with compression of the median nerve through the carpal bones in the wrist.
- Compression of the median nerve results in the decreased sensation of the thumb and first two fingers which can complicate and lead to decreased power in the hand with an inability to use the limb.
- Management of this condition involves initial conservative therapy with pain relieving measure and the use of splints to help take pressure off the median nerve.
- If these therapies are ineffective, or the case is severe, then carpal release surgery is performed.
- An autoimmune condition where antibodies are produced by the immune system that attacks and damages the synovial tissue around joints, especially of the wrists and fingers.
- This process results in damage to the joints leading to deformities of the fingers making them stiff and difficult to use.
- Management of this condition includes using medications such as steroids and non-steroidal anti-inflammatories such as ibuprofen or naproxen. Early therapy may also include medications such as disease-modifying anti-rheumatic drugs (DMARDs) like azathioprine, sulfasalazine, and methotrexate to help reduce disease progression as well as induce more remissions.
- Surgical interventions may be warranted in cases where the medications are not working and the patient’s use of their hands has becomes severely debilitating.