Hand Pain

Our hands are sensitive and intricate structures, consisting of 27 bones, multiple ligaments and muscles. This structure of hands is responsible for better movement and flexibility; thus, they largely control our mobility. Due to their significant role in mobility, they are also quite susceptible to injuries. These repetitive injuries may cause pain in the hands. Moreover, since all of us use our hands for most of our day-to-day activities, any problem with our hands may hamper our daily work.

Pain in hand is a symptom of underlying problems in one’s hand. However, one may also experience the following symptoms in their hands: 

1. Loss of sensation or numbness
2. Swelling 
3. Stiffness
4. Pins-and-needles and tingling sensation
5. Loss of range of motion or dexterity 
6. Tenderness 
7. Weakened grip

One may experience hand pain due to a variety of reasons, and the pain can be of different types. The pain may originate from the nerves, the connective tissues, the bones, the tendons and the joints. The pain can develop due to nerve damage, sprains and fractures, inflammation, repetitive injuries due to movement and several underlying health conditions.

Some reasons why one can have unbearable pain in their hands:

1. Arthritis:
   1. Rheumatoid arthritis
   2. Osteoarthritis
2. Gout
3. Carpal tunnel syndrome
4. Ganglion cysts
5. Dupuytren’s contracture
6. Tendon-related conditions: Include tendonitis and tenosynovitis. Some other common tendon disorders include the following:
   1. DeQuervain's tenosynovitis 
   2. Lateral epicondylitis (commonly known as tennis elbow)
   3. Rotator cuff tendonitis
   4. Medial epicondylitis (commonly known as golfer's or baseball elbow)
   5. Trigger finger/trigger thumb
7. Nerve-related hand conditions: Damaged nerves in the hand cause some common nerve-related hand issues such as: 
   1. Brachial plexus injury
   2. Carpal tunnel syndrome 
   3. Cubital tunnel syndrome
   4. Raynaud's phenomenon

Multiple factors may be responsible for placing an individual at higher risk of conditions causing hand problems and pain: 

1. Taking part in sports and work requiring repetitive movements of the hand and wrist
2. Not following proper guidelines (warm-up before or rest between activities)
3. Inflammatory conditions such as osteoarthritis, rheumatoid arthritis, or scleroderma
4. Poorly fitting equipment
5. History of certain hand problems
6. Diabetes and other nerve-damaging conditions
7. Obesity
8. Weakness in shoulder and wrist muscles
9. Improper technique when playing certain sports
10. Using or working with vibrating equipment
11. Age-related degenerative conditions

To diagnose the underlying problem that may be causing pain in hand:

1. Patient History: A doctor or a physiotherapist will ask about your condition and symptoms and would like to know how long you have been facing them.
2. Clinical Examination: The doctor might examine the wrist and hand and evaluate the range of movement and strength.
3. Investigations: 
   1. Blood tests may be recommended to look for inflammation. 
   2. Other tests such as ultrasound scans, computerised tomography (CT) scans, X-ray examination and magnetic resonance imaging (MRI) scans are used by the doctors to make a clear diagnosis.
   3. Occasionally a nerve conduction study may be needed to understand the underlying condition related to the nerves.

Some solutions to get relief from hand pain, which can be used with expert guidance, are:

1. Lifestyle changes:
   1. Stretches and exercises: Many exercises can be done under the guidance of physiotherapists and occupational therapists that may help in muscle strengthening for better relief from pain.
   2. If work makes the pain worse, try to take the strain off the wrist and hands.
2. Medication (topical, oral, injections):
   1. NSAIDs- Anti-inflammatory drugs without steroids
   2. Injections: A corticosteroid injection into a joint can lessen the inflammation to a great extent.
3. Surgery: In case none of the above treatment measures works, surgery may be performed at the affected area as per requirement, preferably using minimally invasive and endoscopic techniques.

In case of a hand injury or if the hand pain is persistent, the person may lose the efficiency to perform the day-to-day activities. Symptoms that gradually appear over a period of time may be an indicator of a number of other underlying health conditions related to their hand. It may cause the risk of worsening the conditions without timely treatments.

It is advisable to consult a doctor if:

1. The pain isn’t getting better after exercises and other solutions
2. You are feeling unwell and have a high temperature
3. The pain is getting worse or keeps returning
4. There is inflammation and stiffness in the hands, specifically in the mornings and no relief even after half an hour, and the hands are warm and red
5. The pain is preventing you from performing your daily tasks and routine.
6. You have persistent numbness, tingling or weakness in the fingers or hands.

It’s important to get urgent medical attention in case of the following:

1. Broken bone
2. Extreme pain
3. Change in shape or colour in any part of wrist, hand or fingers 
4. Unable to feel any part or all of the hand
5. Injured hand or wrist with a snapping or popping sound
6. Unable to move fingers, hand or wrist.