Wrist and Hand Conditions

What can I do to help?

Types of Pain

Colles Fracture

A colles fracture is a break of the radius, one of the bones in the forearm near the wrist. This is often a result of falling onto an outstretched hand and is the most common type of radial fracture. This is more common in those with osteoporosis due to the decreased bone density and in younger populations is more likely to be due to high impact trauma e.g. contact sports, skiing or horse riding.

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Thumb Osteoarthritis

The thumb joint articulates with the trapezium which is one of the small carpal bones in the hand. This is the most commonly affected joint in the hand with osteoarthritis. More common in women than men with 30% of women aged over 40 years showing arthritic changes on x-ray. May exist as a localised (single joint) or type of inflammatory arthritis e.g rheumatoid arthritis/gout and previous injuries may increase risk.

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De Quervain's Tenosynovitis

De Quervain’s Tenosynovitis is an irritation of the outer layer of the tendon which controls thumb movements. Commonly affects young mothers, thought to be due to hormonal changes and repetitive lifting or can be a result of a direct blow to the area.

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Carpal Tunnel

Carpal tunnel is an irritation of the median nerve as it passes through a tunnel in the wrist. Symptoms tend to occur in the thumb, index and middle fingers but a dull ache may occur more generally into the hand or arm. It is more common in women than men and more common in middle aged and elderly people. Carpal tunnel can be a symptom during pregnancy. Normally these symptoms will resolve in the post-natal period without further treatment.

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Scaphoid Fracture

The scaphoid is one of the small carpal bones located in the first row of carpal bones, on the thumb side of the hand. This can be triggered by trauma e.g. falling onto an outstretched hand or a direct blow. Occasionally stress fractures can occur but these are generally in high level athletes e.g. gymnasts and shot-putters.

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Generally seen in those aged over 65 years. Can be brought on from previous surgery, previous trauma (e.g. fracture), inflammatory condition (e.g. rheumatoid arthritis) or overuse injuries. There is often a poor link between changes visible on an x-ray and symptoms of osteoarthritis; minimal changes can be associated with a lot of pain, or modest structural changes to joints can occur with minimal accompanying symptoms. Osteoarthritis is a condition that results from a loss of cartilage with subsequent remodelling of adjacent bone and subsequent inflammation. It is some of these changes in the joint structure that can then be seen on x-ray. It is a dynamic process that involves all joint tissues: the bones, cartilage, joint capsule, lubricating fluid and surrounding muscles. Sometimes the altered joint structure compensates for the changes and does not cause pain. It’s when the natural repair process cannot compensate enough that the joint starts to become painful.

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