Common Conditions of the Hand, Wrist, Arm and Elbow

As specialized clinicians we offer quality, and expert care for hand and arm conditions. The following list of diagnoses are just a few conditions that we treat on a daily basis. Contact St. Dominic’s Hand Management Center for an evaluation and to begin a healing treatment program today!

Basal Joint Arthritis

Basal Joint Arthritis, which affects the joint at the base of the thumb, occurs as a result of age and related wear and tear on the joint. The most common symptom is pain in the lower part of the thumb that occurs especially with pinching or gripping of objects. The joint may swell, and the thumb may become stiff or deformed.

St. Dominic's Hand Management Center offers both soft supportive splints and custom orthotics that will better align the joint and decrease the pain experienced with pinch activities. We can also show you exercises to help stabilize the thumb and make the joints more flexible. Education on how to reduce stresses placed on the hand with daily activities and modalities such as paraffin bath and ultrasound may also provide relief of symptoms.

Carpal Tunnel Syndrome

The carpal tunnel is a narrow space in the wrist that is formed by carpal wrist bones on one side of the tunnel, and a tight ligament across the palm side. Through this tunnel travel all the tendons that move your fingers and the median nerve. With age, repetitive use, arthritis, swelling, etc. this space can become very tight and produce compression with decreased blood flow to the median nerve. Symptoms include tingling and numbness mainly on the thumb side of the hand, and pain in the same areas that occasionally extends up the arm. Classic carpal tunnel symptoms occur at night and disturb sleep but can also affect your daily routine. Permanent hand weakness and numbness may occur if carpal tunnel syndrome progresses.

St. Dominic's hand therapists offer treatment that can help alleviate these symptoms and potentially prevent surgery. They can apply iontophoresis, pulsed ultrasound, orthotics, show you hand and arm exercises and provide you with expert advice about how to prevent further carpal tunnel symptoms by changing your work habits.

De Quervain's Tenosynovitis

De Quervain's Tenosynovitis is an irritation of the tendons on the thumb side of the wrist. The condition is often caused by making the same motions repeatedly, which causes the tendons to become thickened and not glide smoothly through the supportive tissue tunnel. The constant rubbing action produces pain and swelling on this side of the wrist especially with pinching or grasping activities.

St. Dominic's Hand Management hand therapists can help you with orthotics, exercises, and modalities (paraffin, ultrasound, iontophoresis) that can help you to regain pain free movement in your thumb.

Dupuytren's Contracture

Dupuytren's disease is usually an inherited problem produced by a thickening of the fibrous tissue layer underneath the skin of the palm and fingers. While it is often painless, it can make it difficult to straighten the fingers. Symptoms generally start as a hard lump forming on your palm and if it progresses the fingers can start bending in towards the palm, leading to the inability to place your palm flat on a surface and difficulty in reaching into tight spaces.

The only way to treat Dupuytren's is surgery or collagenase injections performed by a hand surgeon. To find a hand surgeon in the area, visit the websites for the American Society for Surgery of the Hand or visit the American Association for Surgery of the Hand.

At St. Dominic's Hand Management Center, therapists can help you after your surgery or injection with orthotics, exercises and scar remodeling techniques to speed your recuperation.

Flexor Tendon Lacerations/Cuts

A flexor tendon injury is most often caused by a deep cut on the palm side of the hand, wrist or finger. Or, it can also occur when a finger is jerked extremely hard.

If a flexor tendon is cut all the way through, the finger can no longer bend on its own, and if nerves are also injured, the finger may be numb.

If the tendon is cut completely, you will need surgery to rejoin the two ends. You will then need to follow a specific exercise program recommended by a hand therapist to regain movement in your finger.

Fractures/Broken Bones

Broken fingers and wrist bones are a frequent occurrence and often produce stiffness that can lead to permanent loss of function without appropriate care. After evaluation by your physician, you may need a protective orthosis, and may begin supervised exercises to promote soft tissue mobility while protecting skeletal stability.

Ganglion Cysts

A ganglion cyst is a firm, fluid-filled lump which can appear on the front of back of the wrist or base of the finger. The cysts can range in size but do not spread or become cancerous. They can occur after an injury, but often their cause is unknown.

They occur when the tissue, which produces a thick fluid to keep the joints and tendons moving, balloons out from the joint or tendon to form a cyst. The cyst then fills with the fluid and appears as a visible lump.

A ganglion cyst can be painful when it first occurs, and constantly using your hand or wrist can enlarge the cyst and make it hurt worse.

St. Dominic's hand therapists can provide you with orthotics to ease the discomfort. If the pain continues the cyst can be drained or removed by a hand surgeon. Stiffness of the involved joint and scar discomfort may occur post operatively. Our hand therapists can provide heat modalities, desensitization activities and exercises to assist in reducing pain and regaining full motion.

Reflex Sympathetic Dystrophy

Reflex Sympathetic Dystrophy (RSD), also known as complex regional pain syndrome type I (CRPS I), is a painful nerve syndrome that occurs in the hand or foot after an injury. If left untreated, the pain or weakness caused by RSD can limit use of the injured area.

Symptoms include new, severe pain in the original injured area. That pain may spread through the injured limb and then other symptoms may appear, such as stiffening, loss of strength, elevated skin temperature and a swollen, reddish look.

The first way to treat RSD is through a supervised physical or occupational therapy program. St. Dominic's Hand Management Center therapists have a thorough knowledge of this syndrome and can help you improve movement, reduce pain, and regain function as pain diminishes.

Tennis Elbow

Tennis elbow, also known as lateral epicondylitis, is a degenerative condition around the bony knob on the outer side of the elbow. It occurs when the tissue that attaches the muscles to the bone becomes irritated from repetitive use or a sudden increase in activity.

Tennis elbow can be caused by doing anything that involves extending your wrist or rotating your forearm. As you age, this tissue may become irritated more easily.

Symptoms of tennis elbow include pain on the outer side of the elbow and down the forearm. The pain may be frequent or it may occur only when you lift things. The elbow may also swell, get red or feel warm to the touch.

St. Dominic's hand therapists treat tennis elbow through exercise, joint mobilization, modalities, orthotics and ergonomic interventions that can get you back into whatever game or activities you enjoy!

Trigger Finger

Trigger Finger, also known as tenosynovitis, is an inflammation of tissue inside your finger or thumb. The first sign of trigger finger may be pain where the finger or thumb joins the palm. There may be swelling, and you may notice that the finger may start to catch when you try to straighten it. When the locked tendon releases, the finger will jump as if you were releasing the trigger of a gun. This is often quite painful.

The cause of trigger finger is often unknown but sometimes occurs after repeated use of hand held tools.

St. Dominic's certified hand therapists can provide nonsurgical treatment for this condition including orthotics to eliminate triggering and modalities (ultrasound and/or iontophoresis). Sometimes, surgery or injections are indicated, and therapy may be indicated post-intervention to assure maximum recovery.