Carpal Tunnel Syndrome is a condition that occurs when a nerve is compressed at the wrist. Repetitive use of the hands, fractures and arthritis can all cause swelling in the carpal tunnel. When the swelling becomes great enough, pressure is placed on the nerve causing symptoms. The usual symptoms of Carpal Tunnel Syndrome are pain, numbness, and /or tingling that occurs in the arm, hand, or finger. The diagnosis is often confirmed with nerve conduction studies and an electromyogram.

Treatment: consists of reducing strenuous activities on the hand and wearing splints at night to relieve symptoms that interfere with sleep. Anti-inflammatory medication taken orally or injected into the carpal tunnel may reduce swelling within the carpal tunnel (When symptoms are severe or do not improve, surgery may be needed to enlarge the carpal tunnel.) This is usually done on an outpatient basis without a general anesthetic.

Ganglion Cysts are common lumps that can grow in the wrist or hand. These cysts are found on the top or palm side of the wrist, at the base of the fingers, or over the finger joints. Ganglion cysts are not cancerous. The specific cause of ganglions can often not be determined although they commonly appear after an injury or strenuous use of the hand. The cysts can be painful and they may change in size over time.

Treatment: may involve watching the cysts over time, removing fluid from the cyst and/or wearing a splint. If these treatments do not work, the cyst can be surgically removed as an outpatient procedure by numbing the area.

Trigger Fingers involve the pulleys and tendons in the hand that move the fingers. Trigger finger/thumb occurs when the tendon or its lining develops a swelling. This makes it difficult for the tendon to pass under the pulley, which surrounds it at the base of the finger causing a catching or triggering feeling in the finger or thumb. Repetitive use, an injury to the palm, or medical conditions such as diabetes may cause trigger fingers/thumb. Trigger finger/thumb often starts with discomfort at the base of the finger and progresses to catching or locking which seems to be in the middle knuckle of the finger or end knuckle of the thumb.

Treatment:Wearing a splint, taking oral anti-inflammatory medicines, or injecting anti-inflammatory medicines around the tendon may be used to reduce the swelling around the enlarged tendon. Treatment may also consist of changing activities to reduce impact on the hand. If these methods fail, surgery may be recommended to release compression on the swollen tendon. This is usually done on an outpatient basis without a general anesthetic.

Fractures or broken bones are common injuries that occur in the elbow, wrist, hand, and fingers. They are usually the result of a fall or other accident. Thinning of the bones from various medical conditions can predispose one to fractures. The symptoms may include pain, swelling, and a deformity.

Initial treatment: consists of pain control and protection with a splint or cast. Depending on the type and severity of the fracture, splint or cast treatment is continued or surgery is recommended. Therapy to regain motion, strength, and function is started as soon as the fracture is stable enough to allow.

Arthritis is a condition that destroys a joint. In osteoarthritis (also called degenerative arthritis), the cartilage, which normally covers the ends of bones allowing them to move smoothly on one another, wears out. The most common joints to develop osteoarthritis in the hand include the joint at the end of the finger and the joint at the base of the thumb. This often results in difficulty with activities involving gripping such as opening jars, turning doorknobs, and using keys. In rheumatoid arthritis, the body's immune system attacks the lining stiffness and loss of function.

Treatment: for arthritis depends on the diagnosis. For arthritis at the base of the thumb that is discovered early, splints, activity modification, and anti-swelling medicines can relieve symptoms. For more severe cases, joint replacement surgery may be recommended.

In rheumatoid arthritis, the primary treatment involves medicines to control the inflammation produced by the body's immune system. In cases where pain and deformity progress affecting activities, surgery can offer significant improvement in function.

Tendonitis is a condition that may occur with overuse or repetitive use of the upper extremity. Inflammation near where a tendon connects a muscle to a bone or passes through a compartment results in symptoms which include pain, tenderness, and swelling at the affected area. There are many areas where tendonitis occurs including the outer(tennis elbow or lateral epicondylitis) or inner part of the elbow, the thumb (DeQuervain's tendonitis) or other sides of the wrist, and the forearm.

Treatment: includes activity modification, therapy, splinting, and anti-inflammatory medications. Occasionally a surgical procedure is recommended for specific types of tendonitis that do not get better with non-operative treatments. When surgery is in order it can usually be done on a outpatient basis without the use of general anesthesia.

Dupuytren's Disease is an abnormal thickening in the palm and fingers that may limit movement. The cause of Dupuytren's is not known but it more commonly affects Caucasians with ancestors from Northern Europe. It occurs more frequently in men, runs in families, and usually begins after age 40. Dupuytren's Disease begins as a small lump or pit in the palm often near the crease at the base of the small or ring fingers. As time goes on, a cord may develop between the palm and fingers drawing the fingers into the palm and affecting activities.

There is no permanent cure for Dupuytren's. Surgery can relieve the bending of the fingers into the palm to improve function and is often done on an outpatient basis without the need for a general anesthetic. After surgery, the cord may return to the same place.