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Hand & Arm Pain

Hand & Arm Pain

Hand & Arm pain refers to pain that is felt at the wrist or fingers. Further diagnosis generally identifies if the pain is external or internal, leading to treatment. In most situations, any form of hand injury can impede one’s ability to carry out simple tasks. Given the significant use of our hands, hand injuries account for up to one-third of all injuries at work.

What Causes Hand & Arm Pain?

Hand pain can be caused by different reasons. Many local causes of hand conditions are due to inflammation, wear and tear while others may be caused by systemic causes such as referred pain from immunological (e.g., Gout or Rheumatological) or nerve impingement from the neck (i.e. cervical radiculopathy).

Types of Hand & Arm Pain Conditions

Fibromyalgia (Finger)

Fibromyalgia is a hypersensitive neurological syndrome. The central nervous system becomes extremely sensitised and muscles will become spastic and stiff while the surrounding joints in the fingers appear to feel pain. It ‘appears to feel pain’ because there is no inflammation or destruction in the joints. The fingers may feel stiffness in the morning and improves after the body has warmed up.

Rheumatoid Arthritis (Finger)

Rheumatoid Arthritis is an immunological condition affecting all joints of the body. The immune system has become overly sensitised and starts to attack and destroy the joints of the body especially fingers, wrists, elbows, knees and toes. This is not due to wear and tear of degeneration but an innate destruction of the joints resulting in inflammatory arthritis. Morning stiffness and pain is a feature of RA, together with signs of redness, warmth and swelling.

Trigger Finger

Trigger Finger is the locking of the finger joints during flexion or extension of the finger. The condition usually begins with an accompanying ache that is felt in the palm from moving the affected finger. It is estimated that 2 out of 100 people suffer from Trigger Finger, which is more common in women with diabetic conditions aged 40 and above.

Wrist Tenosynovitis

Often described as pain and swelling of the wrist joint, the condition is commonly referred to as “De Quervain’s Tenosynovitis”. The inflamed area is on the wrist area close to the thumb. This is commonly seen in repetitive strain injury when subjecting the wrist tendons to a repetitive motion. Mothers looking after their newborn babies also are susceptible to this repetitive strain injury.

Golfer/Tennis Elbow

As the name suggests, Golfer’s elbow can be a result of the overuse of the elbow in activities such as golf, weightlifting or sports. Alternatively, it can also be caused by ordinary circumstances such as cooking or working on a computer. It is a condition that causes pain anywhere from the forearm to the elbow. Though the condition affects only 1% of the population, it is a condition that is equally likely to affect the older age group. Commonly Tennis Elbow occurs in housewives who succumbed to repetitive strain injuries of household chores such as wringing of clothes, wet towels and washing of windows and walls.

Symptoms Of Hand & Arm Pain

Pain
The location of the pain varies depending on the condition. You may feel finger pain and immobility or wrist pain that occurs at night while resting or worse upon waking in the morning. Each of these locations of pain signifies a local injury to the bones, joints and soft tissue.
Stiffness
Some conditions such as Trigger Finger can result in an inability to straighten or flex the joint. You may also feel that the finger, wrist or elbow’s range of motion is limited.
Tenderness & Swelling
Common indicators of infection or inflammation include swelling, significant bruising around the joint, redness, warmth, and tenderness.

A Message About Hand & Arm Pain

Early diagnosis and treatment are important to the overall recovery of the underlying condition. If there is any delay in treatment, there may be complications such as contractures or nodules formation secondary to persistent inflammation of the tendons and soft tissues. Once they are formed, the chance of recurrence of the underlying condition is higher despite successful treatment of the painful condition. Rehabilitation post-treatment is important and changes in lifestyle will reduce the chance of recurrence.

Diagnosing Hand & Arm Pain

Determining the source of the pain is essential to recommend the right method of treatment and rehabilitation. Here at Singapore Paincare, our team of experienced primary care physicians and paincare specialists will conduct a thorough diagnosis. This includes a physical exam, questions about your symptoms, and an evaluation of your medical history. Other reports may be needed such as an X-ray or an MRI scan to evaluate or confirm the degree of your hand pain.

What Treatments Are Available for Hand & Arm Pain?

In many instances, non-surgical treatments methods can provide excellent outcomes.  At Singapore Paincare, we strive to treat your pain with the least invasive option possible after accurately identifying the cause. Our approach to pain resolution focuses on the removal of pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments and cognitive and physical rehabilitative therapies, we help patients improve functions and prevent pain from recurring. 

Non-Surgical Treatments for Hand & Arm Pain

Splinting

Injuries such as trigger finger may require splinting to reduce inflammation and allow for recovery. These splints can be used for a period of six to ten weeks. Wrist splints may be used to support patients with De Quervain’s Tenosynovitis.

Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs are effective in eliminating the pain caused by arthritis, and can also reduce bruises, fractures, and sprains, but are less effective in tendonitis and carpal tunnel syndrome.

Specialised Injection

Cortisone is a steroid that is used by our doctors to treat inflammation. It is a form of anti-inflammatory which can be used to relieve pain quickly. This simple intervention provides immediate relief without significant risks.

It is advisable to inject only three times a year to prevent tendons and bones from becoming weak. In general, if one should need repeated injections (more than 2 times), further evaluations with MRI investigations may be warranted by our specialists before more injections are administered to the painful area.

Minimally Invasive Treatment
Arthroscopy is an alternative minimally invasive procedure offered by our clinics to access and align the joints in the case of wrist fractures. It is also used to treat varying conditions of ganglion or arthritis. The process uses a camera to view the affected region, allowing our doctors to make precise removal of ligaments or fluid as necessary.

Surgical Treatments for Hand & Arm Pain

Sometimes, though rarely, surgery is necessary. Surgery may help if a nerve is pinched and is causing weakness or severe pain which won’t go away. As surgery always comes with associated risks, complications and downtime – it may not be suitable for everyone. You should carefully weigh the decision before deciding to go under the knife by considering the pros and cons of both non-surgical methods and surgical reconstruction.

Carpal Tunnel Release Surgery
Is specifically used to treat carpal tunnel syndrome. It is done as open surgery with local anaesthesia; patients are likely able to return the same day after a period of supervision.
Trigger Finger Release
Usually used if all the other forms of treatments do not show signs of improvement.

How Can I Prevent Hand & Arm Pain?

Wrist pain due to injuries is almost impossible to prevent, but you can minimize the risk by taking the following steps daily:

  • A healthy balanced diet that is rich in calcium and vitamin D
  • Do some stretching to increase blood flow to the area and improve recovery or the range of motion
  • Pay attention to the repetitive movements that may cause the injury and avoid doing it

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