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Proper functioning of the hands and wrists (parts of the body that are also called the "upper extremities") – is necessary for daily activities. Writing, grabbing, driving, or lifting are severely limited if the muscles, nerves, joints, and bones in these areas are not working properly.
The design of the hands and wrists and their daily use put them at risk for injury. In fact, according to the American Academy of Orthopaedic Surgeons, one-third of all acute injuries treated in emergency rooms involve the upper extremities.
Many injuries to these areas can be treated without surgery, and at BMC, physicians explore such options before considering surgery. However, there are times when surgery can be the better option. BMC surgeons are fellowship-trained in hand and wrist surgery and have extensive expertise in caring for the hands and wrists.
4th Floor, Suite 4B
Shapiro Center 617.638.5633
Recovering from an injury or learning to live with a physical disability or limitation can be challenging. Physical therapy (PT) and occupational therapy (OT) can help patients regain strength or mobility, relearn skills, or find new ways of performing everyday tasks.
Conditions We Treat
Carpel tunnel syndrome is the compression of the median nerve which runs from the arm to the hand through the carpal tunnel. The median nerve controls the muscles around the base of the thumb. The tendons that bend the fingers and thumb, called flexor tendons, also travel through the carpal tunnel. When the median nerve is pinched or compressed, numbness, tingling, and pain can occur in the arm and hand. There are a wide range of causes of carpal tunnel syndrome, including: anatomical issues (small wrists), heredity, certain inflammatory conditions, pregnancy and its related hormonal imbalances, diabetes, rheumatoid arthritis, thyroid gland imbalance, age, and repetitive movement such as operating a jackhammer.
Cubital tunnel syndrome (also known as ulnar neuropathy) is a nerve compression syndrome which affects the ulnar nerve that runs along the inside of the elbow. The ulnar nerve passes close to the skin's surface in the area of the elbow commonly called the "funny bone." Its symptoms - numbness, weakness, tingling, and pain - are similar to carpal tunnel syndrome. Cubital tunnel syndrome occurs when the elbow is held in a bent position for an extended period, such as during sleep or while holding a phone.
Tendinosis (or tendonitis) means inflammation of a tendon; De Quervain's tendinosis is the irritation or inflammation of the tendons that run along the base of the thumb. Symptoms include pain and tenderness in the thumb and side of the wrist that can travel up the arm, particularly when gripping or twisting the wrist. Overuse can cause De Quervain's tendinosis, as can pregnancy and its related hormonal changes, and rheumatoid arthritis. This condition is most common in middle-aged women.
Flexor tendons help control movement in the hand. An injury to the forearm, fingers, thumb, wrist, or hand can damage the flexor tendons and affect movement. Symptoms include pain and the inability to move the hand, fingers, or thumbs. Injuries are usually caused by a deep cut, or an athletic injury, but rheumatoid arthritis can also weaken the flexor tendons, causing them to tear.
A ganglion cyst is a common, non-cancerous and fluid-filled cyst (growth). They are most often found on the top of the wrist but can also be found under the wrist, or at the base or end joint of a finger. They can grow larger with increased wrist activity and get smaller with rest. The cyst usually forms a noticeable lump and can come and go with no other symptoms, though sometimes it does press on nerves, causing pain. There is not a known cause, though women are more affected than men and they are more common in younger people age 15-40, as well as gymnasts, who frequently apply stress to their wrists.
Mallet finger, also known as baseball finger, happens when the tendon on top of the hand that straightens the finger (extensor tendon) sustains an injury, stopping the finger from straightening all the way and causing the tip to droop.
Nerves carry messages between the brain and the parts of the body. Sensory nerves carry messages regarding feelings – pressure, pain, and temperature, while motor nerves help the body move. Nerves in the hands, fingers, and wrists are fragile and can be damaged through pressure, stretching, cutting, or any injury to the body.
Osteoarthritis, or "wear and tear" arthritis, is a common degenerative disease that can affect any joint in the body. The hand has many joints that can become inflamed when the smooth cartilage (cushioning) at the end of bones begins to wear away. Symptoms include pain, swelling, and being unable to move the joint.
Arthritis in the thumb affects the joint at the base of the thumb, which becomes inflamed when the smooth cartilage (cushioning) at the end of the bones begins to wear away, causing friction. Symptoms include pain, swelling and immobility.
Osteoarthritis, or "wear and tear" arthritis, is a common degenerative disease that can affect any joint in the body.
With trigger finger, the flexor tendon that controls finger and thumb movement gets stuck. This restricts movement of the finger or thumb, causing a tender lump in the palm, swelling, a popping or pain as the finger straightens, stiffness, or the finger/thumb to be stuck in a bent position. Certain repetitive hand uses and some illnesses like diabetes or rheumatoid arthritis can cause trigger finger, and it is most often seen in women.
Assistant Professor, Boston University School of Medicine
Hand surgery, Rheumatoid arthritis