Common Hand Problems
The most common conditions treated at Peninsula Hand Therapy:
Carpal Tunnel Syndrome
CTS is the most common condition affecting the hand in the western world. It affects 10% of the working and non working population. CTS is caused by compression of the median nerve at the wrist. Compression of a nerve causes decreased blood flow, which reduces nutrient and oxygen supply to the nerve causing disturbances in nerve conduction.
Osteoarthritis (OA) is the most common of all joint diseases. It is the gradual wearing away of cartilage that eventually causes joint deterioration. There is an increased incidence of OA in women and OA affects women more severely. Typically this affects women from the 4th decade and maybe associated with other small joint arthritis around the time of menopause.
This common injury is often caused by a force hitting the tip of the finger causing it to hyper-flex. This injury is frequently sustained during ball sports in particular football, basketball or netball The force to the finger tip causes rupture of the tendon that straightens the tip of the finger. It may also include a small fracture.
Dupuytrens disease is an inherited disorder affecting the connective tissue of the palm of the hand. Dupuytrens presents in two ways. Firstly as either
nodules in the palm, which may be painful with gripping and or thick “cord” like bands that contract the fingers toward the palm.
Trigger finger is a common hand condition. Triggering of the finger or thumb develops when the tendon that bends the finger is unable to glide freely because of a nodule or swelling. This causes the tendon to catch on the pulley at the base of the finger in the palm. The finger may “lock” or “trigger” suddenly following attempt to make a fist and then extend with a “snap”.
De Quervains Tenosynovitis
De Quervain’s Tendonitis causes pain and swelling in the thumb and wrist. It is a common hand condition caused by swelling of the two tendons that lift the thumb up and away from the hand. De Quervain’s can be caused by a number of factors, most predominantly from overuse or frequent manual handling. New mothers are at the greatest risk.
Finger fractures commonly occur as a result of a sporting injury, especially ball sports. Finger fractures can be simple to treat, or very complex requiring surgical correction and long term rehabilitation. There are a number of potential complications following a hand or finger fracture including; pain, stiffness, prolonged swelling, rotation of the finger.
Hand Injuries in the Musician
Musicians demand extraordinary function of their hands. Rehabilitation following trauma, overuse, or degenerative injuries need to be specific to instrument demands. PHT can provide specific treatment and rehabilitation programs that include: early return to modified playing, instrument specific exercises, sensory re-education.
A ganglion or ganglion cyst in the hand or wrist may present as a lump that can be easily seen and felt or may be detected only on diagnostic image such as ultrasound. Ganglions commonly appear next to a joint or insertion of a tendon.
The ganglion is a fluid filled sack that protrudes within an area of the hand that normally has fluid surrounding it.
Distal Radius and Scaphoid Fractures
These injuries routinely require immobilisation of the wrist. PHT offers an alternative to Plaster of Paris with the fabrication of a custom made circumferential thermoplastic wrist splint. The brace allows full finger, thumb movement, for distal radius fractures. The brace can also be fabricated to immobilise the thumb for scaphoid fractures.
Finger tip amputations are a common injury for adults and children often resulting from a crush injury. This can cause problems with hypersensitivity, stiffness of the finger and sometimes poor cosmetic appearance of the finger. Peninsula hand therapy can assist with designing a desensitisation program to assist with this problem as well as bandaging techniques to reduce swelling and assist with tip shape to improve the cosmetic appearance of the finger. In some instances a camouflage prosthesis can be used.