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No matter what your age or occupation your hands are always working. Since your hands are so important any abnormality can be a cause for concern. Many common hand problems that interfere with your daily activities can be diagnosed and treated by your orthopaedic surgeon.

Ganglion Cysts
Ganglion cysts are the most common mass or lump in the hand. They are most common on the back of the wrist. These non-cancerous, fluid-filled cysts arise from the ligaments, joint linings, or tendon sheaths when they are irritated or inflamed. They may disappear or change size quickly.

Many ganglion cysts do not require treatment. However, if the cyst is painful, interferes with function or the patient does not like the appearance, your orthopaedic surgeon can remove the fluid, inject steroids, or remove it surgically.

Carpal Tunnel Syndrome
Common symptoms of carpal tunnel syndrome are numbness and tingling in the hand, especially at night; pain with prolonged gripping such as holding a steering wheel; or clumsiness in handling objects. Sometimes the pain can go all the way up to the shoulder.

These symptoms are caused by pressure on the median nerve as it enters the hand through a tunnel in the wrist. The tendons that bend your fingers and thumb also travel in this tunnel.

Mild cases can be treated with a splint or brace to rest the wrist. Steroid injections into the carpal canal to decrease swelling may be used in more severe cases. Those cases that do not respond to nonsurgical treatment and those that are diagnosed late may require surgery. This is generally done in an outpatient setting under local anesthesia.

Tendonitis of the Wrist
DeQuervain's stenosing tenosynovitis is most common in adult women between the ages of 30 and 50. It is an irritation and swelling of the sheath or tunnel which surrounds the thumb tendons as they pass from the wrist to the thumb. Pain when grasping or pinching and tenderness over the tunnel are the most common symptoms. Sometimes a lump or thickening can be felt in this area. If the hand is made into a fist with the thumb "tucked in" and bent towards the little finger, the pain gets worse (Finkelstein test).

Tendonitis may be caused by overuse and also can be seen in association with pregnancy or inflammatory arthritis such as rheumatoid disease.

If treated early, many cases improve with rest in a splint, injection with steroids and/or taking anti-inflammatory medications. More severe cases or those that do not respond to other treatment may require surgery. Modification of the activities which caused the symptoms initially also may be required.

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