Symptoms

Hand pain: hand pain

Hand pain: hand pain


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Hand pain is one of the more common symptoms, because the delicate structure of the hand makes it very susceptible to injuries, overuse and joint wear (arthrosis). In addition, various diseases such as inflammatory rheumatism can be responsible for the symptoms in the hand. The pain can appear in various facets, from mild, severe, acute or persistent, to boring, tapping, pulling or burning, to locally limited or radiating.

If the complaints are based on an overload, in many cases a hand immobilization provides relief. In other cases (certain breaks, bottleneck syndrome, etc.), surgery may be necessary. Naturopathy offers numerous options for pain in the hand such as warm hand baths, medicinal plants such as the devil's claw or the so-called "Transcutaneous Electrical Nerve Stimulation" (TENS).

Definition

Various diseases, signs of wear and tear and injuries in the hand area are subsumed under the term "hand pain". There are a number of possible causes for this, but accidents or injuries (e.g. falling to the hand), joint wear and tear, or incorrect or permanent overloading are often the reasons.

Building the hand

The hand (med./lat. "Manus") represents the gripping organ of the free upper extremities or arms

and is a complex structure, which, from an anatomical point of view, can be roughly divided into three sections: the wrist (carpus), the metacarpus (metacarpus) and the fingers (digiti manus).

The hand consists of 27 individual bones (8 carpal bones, 14 finger bones and 5 metacarpal bones), which are flexibly connected to capsules and ligaments by joints. They make up a quarter of the total bones of the human body.

In addition to this, the gripping organ has a very complex musculature, blood vessels, nerves and a large number of tendons, which enable the force transmission from the muscle bellies to the hand skeleton.

Functions of the hands

The most important function of the hand is to grasp objects. A distinction is made between the "power grip", for example, by which a heavy bag is lifted or a heavy package is held, and the "precision handle", which is used to hold and guide objects (e.g. pen or knife) through the fingertips of the thumb and index finger or Thumb and middle finger is applied.

The hand can be clenched into a fist or to draw water or similar. be used by bending the palm (s) into a kind of bowl. Another important function is (support), which is possible with the entire palm, the ball of the hand or the fist as well as only with the front limbs with the thumb spread apart.

In most cases, a particular hand is preferred for performing fine motor or complicated tasks ("dominant hand"), accordingly a distinction is made between right-handed and left-handed. In addition to these central functions, the hands serve as a “tool” for communication, for example by pointing to the things or persons meant or by supporting or replacing statements, moods etc. with gestures.

How complex the hands can be used in the field of communication is shown by the sign language for the deaf, which, in addition to posture and facial expressions, primarily uses different hand shapes, hand positions and hand movements (gestures) to communicate thoughts and facts.

Hand pain: causes and symptoms

The delicacy of the hand only makes the diverse, complex and precise movements possible - which on the other hand means great vulnerability. Because the relatively thin bones (as well as the tendons, nerves and blood vessels) are not only surrounded by muscle and fat tissue that offer little protection, but are also located directly under the skin.

In addition, the hands are usually heavily used in everyday life and are constantly exposed to potential sources of danger (sharp, pointed objects, machines, cleaning agents, etc.). Accordingly, injuries and complaints due to wear and tear or constant overuse are very common. Various diseases (e.g. rheumatism), nerve irritation or nerve damage can also be considered.

The pain in the hand can occur in very different intensities and limited to the hand, in other cases, however, it radiates to the shoulder, for example.

Injuries

The hands are very vulnerable due to their complex structure and heavy use. As a result, various forms of injuries can lead to massive pain in or on the hand. For example, bruises, strains, dislocations or a fracture.

Often, a sprain of the hand occurs, which is an injury to a ligament or a joint capsule, caused by a strong overstretching or twisting of a joint. Typical for a sprain are severe, stinging or throbbing pain, which occurs especially when the joint is moved. In addition, there is usually swelling in the sprained joint and bruising (hematoma).

However, a hematoma can cause pain in the hand even without compression. This can in turn arise from various possibilities of external force, such as a shock, blow or after an operation. Hematomas can cause massive pain and swell considerably due to the pressure on the tissue. Typical is a clear red-bluish discoloration of the affected area, which is why the bruise is often referred to as a bruise.

Other reasons for hand pain are bruises, burns, scalds or cuts and lacerations (tear-bruise wound). These injuries often occur because the hands are constantly in contact with potential sources of danger such as knives, scissors, glass, hot water or machines.

Inflammation

A common cause is inflammation, which in principle can occur in all areas of the hands. The best known forms include arthritis, an inflammatory joint disease that can be caused by infections, metabolic diseases (gout) or autoimmune diseases such as ankylosing spondylitis.

Other possible triggers are psoriasis arthritis, inflammatory bowel diseases (Crohn's disease, ulcerative colitis) and rheumatoid arthritis or rheumatoid arthritis (colloquially mostly short: rheumatism).

Characteristic of arthritis are sometimes massive pain in the affected joints and limited mobility. In addition, there are swellings, redness and overheating as well as sometimes fluid (joint effusion) or pus in the joint (joint empyema).

Depending on the cause of the inflammation, there are other symptoms: In the case of rheumatism, for example, the pain mainly occurs at night and in the morning. Other typical symptoms here include morning stiffness of the joints and swelling in the base of the finger and middle finger. If acute infectious arthritis is not treated correctly and in good time, there is a risk that the joint will be destroyed or stiffened. This in turn can lead to permanent malpositions and disabilities.

In the case of chronic inflammation such as rheumatoid arthritis, the course can usually not be predicted. Nevertheless, rheumatism progresses fastest in the first years, which usually leads to the first joint damage with functional impairment after a few years.

Tendonitis (tendovaginitis) often leads to hand pain. In this case, the tissue enveloping the tendon is inflamed, whereby in general every tendon sheath (hand, foot, elbow, etc.) can be affected. In most cases, however, it is an inflamed tendon on the wrist, which causes swelling and pulling or stinging wrist pain. These can radiate into the entire hand, the forearm or even the chest area. In addition, there is often an audible crunch in the affected joint. In the case of chronic inflammation, nodular thickening of the flexor tendons of the fingers is possible.

Tendovaginitis is caused by overuse of certain tendons, which can occur quickly due to constant monotonous movements and / or persistent incorrect posture. Examples include a wrong computer mouse or incorrectly set keyboard, permanent, uniform movements ("mouse arm" or medical: "repetitive strain injection"), heavy loads from sports such as tennis or climbing or from playing musical instruments such as violin or piano. An infection (e.g. from chlamydia or mycoplasma) can also trigger tendonitis.

Arthrosis

Degenerative processes can be the cause of the hand complaints. If it is difficult to move your fingers or wrist and you experience pain, in many cases there is arthrosis behind it. This is a "joint wear" that exceeds the usual age and which can occur only on one hand or both at the same time.

Osteoarthritis of the hand and finger joints is caused by damage to the articular cartilage, whereby a medical distinction is made between primary and secondary osteoarthritis. The first form, which is the well-known osteoarthritis that develops in old age, develops without a recognizable cause. Instead, the wear is primarily genetic, and changes in the hormone balance (e.g. menopause) are also suspected as triggers.

Secondary arthrosis, on the other hand, is a form of wear and tear caused by external influences. This includes, among other things, misalignments (e.g. congenital, caused by an accident or injury) of the joints, long-standing obesity or mechanical overload (e.g. due to hip dysplasia).

Bony deformities can also be caused by diseases such as osteoporosis and metabolic disorders such as gout or diabetes.

Osteoarthritis can also result from inflammation of the joints (arthritis). Osteoarthritis of the finger joints usually develops over time, so that there are often no symptoms at the beginning and the disease therefore often remains undetected at first ("silent arthrosis"). In the further course, stiff joints and joint pain typically appear, which usually become stronger in damp and cold weather and when the fingers or hand are stressed.

Later, the pain occurs even at rest, accompanied by a loss of mobility, as well as swollen, red and overheated joints. In addition, there are often small joint cysts filled with thickened synovial fluid on the extensor finger joint (“mucoid cysts”). Even with osteoarthritis of the wrist, which in most cases results from broken bones or the formation of the wrong wrist, swelling, wrist pain and restricted mobility of the affected joint occur in the advanced stage.

Nerve compression syndromes

In many cases, so-called “nerve compression syndromes” are the cause of hand pain. It is a group of diseases in which there is acute or chronic compression and irritation of nerves.

Frequent in this context is carpal tunnel syndrome (KTS), in which the median nerve (median nerve) is damaged by increased pressure within the carpal channel. The increased pressure arises when there is a mismatch between the size of the channel and the space that the structures contained therein require. This can be due to the system, but also e.g. arthrosis of the wrist, rupture of the spoke or carpal bone as well as swelling of the tendon sheaths (rheumatism, during pregnancy etc.).

At the beginning, carpal tunnel syndrome mostly manifests itself through sensory disturbances (tingling) and slight, sometimes burning pain in the fingers, which can radiate up to the arm. In the further course, the complaints occur especially at night. The hands repeatedly fall asleep, which can only be alleviated by rubbing and shaking the hands.

The pain sometimes extends to the arm or shoulder, in addition, the finger muscle strength and grip strength - especially the thumb - decrease more and more, which limits the function of the hands more and more. This can be clearly seen, for example, in the "bottle test": Since people in the advanced stage can no longer spread their thumbs far enough, it is usually impossible to completely grip a bottle.

Other nerve compression syndromes are also considered for the hand complaints. With “Wartenberg syndrome” (also called “Cheiralgia paraesthetica”), for example, the digitalis dorsalis nerve is damaged, causing thumb pain and back pain. This damage can arise, for example, from watch straps, bracelets, bandages or handcuffs that are too tight. Diabetes is thought to be another possible cause.

Another trigger can be the "Loge-de-Guyon syndrome" (also called "ulnar tunnel syndrome"). There is damage to the ulnar nerve on the little finger side of the wrist, which leads to sensory disturbances and paralysis of the hand and finger muscles. Ulnar tunnel syndrome usually arises from a leg (ganglion) in the area of ​​the Guyon Lodge.

Frequent or repeated pressure damage to the ulnar nerve due to occupational activities (for example, with grinders) or sport is the cause. This particularly affects sports in which a handlebar or similar. is gripped for a longer period of time (cycling, surfing, etc.), which is why the syndrome is sometimes also referred to as "cyclist paralysis".

The reason can be polyneuropathy. Here, the peripheral nervous system (PNS) is disturbed in its function, causing pain or discomfort (e.g. burning, "tingling ants") in the hands, arms, feet or legs. In many cases, there is a reduced sensation of temperature and pain, which quickly leads to injuries or burns on the affected skin areas without the person affected noticing. While a few forms of this nerve disease are congenital, polyneuropathy usually develops as a result of diabetes mellitus, infectious diseases or excessive alcohol consumption.

Treatment for hand pain

Therapy for hand complaints is based on the respective cause. For example, if a short-term overload or irritation could be identified as the reason for acute pain, in many cases this will disappear on its own by immobilizing the hand. If necessary, bandages with NSAID ointment (e.g. voltaren ointment) can be used to reduce pain and swelling, or a supportive bandage for immobilization.

Rapid help is particularly important for injuries such as bruises, strains and sprains. Here, the so-called PECH rule has proven itself by following the actions "P" for break, "E" for ice, "C" for compression "(bandage with an analgesic ointment) and" H "for high camps. Accordingly, the hand should be spared immediately after the injury and cooled quickly so that swelling and bruising cannot spread at all. For this purpose, ice packs or cooling pillows (packed in a kitchen towel) should be placed on the affected hand until the pain and swelling are significantly alleviated - which may take a few hours.

Anti-inflammatory painkillers (e.g. acetylsalicylic acid, diclofenac) in the form of ointments or tablets, plaster casts, cortisone preparations or local anesthetics are also used to treat the symptoms.

In some cases, surgery is required. This is for example with certain types of fractures (broken fingers, broken hands) or painful bottleneck syndromes such as the carpal tunnel syndrome, in which the depressed nerves, muscles and blood vessels have to be relieved by surgery.

Depending on the cause, a number of other supportive measures are used, such as heat or cold treatments or electrotherapy.

Naturopathy for pain in the hand

In addition to conventional medical methods, there are a number of alternative medical natural remedies and home remedies that can be used to treat hand pain sensibly and effectively in a gentle manner.

Various medicinal plants have a pain-relieving and anti-inflammatory effect, which means that they can even be used on their own for mild complaints. In the case of severe pain, they often offer good support for the existing therapy. The devil's claw, which is often used in naturopathic therapy for osteoarthritis or degenerative diseases, has proven its worth.

The healing power of the devil's claw has been known for centuries, because the anti-inflammatory and decongestant iridoid glycosides contained in it alleviate the pain and help to regain mobility. However, the effectiveness of the medicinal plant only begins after two to four weeks - accordingly, devil's claw is not suitable for the treatment of acute, severe pain in the hand, such as during a rheumatism attack.

Instead, it is advisable to take a four-week course of treatment for chronic complaints two to three times a year. The medicinal plant should by no means be taken indefinitely. Before taking it, an individual plan with the doctor should definitely be drawn up.

If rheumatoid arthritis is the cause of the pain in the hand, so-called “basic therapies” (Disease Modifying Anti-Rheumatic Drugs, short: “DMARDs”) are usually used. These are drugs that intervene in the inflammatory process and thereby significantly slow the course of the disease and the destruction of the joints.

At best, however, therapy for rheumatism consists of a holistic interplay of family and specialist doctors (rheumatologists, orthopedic surgeons, etc.), physiotherapists and occupational therapists, psychologists and alternative doctors in order to optimally inhibit inflammatory processes, relieve pain and function and strength of the joints.

Proven approaches include physical treatment procedures such as hydrotherapy with cold or warm water. The preferences here can vary widely from patient to patient, so that such therapy should always be carefully tailored to individual preferences.

Since cold has a pain-relieving, decongestant and anti-inflammatory effect, an ice pack or cooling pillow can be placed on the affected joints for a few minutes, for example, several times a day. It is important that these never have direct skin contact, but always in a dish towel or similar. be wrapped to avoid frostbite.

Heat therapy in naturopathy can also be very beneficial for chronic rheumatism. Because heat relieves pain, stimulates the metabolism, promotes blood circulation and relaxes the muscles. It also affects organ functions and has an anti-inflammatory effect, especially in the case of chronic inflammation.

Heat can be supplied to the painful region in various ways - examples include mud packs, red light, ultrasound or electrotherapy (“transcutaneous electrical nerve stimulation”, in short: TENS).

It is very beneficial when the aching hands are immersed in a warm rapeseed bath.

Good to know: A rapeseed bath has a double effect. On the one hand, it is a boon for sensitive joints when they “immerse”, on the other hand, it simplifies the mobilization of joints that have become stiff or have limited mobility. Because the skin and tissue around the entire joint become smoother due to the heat, which makes movements easier.

Warm rapeseed bath for hand pain
  1. Put about 2.5 kg of rapeseed from organic farming in a larger, high-rim container (e.g. a baking dish)
  2. Warm the seeds to a maximum of 45 - 50 ° C in the oven or in the microwave
  3. Control the exact temperature according to your personal well-being
  4. Once the rapeseed has warmed up, dip your hands in the bath
  5. Move your hands as you like, e.g. grab, stretch, circle etc.
  6. When the seeds have cooled, they can be warmed up again

Danger: Heat should not be used for acute inflammatory processes, as well as for fever, acute injuries or infectious diseases, since in these cases the inflammatory process can even be supported by the application.

Coping with pain with relaxation procedures

Chronic diseases such as rheumatoid arthritis in particular always have an impact on the psyche due to permanent pain and sometimes massive restrictions on movement. Accordingly, the treatment of illness and pain should not be neglected as part of the treatment.

In addition to psychotherapeutic support, a number of relaxation techniques such as yoga, autogenic training, progressive muscle relaxation or meditation have proven their worth. (no; last updated on May 30, 2017)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch

Swell:

  • Assmus H. et al .: Diagnostics and Therapy of Carpal Tunnel Syndrome, S3 - Guideline, German Society for Hand Surgery, (accessed September 6, 2019), AWMF
  • Jeremy Bland: Carpal tunnel syndrome, BMJ (online), (accessed 06.09.2019), PubMed
  • German Society for Hand Surgery e. V .: Loge de Guyon syndrome (available on September 6, 2019), hand experts
  • David R. Steinberg: Osteoarthritis of the Hand, MSD Manual, (accessed 06.09.2019), MSD
  • Deutsche Gicht-Liga e.V .: Information about the disease (accessed: September 6, 2019), gichtliga

ICD codes for this disease: M79.04, M79.24 ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


Video: Worried About Carpal Tunnel? Try 3 Simple Stretches (November 2022).