"Helping Out with Hand Concerns" FAQs

Public and Patient Education Department Program, January 25, 2006


Blaire Biase, PA
Hand Services, Hospital for Special Surgery

What are the symptoms of basal joint arthritis?

The most frequent symptom is a dull aching pain at the base of the thumb that gets worse with activity and better with rest. You may also have swelling and tenderness at the base of the thumb, loss of strength in gripping or pinching, loss of motion of your thumb, and morning pain and stiffness.


What are some treatment options for basal joint arthritis?

There are both conservative and surgical options for the treatment of basal joint arthritis. Conservative treatments include icing the joint, taking anti-inflammatory medications, wearing a supportive splint, or getting cortisone injections into the joint. Surgical options include fusing the bones that make up the basal joint or reconstructing the joint.


What is carpal tunnel syndrome? What causes it?

Carpal tunnel syndrome occurs when there is increased pressure on the median nerve at the wrist in the carpal tunnel. Symptoms include tingling, numbness, pain, and weakness in the distribution of the median nerve. The median nerve supplies sensation to the thumb, index, middle, and occasionally the ring fingers. The median nerve also supplies motor innervation to a muscle in the thumb. Symptoms get worse when there is increased pressure in the carpal tunnel. This usually occurs when the wrist is flexed or extended for prolonged periods of time.


What are some treatment options for carpal tunnel syndrome?

There are both conservative and surgical options for the treatment of carpal tunnel syndrome. Conservative treatment options include splinting your wrists to keep them in a neutral position to avoid flexion or extension at the wrist, injecting cortisone into the carpal tunnel, taking anti-inflammatory medication, and avoiding activities that place your wrists at a higher risk for developing carpal tunnel syndrome. The surgical option is to release the transverse carpal ligament (the roof of the carpal tunnel) to allow more room for the median nerve.


What is trigger finger? What causes it?

Trigger finger is also known as stenosing tenosynovitis. It is an inflammation of the flexor tendon sheath. There are no real causes, but it can be associated with repetitive squeezing or gripping activities. It may also be associated with medical conditions such as gout and diabetes.


What are the symptoms of trigger finger?

One of the first symptoms may be soreness at the base or proximal joint of the finger. The most common symptom is a painful clicking or snapping when attempting to flex or extend the affected finger. In some cases, the finger that is affected locks in a flexed or extended position, and must be gently straightened with the other hand.

What are my treatment options for trigger finger?

The first step to recovery is to limit activities that aggravate the condition. Conservative treatments include splinting the affected finger in extension. These extension splints are initially worn at nighttime only for a few weeks to allow for the swelling around the tendon sheath to calm down. If the splint is not successful, an injection of cortisone may be the next option. The injection may not be the best option for certain patients, depending on their other medical conditions. If the condition does not respond to conservative treatments, surgery may be recommended to release the A1 pulley that restricts the movement of the inflamed tendon sheath.


Are conservative treatments for hand disorders better than surgical?

Conservative methods are preferred and usually successful for most hand disorders. However, if conservative methods are not working for particular case, surgical methods are recommended as a last resort.
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