Carpal tunnel syndrome is one of the most common hand problems treated by McLeod Seacoast Orthopedic Specialist Dr. David Lukowski – but finger joint replacements are becoming more common these days, as well.

Here’s a summary of Dr. Lukowski’s comments:
I’d say the number one problem I treat is carpal tunnel syndrome. Other common problems include trigger finger, tendonitis, arthritis of the hand and wrist, nerve and artery disorders and injuries of the hand and wrist.

Carpal tunnel syndrome is a disorder, where a nerve gets compressed in the hand. It’s the most common nerve compression disorder in the body. It affects a large population of people and the causes are:

• A nerve runs through a small tunnel or channel in the hands and it runs along nine other tendons that move your fingers and your thumb. So, it’s a tight space.
• All those tendons have a lining around them called synovium, which can become thickened over time with repetitive use or due to other diseases such as thyroid disease or diabetes or other conditions.
• As that tendon surrounding synovium thickens, it puts pressure on that nerve.

The most common symptoms are sharp, electrical type pain that shoots into the fingers. Numbness is a common complaint, worse at night in most patients. Also, weakness in the hand is another symptom, if it progresses to that point.

Treatment usually starts with conservative treatments. Especially for the night symptoms, I put everyone in a splint, a brace of one of those Velcro splints you can get at the drugstore. It prevents your hand from flexing down, which usually is what causes the numbness at night. Other treatment options include taking anti-inflammatories, such as Advil or Motrin. Cortisone injections are another effective treatment. And finally, activity modifications. Say if you sit at a computer all day, there are certain things you can to do modify your posture, and the way your hands are positioned while you are typing, which can help.

The final last option is carpal tunnel surgery. It’s a very common surgery that I perform. It’s a very effective last treatment for this condition.

Arthritis occurs in the hand from several different causes. The most common is your degenerative arthritis or osteoarthritis is the technical word for it. It’s just the wear and tear arthritis over time. Your joints experience loss. The ends of the bones have cartilage and that cartilage begins to erode over time, which causes the pain in the joints. Other forms of arthritis are rheumatoid arthritis and other things, such as previous injuries to the hands, can lead to problems with the joints needing replacement.

The way a finger joint replacement differs from the hip and knees, is it’s obviously a smaller joint and the mechanics of the hand are different from the hip and knee. The materials are a little bit different as far was what you place in the hand it quite different from what is used in the knee or hip.

 

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