How to Help Your Aching Hands

When ordinary hand movements – opening a jar, lifting a baby or texting – cause pain, daily life becomes difficult. Find out why your digits are aching; plus, get solutions for relief…

Hands are remarkably complicated and versatile, capable of doing everything from grasping large objects to performing delicate microsurgery. But because a hand has many moving parts – 27 bones, several muscles, tendons, ligaments and thousands of nerve endings all packed into a small space – a lot can go wrong. Especially for women. Picking up tots, cooking dinner and texting on the phone are motions that can cause long-term damage to the joints, muscles and nerves in your hands and arms.Plus, diagnosing hand pain’s cause is complicated. Symptoms may come and go or get worse at different times or movements. In some cases, pain may even travel from one part of the arm or hand to another."The problem is, hand and arm pain may originate from more than one area of the body," explains orthopedic surgeon David Geier, M.D., director of sports medicine at the Medical University of South Carolina in Charleston.For example, muscles and tendons for wrist movements originate in the elbow, causing pain throughout the entire limb. "Tendon problems in the wrist typically cause pain in the wrist and thumb but also the forearm,” Dr. Geier adds.

Age, lifestyle, occupation and genetics determine your risk of hand and arm disorders.For example, mothers-to-be are at a higher risk of carpal tunnel syndrome because the increased fluid caused by pregnancy compresses wrist nerves. "Plus, new moms may be prone to tendonitis in the elbow from picking up and holding the baby throughout the day," Dr. Geier says.Read on to find out other triggers for common hand and arm problems and the best ways to get relief.1. Carpal Tunnel Syndrome (CTS)
Repetitive activities, such as texting and computer work, may gradually trigger CTS, which is caused by swelling from irritated tendons or fluid in the carpal tunnel, a small passageway of bones and ligaments at the base of the hand. The swelling compresses nerves in the CT, leading to pain and tingling in the fingers. People with narrower carpal tunnels are more susceptible to CTS. So are those with autoimmune diseases such as rheumatoid arthritis (see #6), fibromyalgia and lupus, because inflammation and swelling narrows the nerve path.

Symptoms: CTS usually starts with tingling or numbness in hands and wrists. As nerves become more compressed, sharp, piercing pains may shoot through wrists and up arms. "The thumb, index finger and third finger (but not the pinky) often become numb", says Neil Kirschen, M.D., president of Pain Management Centers of Long Island in New York.Treatments:Over-the-counter pain relievers, such as aspirin or ibuprofen, ice packs and splints to stabilize the wrist can reduce pain and tingling. So can massaging the area where wrist and forearm meet. "Some people find relief with acupuncture, vitamin B6 and physical therapy," Dr. Kirschen adds. If symptoms persist, see a doctor to rule out underlying causes such as arthritis. For CTS, doctors may recommend surgery to relieve pressure on nerves. First ask for a nerve conduction test to evaluate nerve function and confirm the CTS diagnosis.

2. Tennis elbow (lateral epicondylitis)
You don't have to play tennis to develop this painful condition. It results from a partial tear of the tendon that connects muscle to bone on the outside of the upper arm. Overuse and repetitive use of muscles from using a computer keyboard and mouse or twisting motions (for example, turning a screwdriver) increase risk.Symptoms:Pain radiating from outside the elbow to the forearm when grasping or twisting, a weak grip, elbow pain that gradually worsens. Treatments: "Ice works best," Dr. Geier says. Two or three times a day, apply a cold pack to the painful area for 20 minutes, followed by 20 minutes off. Don’t apply heat; it can exacerbate inflammation. Drugstorepain relievers also may be effective, but don’t take them more than 20 days a month.

3. Golfer's elbow (medial epicondylitis)
Blamegolf, tennis and racquet sports for this type of tendonitis – especially if you’re using too-small or heavy equipment. Unlike tennis elbow, which affects the outer side, this condition inflames tendons on the inner elbow that are used to flex the wrist. Painting, raking and other repetitive movements, including exercises, can also trigger it."Strength training of the upper body and yoga positions, where hands are flexed against resistance, can also cause golfer's elbow," Dr. Geier says.Symptoms: Pain and tenderness in the inner elbow and, sometimes, the inner forearm. Shaking hands or turning a doorknob may hurt. You also may feel weakness in your hand and wrist and numbness in the ring and little fingers. Treatments:Besides anti-inflammatories, reduce the problem activity and wrap elbow with an elastic Ace bandage to reduce pain and inflammation. Massaging the inner elbow with ice for five minutes at a time, 2-3 times daily, also helps.

4. “Blackberry finger” (De Quervain's tenosynovitis)
Frequent and repetitive overuse of the thumb from handheld devices such as cell phones may trigger De Quervain's tenosynovitis, a thumb pain caused by inflammation of the sheath surrounding two tendons that control the thumb. It also occurs in new mothers who repeatedly pick up infants with the thumb outstretched and wrist bent toward the small finger. "Pinching, twisting or wringing out clothes may also cause de Quervain's," says Melissa Patton, P.T., a physical therapist in Charleston, S.C. Symptoms: Difficulty gripping and grasping objects, pain, weakness, tenderness and swelling of the thumb side of the wrist.Treatments:Splints may help support and rest thumbs and wrists. Also, apply ice and avoid activities that are repetitive or trigger pain and swelling. If those treatments don’t provide relief, see a doctor about oral or injected anti-inflammatory medications, such as cortisone.

5. Osteoarthritis (OA)
Joint wear and tear, an injury, age or even genes may trigger osteoarthritis (OA). It’s caused by a breakdown of joint cartilage, allowing bones to rub together. It most often affects hands and over time may permanently damage joints. "It’s one of the most common of the 120 forms of arthritis," says Gary Silverman, D.O., a board-certified rheumatologist in Scottsdale, Ariz., and a faculty member at Midwestern University in Glendale, Ariz. Symptoms: Typing, writing, knitting, lifting heavy weights, or humid or rainy weather may exacerbate pain. Joint stiffness, particularly in the last joints near the fingerstips, occurs mostly in the morning. Minor swelling may also indicate OA. "However, unlike rheumatoid arthritis [see below], the joint is 'cool' and doesn’t feel inflamed," Silverman says.Treatments:Give your hands a rest, if possible, and take drugstore pain relievers such as ibuprofen. In severe cases, your doctor may prescribe stronger pain relievers."Recent FDA-approved prescription topical pain-relief gels can help [temporarily] when rubbed onto the affected fingers," Silverman says.

As long as your joints are not inflamed, do the following stretches daily to retain flexibility. First, soak hands in warm water to loosen the finger and wrist joints, then hold each stretch for 2-5 seconds.Finger Fan: Place hands flat on a tabletop with fingers together; spread them wide, then bring them back together.Finger Stretch: Put hands together by touching fingertips in front of your chest; bring elbows out to sides as you gently press fingertips together.Prayer Hands: Place palms of the hands together, fingertips pointed up and elbows out to the sides at right angles, forearms parallel to the floor.6. Rheumatoid arthritis (RA)
While its cause is unclear, doctors believe a combination of genetics and environmental factors trigger RA, a disease in which the body's immune system attacks its own tissues, causing painful swelling in fingers and other joints. Symptoms: Typically, you’ll feel pain in the middle knuckle and base of the hand. Unlike OA, which worsens in the morning, RA joint stiffness and pain lasts hours, even all day. "You may also feel sick [with fatigue, appetite loss and low-grade fever] because rheumatoid arthritis is a systemic illness," Silverman says.

Treatments: It’s important to get treatment fast because "prescription medicines often help reduce the inflammatory response [and bone and joint degeneration] and put the person in quick remission," Silverman says.Non-drug therapies include splints or braces, which can stabilize wrist joints while sleeping. Exercise and stretching also help maintain normal joint movement and flexibility and relieve stiffness. Linda Melone is an ACSM- and ACE-certified personal trainer and fitness-and-health writer.

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