Pain in the hands
Pain in the hands
How hands are essential to perform almost any daily activity, one realizes above all when an acute or chronic pain in the hands prevents them from being used in a natural way or limits their movements to some extent. Unfortunately, given their widespread use and the complexity of their anatomical structure, the probability of experiencing pain in the hands of various kinds is quite high at any age and especially after 40-50 years of age.
Main causes of pain in the hands
The possible causes of pain in the hands are innumerable and diverse. Acute traumatic hand pain usually prevails among children, adolescents and young adults, often due to accidents during exercise or work, or to falls with inadequate hand and wrist support.
In adulthood, for those who practice sport or carry out work that requires intense use or repetitive movements of hand, wrist and fingers, a pain in the hands "due to use" may also occur, due to the excessive stress of specific joints and of tendons. In these cases, it is always a pain in the hands with an inflammatory component, which worsens with movement and improves with rest, and which mainly affects the most used hand.
From the age of 40, pain in the hands can begin to occur in a recurrent or chronic manner as an expression of a rheumatic or inflammatory disease on an immune basis (such as gout or rheumatoid arthritis) or following degenerative changes that involve pain in a nerve (for example, the median nerve in carpal tunnel syndrome), in a tendon (such as the extensor and the abductor of the thumb in De Quervain's tenosynovitis) or in joints (as in osteoarthritis of the hand).
In case of carpal tunnel syndrome and De Quervain's tenosynovitis, pain in the hands it is located on the inner side of the wrist, at the base of the thumb (only one at a time) and can be accompanied by swelling, tingling, difficulty grasping objects or thumb snapping/blocking.
In osteoarthritis of the hand and rheumatoid arthritis, pain in the hands is often bilateral, associated with limitation of movement (especially in the morning) and difficulty in grasping; in the more advanced stages of the disease, there is also a joint degeneration with formation of bony prominences and nodules.
How to relieve pain in the hands
Knowing how to behave in case of pain in the hands is important both to reduce discomfort and to limit the resulting disability. The approach to be taken to relieve pain in the hands is related to the acute or chronic cause that caused it and to the presence or absence of damage or alterations to the joint or tendon structures.
For example, acute pain in the hands due to trauma and/or inflammation of a joint capsule or tendon must first be managed with rest and ice application several times a day for 15-30 minutes each time. In addition, non-steroidal anti-inflammatory drugs (NSAIDs) can be taken, such as ibuprofen arginine salt (Spididol®), for a few days.
To avoid making painful movements and maintaining inappropriate postures, the doctor may recommend the use of a brace, during the day and/or night. This strategy is used especially in case of injuries to joint and tendon structures, carpal tunnel syndrome or De Quervain's tenosynovitis.
On the contrary, if the pain in the hands is due to osteoarthritis or rheumatoid arthritis, it is generally advised to start moving the hands again, cautiously, as soon as possible, to avoid promoting joint stiffening and loss of function. Moreover, instead of ice, it can be useful to apply heat to reduce stiffness. Even in these cases, NSAIDs, taken as indicated by the doctor, can be useful to control pain and inflammation in the hands.
In all cases of chronic/recurrent hand pain, physiotherapy and training to a more ergonomic use of the hands can be useful, with learning of alternative gestures to those that cause pain.
When to consult a doctor
In general, after an acute trauma of some importance and when the pain in the hands is moderate-severe, recurrent, associated with limitation of movement and/or not controlled by rest, application of ice and intake of NSAIDs by mouth, it is always advisable to consult a doctor to investigate the situation and identify the most appropriate therapy.
In case of carpal tunnel syndrome and De Quervain's tenosynovitis, when even corticosteroid therapy fails, it often becomes necessary to resort to surgery. On the contrary, for osteoarthritis of the hand and rheumatoid arthritis, possible orthopedic surgery is proposed only in selected cases.
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