The wrist and hand are regarded in orthopedics as the most challenge part of your body to fix. The complex movement of the hands which involve flexing, extending, and rotating along with pinching and grasping is magnificent and very specific. Our ability to sense the outside world and utilize our hands has indeed set the human race above all other species on earth due to the wonders and complexities of our abilities to use our hands. Frequently, problems arise in the hand secondary to aging, trauma, and overuse. In the course of anyone‘s life, generally speaking several hand injuries due to our constant use of our hands and reliance on them.

Carpal Tunnel and Arthritis

Carpal tunnel syndrome. Carpal tunnel syndrome essentially is a squeezing of the nerve called the median nerve at the wrist, which creates numbness in your hand, most pronounced in your thumb, index, and middle finger. This condition can arise from overuse or can be just the nature process of aging and arthritis.

Arthritis of the thumb. Due to the fact that our thumb joint attaches to the hand and sticks out at a 45 degree angle produces a great deal of pressure at the base of our thumbs. Degenerative arthritis of the thumb joint is common with aging and can be quite debilitating. When one has osteoarthritis of the base of their thumb, it is very hard to pinch and grasp objects or open up a jar for instance.

Other Issues

Other problems that occur are trigger thumb and trigger finger. Essentially when you bend your finger, especially in the morning, you have trouble extending it until you feel a popping sensation or a tendon releases. This is due to enlargement of the tendon where it gets caught in a pulley system in your hand.

Ganglion cysts are frequent in the wrist on both the top and bottom and arise generally from mild trauma from over activities over time.

Treatments performed

Carpal tunnel syndrome can be treated with cortisone injections with hydro-dissection technique. Utilizing the ultrasound helps in getting a complete dissection of the median nerve.

Degenerative arthritis of the base of the thumb is treated most efficiently first with a cortisone injection. If that works well, a PRP injection is attempted which is frequently curative. If that is not the case, the patient can go forward to have a stem cell injection into the base of the thumb which here again can be very successful. Trigger fingers and trigger thumbs are easily addressed with cortisone injections placed in the tendon sheath where the blockage is occurring and is frequently successful. During these releases, ultrasound guidance is imperative to put the injection in the appropriate spot.

Ganglion cysts of the wrist are easily identified on ultrasound, can be aspirated, and injected with cortisone or in some cases, aspirated and trephinated and injected with PRP which can be curative.