Hand

• Hand Arthritis

• Wrist Arthroscopy

• Sclerotherapy for Hand Veins

Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis, also known as degenerative arthritis, is the most common form of arthritis and it commonly affects the hands because of their frequent use. Patients can also suffer from an autoimmune condition known as rheumatoid arthritis which causes many of the same symptoms as osteoarthritis in the hand, but has other causes and other systemic effects.

Osteoarthritis of the hand develops as the cartilage protecting the bones of the finger joints wears down. Over time, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. Arthritis of the hand may cause the joints to lose their normal shape and limit their movement. Osteoarthritis occurs more frequently in older individuals; rheumatoid arthritis can have its onset at any age, but is more prevalent as patients reach middle age and beyond.

Symptoms of Hand Arthritis

There are a number of symptoms shared by patients with either osteoarthritis or rheumatoid arthritis of the hand. These symptoms, manifested at the joints of the hand, wrist, and fingers, may include:

• Deep, aching pain
• Stiffness and swelling
• Limited range of motion
• Crepitus, a grinding or grating sensation or sound
• Formation of mucus cysts at the fingertips
• Difficulty using the fingers to grip or turn objects
• Weakness in the hand

Treatment of Hand Arthritis

Treatment of hand arthritis varies according the cause and severity of the symptoms. Some treatments commonly used to alleviate pain and increase mobility include:

• Rest
• Heat or cold therapies
• Analgesics (pain relievers)
• Anti-inflammatory medications
• Corticosteroid injections
• A splint to support the affected joint
• Physical therapy exercises to increase mobility

Pain relievers and anti-inflammatories used to treat hand arthritis may be topical or oral, over-the-counter or prescribed, depending on the severity of the patient's condition.

In the most severe cases, Arthroscopic surgery may be necessary to treat osteoarthritis of the hand. Such surgery may involve joint reconstruction, in which damaged tissue is replaced, or joint fusion, during which two or more bones are surgically joined. In severe cases, surgery may be required to smooth irregular tissue surfaces, or to reposition or replace joints through arthroscopy.

Where rheumatoid arthritis is the cause of the disorder, medications called biologics may be prescribed, but these can have serious side effects. Alternative treatments for either type of arthritis may also be employed, including, but not limited to, acupuncture.

Tendons connect muscles to bones, allowing muscles to function. When there is damage to the tendon that helps a particular muscle to function, the muscle is essentially paralyzed and can no longer be used.

Tendon transfer is a surgical procedure that takes a healthy tendon from one area of the body and attaches it in an area that is no longer functioning.

In the hand, tendon transfer is often used to treat tendon damage that has been caused by nerve injury, muscle rupture or nervous-system injury.

The Tendon Transfer Procedure

Only a healthy, well-functioning tendon with a good blood supply is used for transfer. It must be taken from an area in which the tendons that remain can still provide the function the transferred tendon was providing. During the tendon-transfer procedure, which is performed on an outpatient basis, two incisions are made: one to access the tendon being transferred, and one to access the area in which the tendon will be attached. The healthy tendon is then rerouted to the new attachment site, where it is secured with stitches to the targeted bone or tendon.

Sclerotherapy has been used to treat varicose veins in the legs for quite some time. It is also one of the most effective treatments for bulging veins in the hands. This medical procedure involves the injection of a sclerosant solution into the prominent veins, which causes their eventual collapse. The treated veins are ultimately absorbed into the body and the blood is redirected naturally to flow through other, healthier veins.

Prominent veins can make the hands look substantially older. Over the years, the skin loses some of its elasticity and volume. This can result in the appearance of lumpy, unattractive veins at the skin's surface. Areas like the hands which receive a great deal of sun exposure, tend to show these signs of damage more quickly than other parts of the body.

These bulging veins that can be seen near the surface of the skin are not necessary to the circulatory system. Veins deeper within the hand are sufficient to transport blood to and from the area. Therefore, if surface hand veins are cosmetically bothersome, it is quite safe to treat and remove them.

Schlerotherapy treatment for hand veins is performed in the doctor's office and typically takes only about 30 minutes. Some patients require only a single session of sclerotherapy to completely the issue, while others may require multiple sessions. Anesthesia is not necessary and most patients report experiencing little to no pain, other than a mild burning sensation. After the skin is cleaned with an antiseptic solution, the sclerosant is injected into the affected veins with a very fine needle. The number of injections per session varies based on the number and length of the damaged veins. After the sclerotherapy procedure, cotton balls and compression tape are applied to the injection site.

After sclerotherapy treatment for hand veins, most patients can return to work and other normal activities the same day. Compression gloves and support bandages may need to be worn for several days after the procedure. Some patients may experience mild bruising and discoloration following sclerotherapy, but these side effects usually subside within a few days. The long-lasting results of sclerotherapy begin to show up immediately, and are usually fully visible after 3 to 6 weeks.