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Putting down the smartphone may help

Pain in the hands or wrists is more common than ever, thanks to the prevalence of smartphones and computer-focused work environments. But how do you know if your pain is associated with carpal tunnel syndrome, or a handful of other common diseases? 

“Many of the most common conditions impacting the hands and wrists appear to share traits, but they have very different causes,” said Geisinger hand surgeon Dr. Joel Klena. “They can originate in the muscle or the joint, and can be a result of genetics, general overuse or sudden impact.”

Carpal Tunnel Syndrome
Carpal tunnel syndrome affects as many as 3 percent of all working-age Americans, totaling nearly 8 million people. Plus, it can come out of nowhere and pack a serious punch. 

“The condition is named after the carpal tunnel in your wrist which acts as a passage for your median nerve,” said Dr. Klena. “This nerve controls feeling and movement in your thumb and fingers, except the pinky.” 

In carpal tunnel syndrome, repetitive motions—especially when you’re working with your arms on a downward slant, leaving the hands below your wrists—cause a narrowing of the passage that squeezes the nerve. This can be painful and lead to cramping. In extreme cases, you can also lose muscle mass in the hands leading to chronic cramping and reduced strength. 

Carpal tunnel can be diagnosed through several manual tests performed by your doctor, most of which test your wrists’ reflexes or response to stimuli.

“Carpal tunnel can be treated with brief immobilization using a splint to give the wrists a break, but can also call for anti-inflammatory drugs or even surgery in severe cases,” said Dr. Klena.  

De Quervain's Tenosynovitis

De Quervain's Tenosynovitis, a disease named after the Swiss surgeon who first identified it in 1895, is marked by pain on the “thumb side” of your wrists, making it difficult to make a fist or grasp objects. You may also have trouble moving your thumb or notice swelling near its base. 

Though its exact cause hasn’t been proven, experts believe tendon damage from repetitive motions like playing an instrument (or texting!) can trigger or worsen De Quervain's tenosynovitis.  

A positive diagnosis requires the Finkelstein test, where the fingers and hand are positioned in a way that is painful for damaged ligaments. 

Similarly to carpal tunnel, De Quervain's tenosynovitis is treated with over-the-counter anti-inflammatory medication or corticosteroid injections to reduce swelling. Pregnant women are also more prone to the condition, which usually dissipates after birth or the end of breastfeeding.

Ganglion Cysts
Ganglion cysts are a common type of mass that usually appear on the backs of the wrists. They are almost always benign, but can grow and fluctuate in size quickly. In larger sizes, they can also become painful or limit movement in the wrist. 

“Ganglion cysts come from the joint’s tissue and are filled with a fluid similar to our joints’ lubricant,” said Dr. Klena. “Heavy use or repetitive movements often cause the cysts to grow, while rest can shrink the mass.”

Ganglion cysts are most common in women between the ages of 15 and 40, but can also happen in men and people of all ages. If the cyst causes pain or limits movement, your doctor may recommend immobilization or non-surgical draining the fluid using a localized numbing cream. If the growth returns, they may recommend minor surgery for its full removal. 

Joel Klena, M.D., is chief of Hand and Microvascular Surgery at Geisinger. To schedule an appointment, call 800-275-6401.