Michael S. Vrana, M.D.
Orthopedic Surgeon
Overview
how the hand and wrist workYour hand and wrist pack 27 bones, dozens of joints, and the tendons and nerves that run everything from a power grip to threading a needle. The tendons travel through snug tunnels, and the nerves pass through tight spaces at the wrist. Most hand and wrist trouble is one of three things: a tendon catching in its tunnel, a nerve being squeezed, or wear and tear in a joint, and the pattern of your symptoms usually points straight at which one.
What Usually Causes Hand and Wrist Pain
the usual suspectsCarpal tunnel syndrome
The main nerve to the hand gets squeezed at the wrist. Numb, tingling fingers, often at night, often shaken awake.
Trigger finger
A finger that catches, clicks, or locks as it bends. A swollen tendon hanging up in its tunnel.
De Quervain's tendinitis
Painful tendons on the thumb side of the wrist. Common with new parents and repetitive lifting.
Thumb arthritis
Wear at the base of the thumb. Pain with pinching, gripping jars, and turning keys.
Ganglion cysts
A firm, fluid-filled bump on the wrist or hand. Harmless, and only treated if it bothers you.
Wrist fractures
The wrist is the most commonly broken bone in adults. A fall onto an outstretched hand is the classic story.
When to Come In
timing and warning signsMost hand and wrist soreness settles in a week or two with rest and over-the-counter pain relievers. Come in sooner if the pain followed a fall and the wrist is swollen or crooked, a finger will not straighten, numbness is constant, the hand is pale or cold, or you have redness and fever along with the pain.
What Your Visit Looks Like
exam first, imaging secondYour visit starts with a conversation and a hands-on exam. The pattern of numbness, which fingers are involved, and what motions hurt usually identify the problem. We take X-rays in the office the same day if we need them. Most hand and wrist problems get better without surgery: splinting, activity changes, therapy, and sometimes an injection. When surgery is the right step, many hand procedures are short, done through small incisions, and go home the same day.
How We Treat Hand & Wrist Pain
non-operative first, surgery when it countsMost hand and wrist problems get better without an operation. The usual path is splinting to rest the irritated tunnel or joint, activity changes, therapy, and an injection when inflammation is the driver. Many of these problems (trigger finger, carpal tunnel in its early stages, thumb arthritis) respond well to those steps.
When surgery is the right step, most hand operations are short, done through small incisions, and go home the same day. Your OSI surgeon performs it. See the hand and wrist operations we perform or browse non-operative care.
