Monday, May 17, 2010

Hand Pain and Its Causes

When hand pain strikes, it can be a difficult problem to deal with since we use our hands for so much; our work, our play. It can also be distressing psychologically to have a part of your body not working as it should.

Hand pain can be a difficult thing to diagnose since there are many causes of hand pain. One familiar cause is a carpal tunnel syndrome. This is where the bony tunnel in the wrist is narrowed, entrapping the nerves that pass through and go into the hand.

Another cause for hand pain is a thoracic outlet syndrome. The thoracic outlet can be compressed in the shoulder girdle region causing hand pain, often at night.

The last thing to consider with hand pain is a neck problem such as a disk lesion compressing the nerves in the neck causing referred or radicular (nerve root) pain into the hand.

These three problems can independently cause hand pain or they can all co-exist to varying degrees. You are entitled to more than one cause, correct? Getting a proper diagnosis is the first key to a full correction of a problem. If your hand pain is being treated with analgesics (pain killers), there may be a reduction in pain sensations but pain medications cannot release an entrapped nerve. You might also want to consider that pain is a signal. The problem that is causing the pain should be a patient’s focus. When the fire alarm goes off at home do we think to put out the fire alarm, or put out the fire? Pain is the fire alarm, not the fire.

Recent research (Nord KM, et. al. False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyogr Clin Neurophysiol 2008;48:67.) has shown that differentiating between these three unique disorders with clinical tests can be problematic, since false positive tests are more a rule, rather than an exception. Patients with carpal tunnel syndrome were one of the most frequently misdiagnosed groups of patients.

You may also need x-rays of your spine to fully get at the cause of your hand pain and determine the best course of action; pills, surgery or specific chiropractic care. Chiropractic is an often-overlooked conservative form of care. It carries very low risks, and should be a considered option for anyone who is considering bracing, medications or wrist surgery.

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