At Home with Dr Christian Jessen - 352

| ORTHOPAEDICS|

SINCE FALLING
PREGNANT, MY
HAND HURTS
AND I EXPERIENCE A
TINGLING SENSATION
IN MY FINGERS.
WHAT'S CAUSING IT?

4

Carpal tunnel syndrome (CTS) is
where the median nerve in your wrist
is compressed, causing symptoms
such as the ones you've described,
including pain, numbness and
tingling in the wrist and hand
- in particular your thumb, index
and middle fingers. It's unknown as
to why this happens, but risk factors
include a family history of the
condition, wrist injuries, diabetes,
and pregnancy - indeed, up to 50%
of pregnant women develop CTS.
The good news is that it often
gets better within three months
of giving birth; in the meantime,
moving your hand or shaking your
wrist can help relieve the pain.
Unfortunately, however, the
symptoms can continue for a year or
more after giving birth, in which case
you will probably need treatment.
If the symptoms are mild, a wrist
splint and corticosteroid injections
may suffice. If this doesn't work,
surgery might be required in order
to treat the condition and remove
the risk of permanent nerve damage.
The quicker you are diagnosed and
treated, the more likely it is that you
will experience a full recovery.

I'VE PLAYED
THE VIOLIN
FOR YEARS,
AND HAVE RECENTLY
NOTICED THAT MY
ELBOW HURTS WHEN
PERFORMING TASKS
SUCH AS WRITING
OR OPENING A JAR.
WHAT CAN BE DONE?

5

Lateral epicondylitis, which is more
commonly referred to as tennis
elbow, causes pain around the outside

of the elbow and usually develops
when the muscles and tendons near
the elbow joint become damaged
from overuse or performing the same
action repeatedly. As well as your
elbow, these muscles move your wrist
and fingers (hence why you feel pain
when, say, opening a jar - it's all
connected!). When the muscles and
tendons are strained, small tears
and inflammation can develop on
the outside of your elbow.
If elbow pain is caused by a
repetitive activity, such as playing the
violin, then you should rest and avoid
doing that activity for a few days.
If your symptoms don't improve,
you will need to see your GP, who
will examine your arm and discover
how your symptoms developed.
While this condition will eventually
get better without treatment - most
cases last between six months and
two years - it is possible to speed
up recovery time by resting your
injured arm, holding a bag of peas
wrapped up in a towel against your
elbow for a few minutes each day,
and taking painkillers.
If the symptoms are severe,
physiotherapy and massaging the
area may be recommended. If all
else fails, surgery may be required
to repair the tendon.

A SMOOTH,
PEA-SIZED
LUMP HAS
APPEARED ON THE
BACK OF MY WRIST.
IT DOESN'T HURT,
BUT I HAVE NO IDEA
WHAT IT IS. SHOULD
I BE WORRIED?

6

This could be a ganglion cyst; a fluidfilled swelling that develops near
a joint or tendon, most commonly
on the wrist, hand and fingers. The
cyst (which looks and feels like a
soft lump under the skin) can grow
to be the size of a golf ball. The
fluid inside (synovial fluid) surrounds
joints and tendons to cushion them
during movement - this type of cyst
occurs when the fluid leaks out and
gathers beneath the skin.
However, a cyst like this is harmless
and painless, so you could wait for it
to disappear by itself without treatment.
But if it becomes painful - particularly
if located next to a nerve - it is
possible to get it treated, either by
having the fluid drained out with a
syringe (aspiration), or having the cyst
surgically removed, both of which are
equally effective and performed
under local or general anaesthetic.

YOU MAY HAVE A
FRACTURE IF YOUR
WRIST FEELS NUMB
AND DOESN'T
IMPROVE WITHIN
A FEW DAYS

I TRIPPED WHILE
WALKING UP
THE STAIRS THE
OTHER DAY AND
LANDED AWKWARDLY.
NOW I CAN'T PUT
ANY WEIGHT ON
MY WRIST AND IT'S
SWOLLEN. SHOULD I
GET IT CHECKED OUT?

7

It's likely that you've sprained your
wrist - this occurs when your ligaments
have been stretched, twisted or torn,
usually as a result of a collision or a fall
similar to the one you experienced.
In addition to the symptoms you've
already described, your wrist may
feel tender and eventually bruise,
and you may then find that you have
some difficulty moving it.
A sprain can usually be cared for
at home with the so-called PRICE
therapy (protection, rest, ice,
compression and elevation) and by
taking paracetamol to ease the pain.
However, if the symptoms don't
improve within a few days, the pain
is severe, you experience any numbness
or you are still unable to put weight
on your wrist, then it is advisable that
you visit a minor injuries unit (MIU)
as you might have a fracture.

WORDS: HELEDD WILLIAMS | PHOTOGRAPHS: GETTY IMAGES, SHUTTERSTOCK

cold temperatures can also contribute
to RSI, and so should be taken into
consideration when thinking of how
to alter the way in which you carry
out office tasks. If this isn't possible,
or the symptoms don't get any better,
you should see your GP, who may
give you a course of antiinflammatory painkillers, or suggest
using a heat or cold pack.
You may also be referred to
a physiotherapist to advise on
improving your posture. Osteopathy,
yoga and massage can also help.

44 | MARCH 2015

42-44 Talk to the hand.FINAL.indd 44

23/01/2015 19:47
At Home with Dr Christian Jessen

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