Hand conditions can significantly impact daily life and understanding when to seek specialised care is crucial. Here's an overview of five common hand conditions from a hand surgeon's perspective:

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a prevalent condition caused by compression of the median nerve in the wrist. Patients typically experience numbness and tingling in the thumb, index, middle, and half of the ring finger. Pain or burning sensations in the hand and wrist, often worsening at night, are common. In severe cases, weakness in grip strength and difficulty with fine motor tasks may occur.

Early diagnosis is crucial for effective management. Conservative treatments include splinting and steroid injections. For persistent cases, surgical intervention through carpal tunnel release may be necessary.

Trigger Finger

Trigger finger is characterised by abnormal resistance to smooth flexion and extension of the affected finger. Patients often report a catching or locking sensation when bending or straightening the finger. Pain at the base of the finger or in the palm is common, along with stiffness, especially in the morning.

This condition affects many adults with diabetes and some of the general population. Steroid injection is the first-line therapy, though it may be less effective in people with insulin-dependent diabetes. For recurrent cases or those unresponsive to conservative treatment, surgical release may be necessary. 

De Quervain's Tenosynovitis

De Quervain's tenosynovitis involves swelling of the extensor tendon of the thumb at the wrist. It's more common in women and often affects individuals between 40 to 59 years of age. Symptoms include pain and swelling near the thumb or wrist, difficulty gripping or pinching objects, and pain that worsens with thumb and wrist movements. 

Steroid injections combined with immobilisation can relieve symptoms in most patients. For recurrent cases, surgical release of the first dorsal extensor compartment may be considered.

Dupuytren's Contracture

Dupuytren's contracture is characterised by thickening and tightening of the fascia in the palm and fingers. Patients may notice nodules or lumps in the palm, as well as pits or dimples in the skin. As the condition progresses, it can lead to the inability to fully extend fingers or place the hand flat on a surface.

Treatment options range from less invasive needle aponeurotomy and to more extensive surgical procedures for severe cases. Early intervention is key to preventing significant deformity and functional impairment.

Lumps and Bumps

Various lumps and bumps can occur in the hand, including ganglion, cysts and soft-tissue tumours. Common characteristics include:

- Soft, fluid-filled masses

- Usually painless, though they may cause discomfort if pressing on a nerve

- Can potentially lead to nail deformity or limited joint movement

Ganglion cysts are the most common type of soft-tissue tumour in the hand. They are benign, fluid-filled sacs that often develop near joints or tendons.

Treatment options include observation if the lesion is not causing pain or interfering with function. However, for persistent or problematic lesion, surgical removal may be required. 

It's important to consult a hand specialist if you notice rapid growth, changes in size, or pain associated with any hand lumps. While most are benign, proper evaluation is crucial for appropriate management and to rule out more serious conditions. 

In conclusion, these five hand conditions can significantly impact daily life and function. Early recognition, proper diagnosis, and timely intervention are crucial for optimal outcomes. While some cases may respond to conservative treatments, others may require surgical intervention. A fellowship-trained hand surgeon can provide specialised care and determine the most appropriate treatment approach for each individual case.

Read more about Mr Andy Ang's specialities and contact details.