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How to manage common hand and wrist conditions

By Mr Maxim Horwitz, consultant hand and wrist orthopaedic surgeon from The Wellington Hospital, part of HCA Healthcare UK.

The majority of people in the UK will suffer from a hand or wrist problem at some point in their lives. Hand and wrist pain can be caused by a trauma, for example through an accident or sporting injury, or a medical condition such as arthritis, carpal tunnel syndrome or tendonitis. Chronic hand and wrist pain can be debilitating and can have a major impact on your daily activity and life, so it is important to get the right treatment quickly and effectively.

As a consultant hand surgeon that specialises in hand and wrist conditions, I have provided an overview of the most common causes of hand and wrist problems and how to manage the symptoms, and when to seek medical advice.

Hand and wrist sprain and strain

Hand and wrist sprains are extremely common amongst children and adults, usually due to a fall or if the wrist or hand gets hit forcefully. They occur when the ligament in the hand or wrist is stretched too far and can result in ligament tears of varying degrees.

Signs of a sprain or strain are bruising, swelling, pain, tenderness and warmth around the area.

The best way to manage a sprain or strain is to elevate the hand and use an ice pack for between one or three days when the hand and wrist are swollen and take pain killers. Once the swelling has reduced start using hot packs to promote blood flow to the area to help repair and heal. Sprains or strains usually get better within a week or two but if the pain and swelling have not subsided after a week then you should see a doctor to examine the area.

Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) occurs when the median nerve (which travels through the wrist) is compressed. There is usually no reason for this but it can occur due to inflammation of the tendons, a fracture of the wrist or wrist arthritis. CTS is more common in women particularly during pregnancy.

Symptoms of CTS include a dull ache or pain in the fingers, hand or arm, numb hands, tingling or pins and needles, a weak thumb and difficultly gripping.

If you start to experience CTS related symptoms book in to see a hand and wrist specialist who can assess your condition and recommend a treatment plan. CTS can get better through the use of splints and steroid injections to reduce the inflammation and compression however, surgery is frequently required. The surgical procedure known as carpal tunnel release removes the pressure on the nerve.


Osteoarthritis is a degenerative joint disease where the cartilage between the joints wears down and causes the bones to rub together. Osteoarthritis in the wrist and hand can affect the basilar joint (connecting your thumb and wrist), DIP joint (fingertips) and PIP joint (middle knuckles).

The rubbing of the bones causes pain, inflammation and stiffness and can be extremely debilitating for sufferers.

The main symptoms of osteoarthritis include a dull ache when you use your hands, stiffness (especially in the morning), weak grip, swelling and tenderness in the wrist and hand.

Osteoarthritis can be relieved by over-the-counter anti-inflammatory medications and regularly exercising the joint to stop it getting stiff and achy. Regular use of hot and cold compresses and splints can be beneficial for those suffering from the disease.

If symptoms continue to deteriorate surgery or an injection is recommended to help alleviate the pain. Surgical treatment includes fusing the bones or reconstructing the joints.

Rheumatoid Arthritis

Rheumatoid arthritis is an auto immune disease where the body’s immune system attacks the membrane that encases and protects the joints in the body. The attack on the lining means it becomes inflamed and swollen and erodes the cartilage and bone and in very severe cases the tendons.

Similar to osteoarthritis, common symptoms include pain, swelling and stiffness. Rheumatoid arthritis can also cause symptoms elsewhere in the body, a fever, anaemia, fatigue and loss of appetite.

Anyone displaying signs of rheumatoid arthritis should seek advice from a rheumatologist, a hand surgeon and a hand therapist. Medication can be prescribed to help alleviate the pain and in certain cases surgery can help to improve joint function.


Tendonitis occurs when the tendons are inflamed due to a sudden injury or repetitive motions that cause the tendon to become stuck or inflamed. It is common to develop tendonitis in the wrist and fingers due to the number of tendons that surround the wrist joint.

Common symptoms of tendonitis include pain and stiffness in the hand and wrist, particularly in the morning. The area will also feel tender and you may feel a creaking when moving the wrist or hand. In severe cases tendonitis can cause a restriction in the range of motion or triggering in the fingers.

Stretching the muscles and tendons helps improve flexibility. Corticosteroid injections can be prescribed to reduce the inflammation. Occasionally a small surgical procedure may be needed to release tight tendons and allow them to glide freely.


To book an appointment with Mr Maxim Horwitz at The Wellington Hospital call 0207 483 5148

Request an orthopaedic appointment

We're happy to help you make an appointment with an experienced orthopaedic or sports medicine consultant. We can also arrange imaging and outpatient physiotherapy appointments.

020 7079 4344
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