Chronic causes of pain in hand

The most common cause of pain in the hand and wrists is arthrosis and arthritic changes. The so-called rhizarthrosis, which is the most common form of arthrosis of the hand, should be mentioned here. This form of arthrosis affects the thumb saddle joint, which causes severe to very severe pain during movement.
In rhizarthrosis, a distinction is made between an acute traumatic form and a chronic form, which represents a late stage of polyarthritis of the hands.
In addition to rhizarthrosis, wrist deformities can also cause pain at rest or under stress. The most common cause of joint deformities is rheumatoid arthritis.
Another cause of pain in the hand can be tendonitis, which is caused by overstraining the fingers during movements.
In addition to diseases of the bones, ligaments, capsules and tendon sheaths, pain can also be caused by irritation of the blood vessels or nerves in the hand and wrist. In the so-called carpal tunnel syndrome, there is a constriction of the nerves running along the side of the palm (so-called N. medianus).
In addition to the pain, especially at night, paresthesia in the form of tingling occurs.
In rare cases, diseases of the skin on the hand can also cause pain.

When choosing diagnostic tools, the most important thing is what exactly causes the pain in the hand. If the patient reports an accident or trauma, the diagnostic of choice is an x-ray of the hand to rule out a fracture. Chronic changes and all forms of arthrosis can also be detected by an X-ray.

If there is a suspicion that ligament or capsule involvement has caused the pain in the hand, an MRI of the hand should be performed, which can provide a good image of the soft tissues of the hand in particular. If carpal tunnel syndrome is suspected, a measurement of nerve conduction velocity can provide an indication of whether the nerves are affected by carpal tunneling that is too tight. In addition to the diagnostic tools, patient interviews (anamnesis) and physical examination must not be omitted.