Diagnosis

The first step is a thorough questioning (anamnesis), which should clarify the situation: In order to be able to estimate the strain on the hand, the patient’s handiness, profession and typical everyday activities are also important. Trauma or injury should also be asked about if the pain is acute. Then the hand must be thoroughly examined and compared with the healthy hand.

Attention must be paid to swelling, the specific point of pain, discoloration or other changes, skin temperature, mobility and, in the case of possible fractures, to malpositions or abnormal mobility in the area of the metacarpals. Often an x-ray of the hand is also necessary, possibly also a magnetic resonance imaging (MRI). If an inflammatory disease is suspected, blood tests are performed.

Sometimes an ultrasound examination can also be helpful. Nerve damage can be detected by measuring nerve conduction velocity, among other things. If the findings remain unclear, a (surgical) arthroscopy can provide clarity. Sometimes a therapeutic intervention can also be combined with this.

When the pain occurs
What quality they have (for example, pressing or stabbing)
When they perform
Whether the pain is permanent or has occurred in a similar form before

Treatment

A therapy is based on the results of the diagnosis and thus on the diagnosis.Sometimes the pain goes away on its own after a short period of time if the cause is an overload of the hand. In general, painkillers such as aspirin, ibuprofen or diclofenac can help in the short term. However, this is more likely to be considered symptomatic, i.e. the actual problem is not eliminated.

In many cases, either (short-term) protection of the hand, the use of bandages or other aids, or specific exercises as part of physiotherapy can help. Depending on the cause, cold or heat therapy can help. In general, cold therapy is recommended for inflammatory phenomena, while heat therapy is recommended for muscular tension.

An ointment bandage with, for example, voltar ointment to reduce pain and swelling is usually perceived as pleasant. Depending on the type of fracture, a metacarpal fracture is either immobilized with a plaster cast for several weeks or treated surgically. Plates or nails are used to fix the bone in its straightened form.

A plaster cast or splint must also be worn after an operation. In the case of tendon sheath inflammation, an immobilisation and infiltration of the tendon sheath with cortisone preparations is first tried conservatively. If this does not achieve the desired effect, an operation in which the tendon sheath is split lengthwise can be performed to restore better and pain-free movement.

After such an operation, the hand should be moved again immediately. If a fast finger is diagnosed, the corresponding ring band that causes the discomfort can be split in one operation. This is a procedure that can be performed on an outpatient basis and takes only about 15 minutes. Other causes may make various other operations necessary.