Hand pain is a prevalent condition that can significantly impact a person’s ability to perform daily activities, work tasks, and enjoy hobbies. It can stem from several causes, such as injuries, repetitive stress, and infections.
Surgical intervention is often considered when the pain is caused by conditions that physically change the structure or function of the hand, such as:
Carpal Tunnel Syndrome:
Carpal Tunnel Syndrome (CTS) is characterised by pressure on the median nerve within the carpal tunnel of the wrist, leading to pain, numbness, and tingling in the hand and arm.
Trigger Finger:
Trigger finger occurs when inflammation narrows the space within the tendon sheath of the affected finger. It can cause pain, stiffness, and a sensation of locking or catching when the finger is bent and straightened.
Osteoarthritis:
Osteoarthritis of the hand affects the cartilage in the joints, leading to pain, stiffness, and swelling.
Rheumatoid Arthritis:
Rheumatoid Arthritis (RA) is an autoimmune condition that can cause joint pain, swelling, and deformity in the hands.
Dupuytren’s Contracture:
Dupuytren’s Contracture is a condition in which fibrous tissue in the palm thickens and tightens, causing the fingers to bend into the palm.
Tendon Injuries:
Tendon injuries in the hand, such as ruptures or lacerations, often require surgical repair to restore hand function and prevent permanent disability.
Fractures and Dislocations:
Severe fractures and dislocations of the hand may necessitate surgical intervention to realign the bones and stabilise the hand structure.
Surgical Options for Hand Pain
Surgical treatments for hand pain include different procedures designed to tackle the root causes of discomfort and loss of function.
Carpal Tunnel Release
Carpal tunnel release surgery is designed to alleviate pressure on the median nerve in the wrist due to CTS. The procedure involves cutting the transverse carpal ligament to enlarge the carpal tunnel and reduce pressure on the median nerve, thereby relieving symptoms.
Trigger Finger Release
Trigger finger release surgery treats the condition itself, where a finger becomes locked in a bent position. The surgery involves cutting the affected section of the tendon sheath to allow the finger to move freely again.
Joint Replacement
Joint replacement surgery, or arthroplasty, is performed to replace or repair severely damaged joints due to osteoarthritis or rheumatoid arthritis. Artificial joints made from metal, plastic, or ceramic materials are used to restore mobility and alleviate pain.
Tendon Repair
Tendon repair surgeries address ruptured or severed tendons in the hand. These procedures are important for restoring the hand’s functionality and they involve reattaching the tendon ends or grafting tissue to repair the damaged area.
Dupuytren’s Fasciectomy
Fasciectomy for Dupuytren’s contracture involves the surgical removal of the thickened and contracted fibrous tissue in the palm and fingers. This procedure aims to improve finger mobility by releasing the tension that causes the fingers to bend into the palm.
Considerations for Surgery
Choosing to undergo hand surgery involves thoughtful evaluation of various factors to determine if surgery is the best option. This decision depends on assessing the severity and persistence of symptoms, the effect on daily activities, and balancing the potential benefits with the risks associated with surgical procedures.
Severity and Duration of Symptoms: The consideration for surgery often stems from chronic pain not alleviated by conservative treatments. Without effective surgical intervention, symptoms may progressively worsen over time.
Impact on Daily Life: Hand pain may significantly hamper the patient’s ability to conduct basic tasks, such as gripping or manipulating objects, leading to a profound decline in the quality of life.
Benefits and Risks of Surgery: There are many expected benefits of surgery, such as alleviation of pain, enhancement of function, and prevention of further deterioration. Equally, it is imperative to consider potential risks, including possible infection and nerve damage.
Patient’s Expectations and Lifestyle Considerations: Aligning patient expectations with the realistic outcomes of surgery is fundamental. The decision to proceed with surgery should also take into account the patient’s lifestyle, including work and leisure activities.
Preparing for Hand Surgery
Preoperative Medical Evaluation: A comprehensive medical evaluation is essential to assess the patient’s health and readiness for surgery. This includes reviewing the medical history, performing physical examinations, and conducting diagnostic tests like X-rays or MRI scans.
Medication and Lifestyle Adjustments: Patients may need to adjust their medications to reduce the risk of complications during and after surgery. Patients are advised to quit smoking and limit alcohol consumption to improve surgical outcomes and aid recovery.
Home and Work Preparations: Arranging for time off work is necessary to allow for a focused and uninterrupted recovery period. Set up a comfortable resting area at home and ensure accessibility to essential items.
Conclusion
Hand surgery is a valuable option for those suffering from persistent hand pain and functional limitations, offering a pathway to relief and improved quality of life. For people experiencing hand pain, it’s important to understand the underlying conditions that may require surgical intervention, as well as the benefits and considerations of such procedures. For more information about hand surgery options and to discuss your specific needs, please contact our clinic.