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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain In The Hands?

My thumb, and the top of my left hand from from my lower thumb to my wrist and extending slightly up my wrileft arm-appropimately 5-6 inches hurts. It just started hurting yesterday. I am left handed. I can t recall anything I did to have cause any injury. A vein that runs along that area seems a bit swollen. When I attempt to use my hand for even the simplist thing, it hurts and is also tender to the touch. Any idea what might be causing this? Dona from Va.
Mon, 11 Apr 2016
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Physical Therapist or Physiotherapist 's  Response
hi,

thank-you for providing the brief history of you.

As you mentioned the pain is in the left side, from the base of the thumb to 2-3 inches towards the elbow. The area is painful to touch as well.

As seeing your symptoms what I can understand is to see two possibilities.
1. De Quervain's Tenosynovitis
2. cervical spine disc degenerative changes.

As you mentioned that you are left handed by nature to perform all activities by left hand the above mentioned two provisional diagnosis comes in mind

1. De Quervain's Tenosynovitis - A test called the Finkelstein test can help confirm de Quervain's tenosynovitis. To do this test, you bend your thumb down across the palm of your hand, and then cover your thumb with your fingers. Next, bend your wrist toward your little finger. If this causes pain, you likely have de Quervain's tenosynovitis

2. Cervical spine disc degenerative changes - The Spurling's test (also known as Maximal Cervical Compression Test and Framonial Compression Test) is used during a musculoskeletal assessment of the cervical spine when looking for cervical nerve root compression causing Cervical Radiculopathy.

Following this two test we can rule out one and diagnosis is close by. Also taking an MRI of the wrist or cervical spine based on the positive test either of the above will help guide confirm the diagnosis.

Treatment -
1. De Quervain's tenosynovitis - physical therapy can help you with the therapeutic ultrasound therapy, phonophoresis, TENS and exercises.

2. Cervical Spine disc degenerative changes - Physical therapy with Ultrasound therapy and TENS therapy initially later performed exercises.

I wish you a good health

for more questions you can ask me and I will be happy to you.

Regards.
Jay Indravadan Patel
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What Causes Pain In The Hands?

hi, thank-you for providing the brief history of you. As you mentioned the pain is in the left side, from the base of the thumb to 2-3 inches towards the elbow. The area is painful to touch as well. As seeing your symptoms what I can understand is to see two possibilities. 1. De Quervain s Tenosynovitis 2. cervical spine disc degenerative changes. As you mentioned that you are left handed by nature to perform all activities by left hand the above mentioned two provisional diagnosis comes in mind 1. De Quervain s Tenosynovitis - A test called the Finkelstein test can help confirm de Quervain s tenosynovitis. To do this test, you bend your thumb down across the palm of your hand, and then cover your thumb with your fingers. Next, bend your wrist toward your little finger. If this causes pain, you likely have de Quervain s tenosynovitis 2. Cervical spine disc degenerative changes - The Spurling s test (also known as Maximal Cervical Compression Test and Framonial Compression Test) is used during a musculoskeletal assessment of the cervical spine when looking for cervical nerve root compression causing Cervical Radiculopathy. Following this two test we can rule out one and diagnosis is close by. Also taking an MRI of the wrist or cervical spine based on the positive test either of the above will help guide confirm the diagnosis. Treatment - 1. De Quervain s tenosynovitis - physical therapy can help you with the therapeutic ultrasound therapy, phonophoresis, TENS and exercises. 2. Cervical Spine disc degenerative changes - Physical therapy with Ultrasound therapy and TENS therapy initially later performed exercises. I wish you a good health for more questions you can ask me and I will be happy to you. Regards. Jay Indravadan Patel