Simon Owen-Johnstone


Hand Symptoms

Numbness and tingling

tingling usually comes from nerves that aren’t working properly, and in the hand the commonest condition is carpal tunnel syndrome. Other nerves can be trapped, and the problem can actually be in your neck


Stiffness maybe after an injury, maybe because of something blocking movement, such as a ganglion, or may come from something affecting the joint surface


Most hand lumps are harmless soft tissue masses such as a ganglion or a mucus cyst . Arthritis can be lumpy too. Sinister lumps are very rare 


Lots of things make hands hurt, including arthritis, sprains and strains, ganglia, inflammation 


Fractures, dislocations, ligament tears, nerve injuries, tendon lacerations, nail problems

Hand Conditions

Carpal Tunnel Syndrome

The median nerve , which supplies sensation to the thumb index and middle fingers, can be trapped as it passes from the forearm into the hand through a narrow tunnel at the wrist. It causes tingling and numbness, often at night.

Therapy, injections or release


A bulge of the capsule of the wrist joint, usually full of rather thick joint fluid. Typically comes out on the back of the wrist but sometimes comes on the palm side near the thumb

We can discuss leaving alone vs injection vs operation

Trigger Finger / Thumb

A nodule forms on the finger tendons at the far end of the palm, and causes them to get stuck . This makes the finger remain either straight or bent, and painful to move between the two

Splint, inject, exercise or operate

Dupuytren’s Contracture

This condition is probably largely genetic , and causes fibrosis of the layer under the palm skin. The layer passes into the fingers, and the disease causes it to shorten , making the fingers bent

Nothing gets rid of it, so intervention is for the consequences. 

De Quervain’s Disease

A very painful condition affecting some tendons near the base of the thumb . Can affect anyone, but is particularly common in new parents

Splint first, inject later, operate rarely

Thumb and finger Arthritis

The base of the thumb is a saddle joint , and rather prone to wearing out prematurely. Women around 60 are the peak group but older and younger, and men, can get this too

Multiple options to be considered

Mucous Cysts

Clear “bubbles” at the base of the fingernail . Due to arthritis, these can be painful and groove the nail

Can be removed under local anaesthetic if needed

Cubital Tunnel Syndrome

The ulnar nerve passes around the medial side of the elbow , and banging it here is colloquially called the funnybone. If it gets trapped it makes the little finger tingle

Generally best to release the nerve

Mallet Finger

A drooping tip of the finger after minor trauma. These do very well if splinted properly (which is really awkward)

Dislocated Finger

Rugby, Cricket, moving furniture and many other causes. Important to put them back together ASAP, then watch for ligament damage and joint contractures

Hand Fractures

Many different patterns, very few of which need surgery, but it takes an expert to know which ones do

Skiers Thumb

A ligament injury, which can usually be treated without surgery, but occasionally need an operative repair


If you have wrist pain, someone will tell you it’s the TFCC, although few know what this really is. A little disc of cartilage between the ulna and wrist bones, easily torn

Wrist Fractures

A complex joint sustains complex fractures. Some are better with surgical fixation, to restore the delicate surface of the joints. Surgery also allows rehab to start sooner, which is always good

Carpal Instability

The eight bones of the wrist move around each other and slide in an incredibly complex pattern to allow the movement we are all used to. When this synchrony  breaks down, pain and clunks follow

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