There are 27 bones in the human hand. An injury to any one of them or a disease that affects the bones, tendons, muscles or blood vessels in the hand, are the most likely causes for pain in the hand and tenderness.

Some of the most common conditions that cause hand pain are:

De Quervain's Tendinitis: Pain on and around the thumb is the characteristic sign of this condition. This pain may develop gradually or come on suddenly and can travel the length of the thumb and forearm. De Quervain's tendinitis is caused by the swelling of wrist tendons at the base of the thumb. Repetitive actions and overuse are the most common triggers for this condition.

Carpal Tunnel Syndrome: The symptoms of carpal tunnel syndrome are felt mainly in the thumb, index finger and middle finger. This pain is often worse at night and is caused by the swelling of inflamed tendons at the base of the hand that puts pressure on the median nerve. This syndrome can make it very difficult for a person to grip objects.

Fractures: The fracture can cause extreme pain along with stiffness, swelling and loss of movement. A fracture refers to the breaking of a bone and can be of many types including simple fractures, complex fractures, comminuted fractures and compound fractures. The type of fracture dictates the type of treatment required. Spraining a muscle in the hand is another leading cause of pain in the hands.

Arthritis: This is one of the most common causes of pain in the hand that is related to ageing. Arthritis causes loss of cartilage that makes the movement of one bone against the other extremely painful. It may or may not also be accompanied by swelling. When it comes to the hand, arthritis affects the base of the thumb and middle or top joints of the fingers. Osteoarthritis may also cause bony nodules to be formed on the fingers.

Trigger Finger: This condition is also known as stenosing tenosynovitis. This condition locks the fingers or thumb in a bent position. This condition is triggered by the flexor tendons getting irritated. These tendons control the movements of the thumb and fingers. As the tendon is inflamed, the sheath that surrounds the tendons may also thicken and nodules may form of the affected tendons. People suffering from rheumatoid arthritis, gout and diabetes are at a high risk of suffering from this condition.

Pain And Tenderness In Bones Of The Hand - Factors That May Cause it!

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases. Based on the affected bone and impact, different types of fractures are commonly identified as:

Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
Incomplete: When the breakage is incomplete, where the bone has cracked, but does not break into pieces, it is known as an incomplete fracture.
Another type would be the open or closed fracture:
Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, here are different types including hairline, greenstick, oblique, etc.
What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

Develop an exercise routine to strengthen the muscles
Manage weight
Use the right footwear and exercise gear
Watch your medications (avoid sleep inducing ones)
Increase lighting in the room/home to improve clarity of vision for elderly
Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedroom, using rubber mat, etc.
While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage.

Bone Fracture - Common Types and How They Can be Prevented?

Clubfoot is a deformity of the foot in infants. The condition is usually present from birth. This happens when the tissues linking the muscles to the tendons are shorter than usual, as a result of which the infant s foot appears twisted and out of shape. The condition can be mild or severe, depending on the symptoms. Often times, babies who are born with clubfoot have it in both the legs.

How to identify if your child has clubfoot?

Since the condition is present from birth, the symptoms are also easily observable. Identifying the following signs can help detect if your child is born with clubfoot-

  A foot that turns downward and inward and toes that point towards the opposite foot
  The affected foot may appear half an inch shorter than the normal foot size
  The heel of the affected foot may be smaller in size than it normally should be
  The calf muscle on the affected leg will be underdeveloped (appear slightly smaller)
  If the condition is severe, the foot may be twisted upside down

Despite its unusual shape, clubfoot does not cause pain or discomfort. The doctor will most likely notice the symptoms after the infant s birth. He/she will recommend appropriate treatment of the condition, or refer to an orthopaedic who specializes in muscle and bone ailments.

What is the treatment of clubfoot?

Clubfoot is curable so parents need not worry about their child living with a lifelong deformity.

Depending on the severity of the condition, the orthopaedic will either use devices, resort to stretching methods, or will recommend surgery.

  Ponseti Method (stretching and casting) - It is the standard treatment worldover. It starts at birth or anytime within two weeks of age and has best results in younger kids. It involves stretching the clubfoot and casting it in correct position several times over the months to restore the foot shape.
  French Functional Method (stretching and taping) - The doctor will stretch the affected foot and tape it in position several times over a couple of months to realign the shape. It, however, has very limites following.
  Surgery - Surgeries may be needed in older neglected kids or adults. The surgeon performs a surgical procedure (Achilles tenotomy) to lengthen the tendon of the clubfoot and realigns the joints and bones. Following the surgery, the child will need to be in a cast for about 2 months. Further, to prevent the recurrence of the condition, the child will be advised to wear braces for a year at least.
  Devices - They are adjunctive maintenance devices which are used by doctors in treatment of clubfoot. They are applied to the body to stabilize and limit or protect the movement of the damaged joint.

Parents should seek medical intervention if their baby is born with clubfoot. If the condition is not treated early, the child may face difficulty walking, or may even develop other disorders affecting the joints, like arthritis.

Clubfoot - Ways To Identify & Treat It Well!

Majority of bone tumours are benign, meaning they are localised and do not spread. Since benign tumours do not metastasize, they are not forms of cancer. Despite not being malignant, the severity of their presence should not be ignored as they may cause a lot of pain and lead to other problems such as damaged bones and fractures.

Benign Bone Tumors

Osteochondromas: These form over 40 per cent of all benign bone tumours. They are mostly found in children and teenagers. Osteochondroma is a growth abnormality and they are found in the growing ends of long bones. An osteochondroma might grow separately or might be accompanied by other similar tumours.
Osteoclastomas: They are also called giant cell tumours of the bone. They are common and are found in the epiphysis of long bones and around the knee.
Osteoid Osteoma: These grow mostly in adolescents and very rarely in adults above 50. They primarily grow in the legs but they might also be found in other bones in the body.
Enchondroma: It is a bone tumour that starts in the cartilage. It is mostly found in the cartilage of the inner lining of bones. Small long bones of the feet and the hands are affected the most. Teenagers get more affected than other age group.
Osteoblastoma: These are slow growing tumours that take about two years to get diagnosed. An osteoblastoma makes the surrounding bones weaker as they dissolve them and make them more susceptible to fracture caused by small injuries. Men are twice as more likely to be affected by an osteoblastoma than women. Surgery is essential in all cases of osteoblastoma as they destroy healthy functional bone and grow in size with time.
In rare cases, these have also known to become malignant over time, despite their benign nature. It affects people under 30 mostly.

Malignant Bone Tumours

Osteosarcoma: It affects the hip, knees and shoulders of mostly children and teenagers. It is also referred to as osteogenic sarcoma.
Ewing Sarcoma Family of Tumours: These generate from medullary cavities and can also grow in blood vessels and adipose tissues. It primarily affects children and teenagers.
Chondrosarcoma: It usually affects the hips, pelvis and shoulders of middle aged people.

5 Most Common Types Of Benign Tumours!

Osteoporosis is a disease that affects the bones of a patient. This is most commonly found in women, especially in those women who are close to or going through, menopause. Hormonal changes around this period in a woman's life usually lead to various changes in her body. One of these changes include loss of bone tissue which can leave the patient with brittle and weak bones, a condition that is also known as osteoporosis. This condition literally imbibes the word porous, meaning hollow bones. It is born from an acute deficiency of calcium and vitamin D. The DEXA Scan or bone density test, also known as the Dual Energy X-ray Absorptiometry Scan, is one of the most effective tests that can help you in detecting this kind of damage or thinning bones. Here's why.

    Fractures: The DEXA Scan is an important one because it sends low energy beam to areas like your joints and tissues to show how susceptible you are to fractures. It does so by measuring the strength of the tissues as well as the bones to see how brittle they may be.
    Other Ailments: Measuring the thinning of your bones can also point to the presence of other ailments that may have gone unnoticed or undetected, earlier. These can include kidney disease, hyperparathyroidism which happens due to overactive secretions of the said gland, as well as liver disease due a malfunctioning liver, intestinal disease and various disorders in the intestinal tract, and a serious vitamin D deficiency. With this scan, you can get an insight into the other parts of the body affected by the bone density and whether or not they are functioning properly.
    Estrogen: Simply checking the estrogen levels cannot ascertain whether or not you have osteoporosis, as a high estrogen level can be credited to a particularly heavy period cycle. It does not show the bone health the way a DEXA Scan does.
    Easy and Standardised: This method of scanning usually happens with the help of a mounted X ray machine type, hand held gadget which can be extended to conduct the scan. This is an easy and standardised method that releases low levels of radiation which also makes it a healthier option.
    Bone Density Scores: The T Scores and Z scores point towards the bone density and help in diagnosing the condition efficiently. With a systematic scoring system, it is a sure shot test for osteoporosis.

Osteoporosis is a serious condition. The first step in treating the same is to get a detailed scan like the DEXA scan done, so as to test the extent of the bone thinning to ensure that proper and timely treatment takes place.

Why is the DEXA scan important for osteoporosis patients?

Most bone fractures mend very easily with proper medical treatment and rest. However, in rare cases, a fracture caused by trauma may not mend even after adequate treatment. When a broken bone fails to heal, it is known as non-union. There are two major reasons for non-union:

  Bone lacks adequate stability

All broken bones require stability to heal. In case of a fracture, doctors place the dislocated bone in its original place and use an external device to hold the broken part in place. Usually, this stability is provided by a splint or cast, but can also be offered by frames and rods as well. However, if the broken bone lacks the required support, it may not set or heal properly, leading to the non-union.

  Fracture lacks proper blood supply

Even with proper stability, a broken bone requires a proper blood supply to start the healing process. The blood carries oxygen and other chemicals that aid in the repair of the bone and makes it crucial during the recovery stage. However, if the blood supply is disrupted, the bone cannot heal and leads to non-union.



Risk factors of non-union:

You are more likely to suffer from non-union if one or more of the following is true in your case-

  People who engage in cigarette smoking and any other form of nicotine addiction have a higher risk of non-unions after a fracture
  Older people can often face non-union, which is why fractures may take longer to heal in these people
  Severe anaemia can often restrict proper blood flow to the broken bone, thus inhibiting the healing procedure
  Similarly, people suffering from diabetes face a greater risk of non-unions
  Lack of proper nutrition may also be blamed for the non-union
  Non-union risks may increase because of side effects from certain medication, such as prednisone, ibuprofen, and aspirin. Consult your doctor in such a case, so that proper precautions can be taken accordingly.

Non-surgical treatment can be used for treating the non-union. Electromagnetic and ultrasound waves are passed through the skin and into the affected bone, in order to treat the non-union. In most cases, this treatment is very effective in curing the fracture. However, if the non-surgical treatment proves ineffective, surgical procedures, such as bone grafts and allograft can be utilized.

Trauma And Nonunion - The Various Risks Involved With It!

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