Hands Archive

Inside your wrist, a slick tunnel passes through the carpal bones. The nerves and tendons of the wrist pass through this space, called the carpal tunnel. One of these nerves, the median nerve, controls sensations in the palm side of the thumb, the index and middle fingers, and half of the ring finger. It also transmits the impulses to certain hand muscles that allow the fingers and thumb to move. Carpal tunnel syndrome occurs when this nerve becomes irritated or squeezed. Symptoms include numbness, tingling, pain, or weakness in the hand of the affected wrist.

Because the carpal tunnel starts out narrow, it doesn't take much to aggravate or compress the median nerve. A number of conditions can make a person more prone to carpal tunnel syndrome. These include:

Q. You wrote about weak, brittle fingernails with longitudinal ridges. I have strong nails with horizontal ridges. What causes this, and what can I do about it?

A. You may be referring to Beau's lines, which are grooves that run horizontally across the nail plate. They usually develop when nail plate growth, which begins in the nail matrix (located under the cuticle), is temporarily disrupted. This can occur with direct injury to the nail matrix; an inflammatory condition such as psoriasis; infection around the nail plate; repetitive picking at the nails or cuticles; or even a manicure. Systemic causes include a common side effect of chemotherapy, nutritional deficiencies, illnesses accompanied by high fever, metabolic conditions, and diminished blood flow to the fingers (from Raynaud's phenomenon, for example).

Your hands perform countless small and large tasks each day—from pouring coffee, brushing teeth, and buttoning shirts to raking leaves or kneading bread.

But aching hands can transform the simplest task into a painful ordeal. Hands can hurt for a variety of reasons, from the mechanical to the neurological. Arthritis—which affects one in five American adults—and other persistent joint problems are by far the most common cause of hand pain and disability.

Q: I have strong hand cramps that curl my fingers into a claw shape. I can only straighten them by using my other hand. What can I do to keep this from happening? 

A: What you describe sounds like carpal spasm. Spasms, or cramps, are involuntary muscle contractions. The most common causes of spasms are overused muscles (in the hands that might be due to writing or typing) and dehydration. Other causes of muscle cramping include low levels of calcium and magnesium.

Repetitive motion and poor posture can lead to aches and pains.

 Image: © Johnny Greig/Getty Images

You've mastered the art of texting, emailing, and web surfing on your smartphone and computer. But along with that digital prowess, you've picked up an unexpected side effect.

"We get a number of patients who develop injuries from these activities," says Dr. Tamara Rozental, an orthopedic surgeon who specializes in hand, wrist, and elbow disorders at Harvard-affiliated Beth Israel Deaconess Medical Center.

Inflammation is a key component of arthritis and other chronic joint diseases. Gout, a painful and potentially debilitating form of inflammatory arthritis, develops when tiny, needle-shaped crystals of uric acid (a biological waste product) accumulate in the joints. The presence of these uric acid crystals triggers the release of cytokines, and these inflammatory messengers attract neutrophils and other white blood cells to the scene. Gout usually affects one joint at a time, most often the big toe, but sometimes it occurs in a knee, ankle, wrist, foot, or finger. 

Early on, gout flare-ups tend to be intermittent. If gout persists for a long time, the joint pain can be ongoing and mimic other types of arthritis. After several years, uric acid crystals may collect in the joints or tendons. They can also collect under the skin, forming whitish deposits. They are called tophi, lumps of tissue that form under the skin of fingers, knuckles, and elsewhere. 

Aches or numbness may keep you from doing the things you love. Find out what's behind your pain, and do something about it.

Hand pain becomes common as we get older. Tingling and numbness, aching or locking joints, and difficulty grasping objects are frequent complaints. But don't make your own diagnosis and suffer in silence. "It's difficult to discern between different types of hand pain. Some have overlapping symptoms," says Dr. Sang-Gil Lee, a hand surgeon at Harvard-affiliated Massachusetts General Hospital.

Dr. Lee advises that you seek treatment as soon as possible for persistent hand pain, before it gets so advanced that it's tough to use your hands for even the simplest jobs, like brushing your teeth or buttoning a shirt.

Raynaud's phenomenon—an extreme reaction to cold—can be annoying, or it may signal a serious chronic condition.

 Image: Bigstock

If you live in the northern latitudes, you may have already had an episode in which your fingers froze or your nose, toes, or earlobes grew cold, pale, and numb. And if you're a southerner, you might have neighbors who migrated to avoid such episodes. While some people with chilly fingers just have cold sensitivity, others—especially women—may have Raynaud's phenomenon.

What is Raynaud's?

Living with Raynaud's

Your ability to grab, hold, twist , and squeeze is essential for many everyday functions.

Image: JannHuizenga/Thinkstock

Think how much you rely on a strong grip every day. It helps you open cans, grip a golf club, hold a steering wheel, brush your teeth, and pick up a grandchild. "The ability to stay active and independent often begins with our hands," says Maria Cole, a physical therapist with Harvard-affiliated Spaulding Outpatient Center. "Weak grip strength can limit your enjoyment of many life pleasures, so you need to ensure your hand and grip strength always are up to the task."

A measure of health

Exercise your hands

A few simple exercises can preserve the strength and flexibility of your hands and wrists.

 Image: Thinkstock

There's a reason that "having a good grip on the situation" is used as a metaphor for mastery. In physiological testing, grip strength is one of the indicators of health and vitality. Yet, although we may exercise to strengthen our cores and limbs, most of us don't make an effort to strengthen our forearms and our hands. "We use our hands continually, but we don't take the time to deliberately exercise them," says Joanne P. Bosch, a physical therapist and certified hand therapist at Harvard-affiliated Brigham and Women's Hospital.

That said, it's not a good idea to rush out and buy a device promoted for building a "crushing hand grip" or to start squeezing a tennis ball. "Doing the wrong exercise can actually exacerbate some problems, particularly carpal tunnel syndrome," Bosch says.