Hand and wrist: understanding and treating complaints

Anatomy of the hand and wrist – briefly explained

The wrist connects the radius (radius) to the carpal bones. It allows bending, stretching and side bending. The hand consists of eight carpal bones, five metacarpal bones and the phalanges. Numerous ligaments stabilize the fingers, tendons move the fingers, and nerves provide feeling and strength.

• Bones and joints: radius and ulna, carpus (e.g. scaphoid/scaphoid, lunate/lunate), metacarpal, finger joints; Important joints: radiocarpal joint, midcarpal joint, thumb saddle joint
• Bands and capsules: stabilization, e.g. B. scapholunate ligament; on the ulnar side the TFCC complex (discus triangularis)
• Tendons: Flexor and extensor tendons with sliding tissues and annular ligaments
• Nerves: median (thumb, index, middle finger), ulnar nerve (little finger side), radial nerve (extensor side – sensitivity)
• Vessels: Radial and ulnar arteries form palmar arches for blood circulation in the hand

Frequent hand and wrist complaints

• Pain on the ball of the thumb or during twisting and supporting movements
• Pressure and rest pain in the wrist (radial or ulnar)
• Tingling, numbness, hand falling asleep at night
• Weak grip, loss of strength, uncertainty when holding
• Swelling, snapping of fingers, clicking or rubbing
• Restricted movement, morning stiffness, feeling warm

Complaints can occur suddenly after a fall or develop gradually due to overuse. An exact classification is usually achieved through a combination of anamnesis, examination and targeted imaging.

Typical causes and diagnoses at a glance

Hand problems have many faces - from irritation of the tendons to joint wear and tear to nerve congestion syndrome. The following categories lead to our subpages with details on symptoms, diagnostics and therapy:

• Muscles, tendons, ligaments: tendonitis (e.g. de Quervain), trigger finger, ligament overstretch/tear, instability
• Joints and cartilage: Osteoarthritis (e.g. thumb saddle joint/rhizararthrosis, wrist), cartilage damage, TFCC lesion
• Nerves: carpal tunnel syndrome (median nerve), Loge de Guyon syndrome (ulnar nerve), nerve irritation
• Bones: Fractures (e.g. distal radius, scaphoid), bone bruises, nonunion
• Blood circulation: circulatory disorders, Raynaud's phenomenon, swelling pattern
• Trauma and acute injuries: fall injuries, cuts, ligament and tendon tears
• Functional and chronic pain diagnoses: overuse syndromes, myofascial pain, complex regional pain syndrome (CRPS – to be clarified by a specialist)

Topics and subpages hand/wrist

You can find more detailed information on our subpages. Choose the category that best suits your symptoms:

• Muscles, tendons, ligaments – irritation, inflammation, instability
• Joints and cartilage – osteoarthritis, cartilage damage, TFCC
• Nerves – carpal tunnel, Loge-de-Guyon, sensory disorders
• Bones – fractures, bruises, scaphoid problems
• Blood circulation – Raynaud’s, swelling, healing process
• Trauma and acute injuries – first aid to therapy planning
• Functional and chronic pain diagnoses – long-term strategies

Diagnostics: step by step to the cause

Our goal is a precise, gentle clarification. A combination of examination and ultrasound is often sufficient; Further diagnostics are used specifically.

Conservative therapy first – which is what we often use

• Advice and adjustment of the load: breaks, ergonomic aids, gripping techniques
• Temporary immobilization: functional splints or tapes for acute irritation
• Physiotherapy and hand therapy: tendon gliding, scar management, strength and coordination
• Occupational therapy: everyday strategies, splint provision, workplace adaptation
• Medication: anti-inflammatory ointments, if necessary short-term tablets as indicated
• Injections: locally targeted – e.g. B. with tendonitis or trigger finger; Benefit-risk is weighed individually
• Puncture/relief: e.g. B. in the case of painful ganglia or joint effusion after explanation
• Pain management: cold/warm, gentle activation, if necessary multimodal approaches for chronic processes

Conservative measures provide significant relief for many hand problems. The course and goals are determined together; Immobilization that is too early or too long is avoided in order to prevent loss of function.

Regenerative processes – selected and with information

Biological treatments such as platelet-rich plasma (PRP/autologous blood) or cartilage-sparing injections are used selectively in hand orthopedics - for example in the case of tendon attachment irritation or early arthrosis (e.g. thumb saddle joint) after careful indication.

• Goal: Pain relief and functional improvement through biological stimuli
• Evidence: heterogeneous depending on diagnosis and stage - an individual consultation is important
• Approach: clearly defined therapy goals, accompanying hand therapy, regular follow-up

Treatment success cannot be guaranteed. We discuss benefits, alternatives and possible risks transparently.

When does an operation make sense?

Surgical procedures are considered when conservative measures have been exhausted or structural damage requires prompt stabilization.

• Fractures with malalignment or instability (e.g. displaced distal radius fracture, scaphoid fracture)
• Complete tendon tears or severe ligament ruptures with instability
• Therapy-resistant carpal tunnel syndrome with progressive numbness/weakness
• Painful, functionally limiting osteoarthritis with failure of conservative options
• Free joint bodies, pronounced TFCC lesions with blockages

The decision is made individually based on findings, everyday requirements and risk-benefit assessment. We provide you with open-ended advice and coordinate hand surgical partners if necessary.

Prevention: What you can do yourself

• Set up the workplace ergonomically: neutral wrist position, gel pads, adapted mouse/keyboard
• Schedule regular breaks: micro-breaks when working on the keyboard and smartphone
• Changing gripping techniques: alternate power grips, use aids
• Warm up and stretching: before sports and hand-intensive activities
• Plan to increase your load slowly: for new sports or instruments
• Skin and scar care after injuries: Follow hand therapy instructions

Warning signs: Please have this clarified promptly

• Sudden numbness or feelings of paralysis
• Pale, cool or bluish fingers, no pulse
• Severe pain and swelling after a fall
• Severe pain at rest, fever or redness - suspected infection
• Open injuries, visible misalignment or bone cracking under stress
• Pain that does not subside for several weeks despite rest

If you experience such signs, a medical examination is urgently recommended to avoid complications.

Your orthopedic contact point in Hamburg

We combine precise diagnostics with therapies suitable for everyday use. This includes structured functional examinations, high-resolution ultrasound and a network of experienced hand therapists. Our focus is on conservative solutions; We accompany you from acute cases to long-term stabilization.

Practice address: Dorotheenstraße 48, 22301 Hamburg. You can easily obtain appointments online via Doctolib or by email. Bring preliminary findings and imaging with you, if available - this will make it easier to provide targeted advice.