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pain in the top of my hand that generates from

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Neurologist
Practicing since : 2004
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Question
pain in the top of my hand that generates from below my wrist into my first finger and between the first and middle fingers. Feels like a sharp or tearing feeling when I stretch my hand too far. It feels like a vein or tendon is moving as i touch it.
The pain starts in the middle of my hand and when I press gently on it - it radiates pain into the first finger. Feels like it a tendon is moving. The finger feels a little stiff from the hand to the first 1/3 of the finger only. If I ball my hand by accident it feels like something is tearing. Rest on the hand has the most results but it is isn't getting worse or better for over 5 weeks.
Posted Wed, 6 Dec 2017 in Bones, Muscles and Joints
 
 
Answered by Dr. Olsi Taka 1 hour later
Brief Answer:
Carpal tunnel syndrome most likely.

Detailed Answer:
I read your question carefully and I understand your concern.

Judging from your description and the distribution of the pain I would say that the most likely diagnosis is that of carpal tunnel syndrome. It results from compression of the median nerve (which supplies sensation for the first 3 fingers) in the wrist as it traverses the carpal tunnel, a small tunnel where the median nerve and tendons pass. Contributing factors may be many such as prolonged compression and repeat use of the wrist, arthritis, diabetes, genetic predisposition etc.

Of course the diagnosis has to be confirmed, usually a routine test called nerve conduction study (NCS) is enough to identify whether there is nerve suffering and the site of damage.

If confirmed management consists first in trying to remove predisposing factors if possible, rest, splinting of the wrist. If those do not work or the NCS shows the damage to be of an advanced stage, a simple surgical procedure may be done to relieve the pressure (really simple, will be back home on the same day).

I remain at your disposal for other questions.
Above answer was peer-reviewed by
 
Follow-up: pain in the top of my hand that generates from 1 hour later
Thank you for your answer Dr. Taka.
I am confused on how I would contract carpel tunnel. I don't sit at a computer all day, I don't play an instrument and it is my left hand. I am right handed. When I do type at the computer I don't have any issues or pain in my hands.
I just moved, and I remember banging my hand pretty hard but it was like a normal passing situation that didn't have any immediate repercussions.

Is carpel tunnel something that can occur without a reason for it?

Thank you. XXXXXXX
 
 
Answered by Dr. Olsi Taka 9 minutes later
Brief Answer:
Read below.

Detailed Answer:
Thank you for the update.

Yes, carpal tunnel syndrome can occur without a cause being found. Actually there are often patients who may present with symptoms on both hands (either at the same time or at different periods in time), whether the left or right hand doesn't support or exclude the diagnosis. The factors I mentioned above are possible contributors but aren't necessarily found, in most patients the cause is unknown and is thought that genetic factors may be at play.

So my opinion remains more or less the same, I still see it as the most likely diagnosis. Of course in medicine there rarely are certainties (even more so in this virtual setting where I can't conduct a physical exam on you), that is why nerve conduction study is recommended to confirm the diagnosis.

Let me know if I can further assist you.
Above answer was peer-reviewed by
 
Follow-up: pain in the top of my hand that generates from 17 minutes later
Thank you. XXXXXXX
 
 
Answered by Dr. Olsi Taka 1 minute later
Brief Answer:
Hope you'll feel better soon.

Detailed Answer:
You're welcome, hope you'll feel better soon.
Above answer was peer-reviewed by
 
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