Hands Archive

The typical causes of cramps in the hands include dehydration and straining the muscles with repeated motions like typing. Low calcium or magnesium or a compressed nerve in the wrist may also cause cramping. Stretching the fingers may help.

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:

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 wake up at night with pins and needles in one or both of my hands. I've tried chiropractic treatments, physical therapy, and a special pillow, with no success. What's causing this, and what can I do to stop it?

A. The likeliest cause of your symptoms is compression of one or both of the main nerves that supply feeling and function to your hands. These nerves—the median and ulnar nerves—run from the spinal cord at the neck all the way down to the hands. If they come under pressure at any point along the way, the arm or hand may feel as if it has "fallen asleep."

Q. I have Dupuytren's contracture in both hands. I've had "needle" surgery in one hand, and the fingers straightened. But they seem to want to contract again. What can I do?

A. Dupuytren's contracture is a disorder that develops when the palmar fascia — the tissue between the skin and tendons in the palm — thickens and contracts due to an abnormal buildup of collagen, causing one or more fingers (usually the little and ring fingers) to bend inward. Over time, Dupuytren's can make it difficult or impossible to grasp objects, button buttons, use a computer, and perform many other everyday activities. The treatment you mention sounds like needle aponeurotomy (also called percutaneous needle fasciotomy), in which a needle is used to sever the cords that are causing the fingers to contract. Unfortunately, recurrence following treatment is common.

In the age of swine flu, anthrax, SARS, HIV, and drug-resistant tuberculosis, microbes are high on nearly everyone's list of villains. But scientists have learned to harness some of the most dangerous critters, using microbial components or products to fight disease. Immunizations are the obvious example, but other applications are increasing. For example, while the bacterium Clostridium botulinum can cause lethal outbreaks of botulism, it also produces Botox. And now doctors can inject an enzyme produced by Clostridium histolyticum, a bacterial cause of deadly gas gangrene, to treat a common, sometimes disabling hand condition called Dupuytren's contracture.

What is Dupuytren's?

You may never have heard of the condition or the French surgeon responsible for its difficult name, but you've probably met someone with the problem. Affecting 2% to 42% of various population groups, Dupuytren's is one of the most common chronic hand conditions. It is particularly prevalent in older white men of Northern European descent; President Ronald Reagan was one of the many famous people who've had Dupuytren's.

Painful conditions like de Quervain's tenosynovitis, inflammation of the tendons that move the thumb, and stenosing tenosynovitis, or trigger finger, when a digit becomes locked, can develop due to overuse or repetitive movement.

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).