Hand, Wrist, and Elbow Overuse Injuries

Recognized by U.S. News & World Report

UT Southwestern Medical Center has earned a "High Performing" rating from U.S. News & World Report for orthopaedic care, placing us among the nation’s leading hospitals in this area of care.

UT Southwestern Medical Center’s orthopaedic surgeons specialize in caring for the many bones in the hand, wrist, and elbow, as well as the intricate network of tendons, ligaments, and muscles that connects them.

Because the hand, wrist, and elbow are crucial for everyday activities, the goal of orthopaedic experts at UT Southwestern is to provide personalized care to enable patients to regain full use of their hands and arms as soon as possible. 

Specialized Care for the Hand, Wrist, and Elbow

Overuse injuries in the hand, wrist, and elbow can happen as a result of repetitive motion related to sports, work, or hobbies. 

Our combined 50 years of experience as hand surgeons make our doctors experts at diagnosing and treating overuse injuries in the hand, wrist, and elbow.

Because postoperative care is crucial to recovery, our surgeons collaborate with certified hand therapists to create comprehensive treatment plans for each patient. We also offer patients access to the latest technology, fixation devices, and surgical techniques to ensure excellent results.

Symptoms of Hand, Wrist, and Elbow Conditions

Symptoms of hand, wrist, and elbow overuse injuries appear in different ways. Examples include:

• An injured thumb or finger, as in de Quervain’s tenosynovitis or skier’s thumb, can cause pain or swelling near the base of the thumb, difficulty grasping or pinching, or a sticking sensation in the thumb.
• Golfer's, tennis, or baseball elbow can cause minor pain during activity and rest or a sudden pain during actions such as throwing, lifting, and reaching. These conditions often result in loss of strength and motion in the arm.
• Patients with carpal tunnel syndrome often have numbness in the fingers, hand, or arm. They might experience decreased grip strength that makes it hard to grasp small objects, write, or perform other common tasks.
• Symptoms of a ganglion cyst, a common injury in gymnasts, are hard bumps on the wrist that are painful and limit motion.

Diagnosis

Diagnosing the cause of hand, wrist, or elbow overuse injuries always starts with a physical exam and patient history. Our surgeons take time to talk with patients individually, find out how the injury is affecting them, and then tailor treatment to best suit their needs.   

We sometimes use X-rays, magnetic resonance imaging (MRI), and ultrasound to get a better look at the injury and rule out tumors, arthritis, fractures, or other conditions.

Conservative Treatments

For most overuse injuries, we first recommend conservative treatment that starts with rest, ice, and anti-inflammatory medications. If the pain persists, we’ll discuss other treatment options that might include nonsurgical and surgical approaches. 

Nonsurgical treatments include:

• Aspiration of a cyst to release the liquid
• Physical or occupational therapy using exercises to strengthen the hand, wrist, or elbow or decrease pressure on the injured area or recommendations to reposition a patient’s hands or arms during work or sports to reduce pain and aid healing
• Medication or injections of a steroid or cortisone at the site of the pain
• Splints for carpal tunnel syndrome or other elbow conditions to straighten the wrist or arm to keep it from flexing or extending, which reduces pressure on the nerve

Surgery for the Hand, Wrist, and Elbow

Hand surgeons were among the first to use minimally invasive surgical techniques, conducting complex surgeries through small incisions in the hands, wrists, and arms. 

Surgeries that we offer include:

• Carpal tunnel release surgery: Our surgeons have extensive experience performing endoscopic carpal tunnel release surgeries. Small, powerful cameras are used to direct the surgeon as he or she releases the tight ligament over the nerve. Endoscopic carpal tunnel release surgery typically results in faster healing and fewer complications.
• Excision surgery: For ganglion cysts that return after aspiration, excision surgery is sometimes offered to remove the cyst altogether.
• Ligament reconstruction surgery: When ligaments in the hand, wrist, or elbow are injured from overuse, we offer endoscopic ligament reconstruction surgery to stabilize the joint by sewing the tendons or nerves end-to-end using high-powered operative microscopes.
• Thumb surgery: For patients with skier’s (or gamekeeper’s) thumb, our surgeons make small incisions in the hand and use sutures beneath the bone to sew the tendon back to the bone in its original position so it can heal properly.
• UCL reconstruction (or Tommy John surgery): When the UCL in the elbow is injured, we offer elbow reconstruction to replace the torn ligament with a tendon from somewhere else in the body. This surgery is most often performed in baseball players. 

Following surgery, our certified hand therapists will work closely with each patient to ensure he or she regains full use of the hand, wrist, or elbow.