When people injure their hand or wrist and are concerned they may have a fracture or other injury, they often seek treatment immediately in the emergency department. Often parents of young children want peace of mind and go to an emergency department to get an x-ray. Unfortunately, the end result is usually a large bill and instructions to follow-up with an orthopedic surgeon. Unless there is severe pain, deformity, crushed tissue or open wounds, there is no need to rush to an emergency department or urgent care for treatment.
Getting the Right Care at the Right Time in the Right Place
If you have an injury to the hand or wrist, it is important to have the injury properly assessed and treated. We encourage patients to make an appointment as soon as possible. Some patients wait to see if the injury gets better with time and only seek treatment if it does not get better, and others may have heard x-rays should wait until the swelling goes down. Neither is true. It is better to get an accurate diagnosis as soon as possible. In many cases, delay in diagnosis makes treatment more difficult.
The ideal time frame to be seen with a hand or wrist injury is as soon as you can – the next business day if possible. We recommend you either make an appointment with an orthopedic specialist or go to an orthopedic walk-in facility where you do not need an appointment to be seen. In the meantime, while you are waiting to see an orthopedic specialist, purchase a splint or brace at a pharmacy to immobilize the injured area. An over-the-counter splint for a finger or a brace for the wrist can be very helpful in providing comfort and protection.
For walk-in and same-day options, see our orthopedic urgent care page. You can have x-rays taken and be seen by an orthopedic specialist at a regular specialist visit charge to your insurance. This can save money and time getting an accurate diagnosis and treatment plan.
Common Signs of an Injury that Need Care from an Orthopedic Hand Specialist
- Any deformity in the hand or wrist
- Swelling in the affected area
- Bruising
- Pain with movement or decreased range of motion
- Laceration that has caused limited movement or numbness
Even if you do not have these symptoms, but you have any injury that is causing pain, limited range of motion, tingling or numbness it is important to be evaluated. Finger fractures are not always deformed or significantly swollen but still may require surgery to be properly aligned. Even if you can bend or move it, there may still be a fracture. Some fractures, usually in the wrist, cannot be seen on an x-ray and may require an MRI. Dislocated joints or jammed fingers can result in ligament or tendon injuries that need to be accurately diagnosed and treated to avoid long-term deficits. Without proper care and diagnosis, some injuries result in permanent stiffness, decreased range of motion, joint laxity, or even post-traumatic arthritis.
Hand Injuries: A Two-Part Process
When we are treating hand injuries, we focus on two goals: relieving pain and restoring the function of the hand. Not only do you want to feel better, but it’s critical to make sure the hand is working properly.
If you injure your hand and it seems like a minor injury, then you might try at-home treatments first to see if you can manage the pain and swelling without medical care. When the symptoms continue to worsen, or you have mobility concerns, then it’s best to talk to an orthopedic specialist as soon as possible.
We use a thorough diagnostic process, including an examination and digital imaging as necessary, to determine the underlying cause of your injury. The doctor will also ask questions about the length of time you’ve been in pain, when the injury occurred and other symptoms that coincide with the pain.
Two Types of Hand Injuries
Orthopedics are helpful for treating both acute and chronic hand injuries:
- Acute Hand Injuries: An acute injury means that an accident happened, and you suddenly have new pain. These injuries often require medical treatment, and the pain goes away when the injury heals. Examples of acute injuries include broken bones from a sports accident or car accident.
- Chronic Hand Injuries: Some patients can’t identify a specific time when their hand was injured. Instead, the pain slowly crept in, resulting in a situation where the pain is fluctuating or ongoing for weeks or months. Chronic hand injuries are often caused by repetitive motions, such as carpal tunnel from typing. Or, they can happen in people with autoimmune diseases and other health conditions.
Treatment varies depending on the type of injury we are dealing with and the underlying cause of the injury. Our team of orthopedic doctors works closely with each patient to identify an accurate diagnosis so we can design a personalized treatment plan.
Treatment Options for Hand Injuries
What is the best way to alleviate your pain and help your hand heal as quickly as possible? Here are a few options that your orthopedic doctor might recommend:
RICE Method
This at-home remedy can be used on any injured part of the body, not just the hands. RICE stands for rest, ice, compression and elevation. These four steps can be an effective way to reduce inflammation and alleviate pain associated with tendonitis, strains and sprains.
When an acute injury occurs, it’s important to give yourself at least one to two days for recovery. During this time, follow these RICE steps:
- Rest: Minimize the use of that hand as much as possible. Take it easy to avoid straining the injured areas.
- Ice: Apply an ice pack to the injury every few hours for 15 to 20 minutes each session. Ice helps to relieve pain and reduce inflammation at the same time.
- Compression: A bandage or hand brace can be helpful to stabilize the hand and reduce the swelling at the same time.
- Elevate: When you are resting, place the hand on a pillow or elevated resting place above the heart. This helps to minimize swelling.
RICE can be helpful for mild or moderate hand injuries. It’s still a good idea to visit an orthopedic doctor to rule out more serious injuries.
Medications
Over-the-counter pain relievers and anti-inflammatory medications can be helpful in alleviating your pain and reducing swelling. Talk to your doctor about the right dosages and types of medications.
For more serious injuries, your orthopedic doctor might recommend a prescription pain reliever. Many doctors try to avoid these stronger drugs whenever possible because of the risk of dependency.
Another alternative to taking pills is to use anti-inflammatory injections. This minimally invasive treatment includes both anesthetic medication (to target the pain) and steroids (to target the inflammation). The treatment can be done in an orthopedic office.
Physical Therapy
Not only is physical therapy a crucial part of your recovery process, but these exercises can minimize the risk of re-injuring your hand again in the future. For mild and moderate injuries, you can meet with a physical therapist a few times to design a personalized physical therapy plan.
Then, you will have exercises to do at home. These exercises focus on building strength and improving flexibility. Physical therapy can be an effective treatment for both acute and chronic hand injuries.
Maintaining consistency with your physical therapy exercises is one of the most effective things you can do to restore function in your hand. These targeted exercises are helpful to ensure you have proper mobility and function in all of the fingers.
Hand Surgery
Our team at OrthoTexas prefers to use minimally invasive treatments whenever possible. But if the other treatments aren’t working for you, then you might need to talk to the doctor about more intensive treatment options – such as surgery.
Sometimes, hand surgery is the only option for an acute injury caused by severe trauma because it’s necessary to realign the bones, muscles, ligaments and tendons. Or, surgery might be a good option to consider if you have a chronic hand injury that isn’t getting better.
Expert Care from the Right Expert
There are 27 bones, 27 joints, 34 muscles, over 100 ligaments and tendons, and many blood vessels and nerve in our hand and wrist. An orthopedic hand surgeon has in-depth knowledge of this complex anatomy and extensive training in treating hand and wrist problems. It is also important to note that a hand surgeon is qualified to diagnose and treat injuries both surgically and non-surgically.
We use our hands and fingers daily working, performing activities of daily living, and playing sports or instruments. It is important to make sure that if your hand or wrist is injured, proper care is provided from a doctor who specializes in treating such injuries so proper pain free function exists for years to come.
Victoria Knoll, MD, is an orthopedic surgeon at OrthoTexas and is specialty trained in hand and wrist injuries.