State-of-the-Art NonSurgical Treatment with Wrist & Hand Injections
Pain, stiffness and swelling in the hand or wrist can make everyday tasks such as buttoning a shirt, typing or gripping a steering wheel difficult. Many patients assume that surgery is the only lasting solution, but a wide range of hand and wrist conditions respond well to targeted hand injections. Hand injections are safe, minimally invasive treatment options for many hand, wrist and nerve-related problems.
Hand injections deliver medication directly to the affected area, where it can reduce inflammation, relieve pain, stimulate healing or improve mobility. Depending on the diagnosis, hand injections may contain corticosteroids, local anesthetics, platelet-rich plasma (PRP) or specialized medications such as collagenase. Board certified Shelby Township hand doctor Uzma Rehman uses hand injections both to treat conditions and, in some cases, to help confirm a diagnosis.
Most hand injections are performed in the office in a matter of minutes, and ultrasound guidance can be used when precise placement is important. Patients typically return to light activities the same day.
Corticosteroid Hand Injections
Corticosteroids are powerful anti-inflammatory medications, and corticosteroid hand injections are among the most common treatments in hand care. By reducing inflammation and swelling within a tendon sheath, joint or confined space, corticosteroid hand injections can relieve pain and restore smoother movement. Relief usually begins within a few days and may last for months.
Corticosteroid hand injections are frequently used for trigger finger, de Quervain’s tenosynovitis, carpal tunnel syndrome and arthritis at the base of the thumb. For trigger finger in particular, a single corticosteroid injection resolves symptoms for many patients, especially when symptoms are recent.
Corticosteroid hand injections are generally safe, although side effects can include temporary soreness, a short-term rise in blood sugar in patients with diabetes and, rarely, thinning or lightening of the skin at the injection site. Because repeated injections into the same area can weaken tissues over time, Dr. Rehman limits the number of corticosteroid injections to any one site and considers other options if symptoms return.
Anesthetic Hand Injections
Local anesthetics such as lidocaine and bupivacaine numb the nerves in a specific area and provide rapid pain relief. Anesthetic hand injections are commonly combined with corticosteroids to reduce discomfort from the injection itself and provide immediate relief while the corticosteroid begins to work.
Anesthetic hand injections also serve an important diagnostic purpose. When the source of pain is uncertain, numbing a specific joint, tendon sheath or nerve can help pinpoint where the pain originates. If the pain resolves after an anesthetic injection into a particular structure, that structure is likely the source, which helps guide further treatment.
Anesthetic hand injections are also used as nerve blocks to numb the hand or fingers for minor procedures. Local anesthesia techniques now allow many hand procedures to be performed without general anesthesia, which reduces risk and speeds recovery for appropriate patients.
PRP Hand Injections
Platelet-rich plasma (PRP) is prepared from a small sample of the patient’s own blood. The blood is spun in a centrifuge to concentrate the platelets, which contain growth factors involved in tissue repair, and the concentrated plasma is then injected into the injured area. Because PRP is derived from the patient’s own blood, the risk of an allergic reaction is very low.
PRP hand injections are used to stimulate healing in chronic tendon conditions and degenerative joint problems that have not responded to conventional treatment. The strongest evidence for PRP in the upper extremity involves lateral epicondylitis, commonly called tennis elbow, and research into PRP for thumb basal joint arthritis and other hand conditions is ongoing. PRP typically works gradually, with improvement developing over several weeks to months.
PRP hand injections are considered a regenerative therapy, and they are not appropriate for every patient or condition. PRP is often not covered by insurance, so board certified Shelby Township hand doctor Uzma Rehman discusses the current evidence, expected benefits and costs to help each patient make an informed decision.
Collagenase Hand Injections
Collagenase clostridium histolyticum, marketed as Xiaflex, is an FDA-approved injectable enzyme for adults with Dupuytren’s contracture who have a palpable cord. Dupuytren’s contracture is a condition in which thickened, cord-like tissue forms in the palm and gradually pulls one or more fingers into a bent position, making it difficult to lay the hand flat, shake hands or put on gloves.
Collagenase hand injections work by breaking down the collagen that makes up the abnormal cord. The medication is injected directly into the cord, and at a follow-up visit one to three days later the finger is gently manipulated under local anesthesia to rupture the weakened cord and straighten the finger. Patients usually wear a night splint for several months afterward.
Collagenase hand injections offer a nonsurgical alternative for many patients with Dupuytren’s contracture, with a shorter recovery than open surgery. Temporary swelling, bruising and tenderness are common, and less common risks include skin tears and, rarely, tendon rupture. As with every treatment for Dupuytren’s contracture, the condition can recur over time, and Dr. Rehman considers the location and severity of the contracture when recommending collagenase or another approach.
Other Hand Injections
Several other hand injections may be recommended depending on the diagnosis. Hyaluronic acid injections, which supplement the natural lubricating fluid in joints, are sometimes used off-label for thumb basal joint arthritis. Hydrodissection, an ultrasound-guided technique that uses fluid to gently separate a compressed nerve from surrounding tissue, is an emerging option for some patients with carpal tunnel syndrome.
Aspiration, in which fluid is withdrawn through a needle, can drain a ganglion cyst and relieve pressure, although cysts frequently return after aspiration alone. Botulinum toxin injections have also been used off-label for severe Raynaud’s phenomenon, a condition in which reduced blood flow causes the fingers to turn white or blue in response to cold.
Every patient’s condition is unique, and the most effective hand injection depends on an accurate diagnosis. Board certified Shelby Township hand doctor Uzma Rehman combines a detailed examination, imaging when needed and knowledge of the full range of treatment options to recommend the hand injections most likely to provide lasting relief.
Hand Injections | Shelby Township
If hand or wrist pain, stiffness or a bent finger is interfering with your daily life, hand injections may offer effective relief without surgery. These quick, minimally invasive treatments can reduce inflammation, ease pain and restore movement, often with little or no downtime.
Schedule an appointment with board certified Shelby Township hand doctor Uzma Rehman at Macomb Hand Surgery to find out which hand injections may be right for your condition. A precise diagnosis and a personalized treatment plan can help you return to the activities you enjoy.
