carpus

Your wrist connects your hand to your forearm. It is not one big joint; it has several small joints. This makes it flexible and allows you to move your hand in different ways. The wrist has two big forearm bones and eight small bones known as carpals. It also has tendons and ligaments, which are connective tissues. Tendons connect muscles to bones. Ligaments connect bones to each other.

Some of the more common types of wrist injuries and disorders are:

• Carpal tunnel syndrome, which happens when a nerve that runs from your forearm into your palm becomes squeezed at the wrist
• Ganglion cysts, which are noncancerous lumps or masses
• Gout, which is a form of arthritis caused by a buildup of uric acid in your joints
• Fractures (broken bones)
• Osteoarthritis, the most common type of arthritis. It is caused by wear and tear of the joints.
• Sprains and strains, which are injuries to ligaments and injuries to muscles or tendons
• Tendinitis, inflammation of a tendon, usually due to overuse

Certain things can put you at higher risk of having a wrist problem, including:

• Doing sports, which can put you at risk for injuries and puts stress on your wrist. For example, you may fall on your outstretched hand when you are skating or snowboarding. Your wrist could be injured while doing contact sports. And other sports such as gymnastics and basketball can strain your wrists.
• Doing repetitive wrist motions, such as typing on a keyboard, working on an assembly line, or using power tools.
• Having certain diseases. For example, rheumatoid arthritis can cause wrist pain.

The symptoms of a wrist problem can vary, depending on the problem. A common symptom is wrist pain. Some other possible symptoms include swelling, a decrease in wrist strength, and sudden numbness or tingling.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam, including checking your wrist strength and range of motion
• An x-ray or other imaging test
• Blood tests

Treatments for wrist pain depends on the type of injury or disorder. They may include:

• Resting your wrist
• Wearing a wrist brace or cast
• Pain relievers
• Cortisone shots
• Physical therapy
• Surgery

To try to prevent wrist problems, you can:

• Use wrist guards, when doing sports that put you at risk for wrist injuries
• In the workplace, perform stretching exercises and take frequent rest breaks. You should also pay attention to ergonomics to make sure that you are using the proper wrist position while working.
• Make sure that you get enough calcium and vitamin D to keep your bones strong

Carpal tunnel syndrome is the name for a group of problems that includes numbness, tingling, weakness, or pain in your wrist or hand. It's a very common condition that happens when a nerve in your wrist becomes squeezed.

The carpal tunnel is a narrow opening between the bones in your wrist and the ligament that holds them together. A nerve, called the median nerve, runs from your lower arm through the carpal tunnel and into your hand. This nerve provides feeling to your thumb and first three fingers. It also helps you move your thumb.

Tendons also run from your lower arm, through the carpal tunnel, and into your hand. The tendons connect your finger bones to muscles in your arm, so you can bend your fingers.

If the tendons become swollen or irritated inside the carpal tunnel, they may press on the nerve. The squeezed nerve may not work well, which can lead to numbness, weakness, and other symptoms of carpal tunnel syndrome.

In certain cases, the cause of carpal tunnel syndrome is unknown. But it usually happens from a combination of things that affect the structures in your wrist, such as:

• Injury to your wrist that causes swelling, such as a sprain or broken bone
• Health conditions that can affect your nerves, joints, or other parts of your wrist, for example:
  • Diabetes.
  • Rheumatoid arthritis.
  • A cyst or tumor in your wrist.
  • Changes in certain hormones, which may cause swelling from extra fluid in your body. Examples include an underactive thyroid gland (hypothyroidism), pregnancy and menopause.
  • Problems with the way your wrist is formed.
• Doing the same wrist and hand movements over and over, such as:
  • Assembly line work.
  • Carpentry or using tools that vibrate.
  • Knitting, gardening, or sports, such as golf.

Researchers aren't sure whether long-term typing or computer use leads to carpal tunnel syndrome.

Carpal tunnel syndrome usually happens only in adults. You're more likely to develop it if you:

• Are a woman. Women are three times more likely to have carpal tunnel syndrome than men.
• Have a health condition that may affect structures in your wrist.
• Do activities with repeated hand motions.
• Have had a wrist injury.
• Have a close relative who has had carpal tunnel syndrome, such as a parent, brother or sister.

You may feel numbness, tingling or burning in your fingers, especially in your thumb, index, and middle fingers. Symptoms often affect both hands.

In the early stages, symptoms usually:

• Start slowly in your dominant hand (the one you write with)
• Happen at night if you sleep with your wrists bent

As symptoms get worse, you may notice:

• Tingling, pain, or weakness with certain activities, such as driving or holding a phone
• Difficulty grasping or holding small things
• Feeling like your fingers are swollen when they're not

Without treatment, you could lose feeling in some fingers and have permanent weakness in your thumb. But early diagnosis and treatment can help prevent lasting damage.

To find out if you have carpal tunnel syndrome, your health care provider will:

• Ask about your medical history
• Ask about your family health history
• Do a physical exam
• Order tests if needed, such as:
  • Lab tests to look for diseases that may damage nerves
  • X-rays to look for broken bones or arthritis
  • Tests to measure the electrical activity in your nerves and muscles
  • Ultrasound to check the nerve in the carpal tunnel

It's easier to treat carpal tunnel syndrome early on, so you should start treatment as soon as possible. Your provider will first treat any health conditions you have that may cause your symptoms. The next step would be treatments for carpal tunnel syndrome. They may include:

• Wrist splints (usually worn at night).
• Rest.
• Medicines to reduce swelling and pain:
• Over-the-counter pain relievers, such as aspirin, ibuprofen, and naproxen sodium.
• Prescriptionsteroids, either pills or an injection (shot) into your wrist.
• Other therapies (complementary and integrative medicine). Research shows that yoga may help with pain and weakness. Some people may find acupuncture and chiropractic care helpful, but research hasn't shown that these therapies can improve carpal tunnel syndrome. If you want to try other therapies, talk with your provider first.
• Surgery to make more space in the carpal tunnel. Surgery may be an option if your symptoms are severe and other treatments don't work. It involves cutting the wrist ligament to take pressure off the nerve. Recovery may take months. Carpal tunnel syndrome rarely comes back after surgery, but mild symptoms may last.

You may help prevent carpal tunnel syndrome if you protect your wrists:

• Use good posture to keep your wrists in a natural position.
• Keep your hands warm to keep your muscles flexible. Fingerless gloves may help.
• Take work breaks and vary your tasks.
• Stretch and exercise your hands and wrists.
• Organize your workspace and tools to reduce strain on your hands and wrists.

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Types of arm injuries include :

• Tendinitis and bursitis
• Sprains
• Dislocations
• Fractures (broken bones)
• Nerve problems
• Osteoarthritis

You may also have problems or injure specific parts of your arm, such as your hand, wrist, elbow, or shoulder.

A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising, and being unable to move your joint. You might feel a pop or tear when the injury happens.

A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can cause a strain. Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle.

At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

No matter how old you are or what you do for a living, you are always using your hands. When there is something wrong with them, you may not be able to do your regular activities.

Hand problems include :

• Carpal tunnel syndrome - compression of a nerve as it goes through the wrist, often making your fingers feel numb
• Injuries that result in fractures (broken bones), ruptured ligaments and dislocations
• Osteoarthritis - wear-and-tear arthritis, which can also cause deformity
• Tendinitis - irritation of the tendons
• Disorders and injuries of your fingers and thumb

Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, and stiffness in your joints. RA is an autoimmune disease. Although it is most common in the wrist and fingers, this disease can cause your immune system to attack any joint tissue. The inflammation (swelling) that comes with RA can also affect other body parts. Inflammation could cause medical issues in your eyes, skin, heart, nerves, blood, or lungs.

RA differs from osteoarthritis, a common arthritis that often comes with age. RA affects the lining of your joints and damages the tissue that covers the ends of the bones in a joint. Eventually, this might cause your joints to not work as well.

There is no cure for RA, but early treatment can help you manage symptoms, reduce joint damage, and lead a productive life.

Rheumatoid arthritis can happen at any age, but your risk increases as you become an older adult. Your chance of developing RA can also increase if:

• You're a woman. Women are more likely to get RA than men.
• You have a family history. If a member of your family has RA, you're more likely to get the disease.
• You're a smoker.Smoking over a long period of time increases your risk of getting RA and how serious the disease can be.
• You have other medical conditions that may increase your risk of getting RA. These include obesity, gum disease, and lung disease.

No one knows what causes rheumatoid arthritis. A few things that might play a part in getting RA include:

• Your genes are parts of DNA in your cells that are passed down from your parents. Certain genes may increase your risk of getting rheumatoid arthritis, but not everyone with these genes gets RA.
• The environment, which includes things such as cigarette smoke, sometimes triggers RA symptoms.
• Hormones are chemical messengers in your bloodstream that control the actions of certain cells or organs. Researchers think that sex hormones might play a role in getting RA. Women are more likely to develop the disease, and RA symptoms may change during and after pregnancy.

Your immune system may start turning against your body's joints and tissues years before you notice any symptoms of RA. The changes from this type of immune malfunction usually settle in your joints.

RA affects people differently. You might have the disease for only a short time, or your symptoms might come and go. The severe form can be chronic (long-lasting) and may last a lifetime.

Symptoms of rheumatoid arthritis may include:

• Joint pain or stiffness when moving. This is usually worse in the morning or after inactivity. RA usually affects both joints. If one of your hands or knees is affected, so is the other.
• Joint tenderness, redness, and warmth.
• Joint swelling may make daily activities hard. These could include things such as combing your hair, buttoning your clothes, or bending your knees.
• Fatigue, fever, and a loss of appetite.
• Hard bumps (rheumatoid nodules) under your skin near the joints.

There's no single test for rheumatoid arthritis. The disease develops over time. At first, you may only have a few symptoms, making it hard to diagnose RA in its early stages. To find out if you have RA, your health care provider may:

• Ask about your medical history, including your symptoms.
• Ask about your family health history, including relatives who have had RA.
• Do a physical exam, which includes checking your joints, looking for rashes or nodules, and listening to your chest for signs of inflammation in your lungs.
• Order blood tests or imaging studies (x-ray or ultrasound) to make sure other health conditions aren't causing your symptoms since they may be like other types of arthritis and joint conditions.

Your provider may refer you to a rheumatologist (a doctor who specializes in arthritis care) for tests, diagnosis, and care.

There is no cure for RA, but early treatment can help prevent your symptoms from getting worse and damaging your joints. Treatment can include medicine, lifestyle changes, and surgery. These may slow or stop joint damage and reduce pain and swelling.

Your provider may use a combination of treatments. Your treatment may change based on your symptoms.

You can help manage your RA symptoms if you:

• Are physically active
• Keep a healthy weight
• Avoid injuries to your joints
• Avoid activities that have repetitive motions, like bending your knee over and over
• Stop smoking, or don't start

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Angioplasty is a procedure to improve blood flow in coronary arteries that have become narrow or blocked. Your coronary arteries supply oxygen-rich blood to your heart. If you have coronary artery disease, a sticky material called plaque builds up in your coronary arteries. Plaque is made of cholesterol, calcium, and other substances in your blood. Over time, it can narrow your arteries or fully block them. When this happens, some parts of your heart don't get enough blood.

Angioplasty widens the blocked part of your artery so more blood can get through. It is also called percutaneous coronary intervention (PCI).

Doctors (usually a heart specialist called a cardiologist) use angioplasty to:

• Reduce chest pain from blockages in the coronary arteries. This type of pain is called angina. There are different types of angina. Angioplasty treats certain types.
• Limit damage to the heart during or right after a heart attack. In this case, angioplasty is an emergency treatment.

Angioplasty does not cure coronary artery disease. To help prevent more plaque blockages, you'll need to take any prescribed medicines, eat healthy foods, and get regular exercise.

Most people have angioplasties in a hospital in a special room called a cardiac catheterization, or cath, lab. You will be awake and lying down. You'll get medicine to help you relax through an intravenous (IV) line. This is a small tube that goes into a vein in your hand or arm.

Angioplasty is done through a blood vessel in your arm, wrist, or groin. Your doctor will:

• Make a small opening in that area to insert a thin tube (a catheter) into a blood vessel.
• Thread the tube through the vessel to your heart, using x-rays as a guide.
• Inject contrast dye inside your arteries. The dye highlights your heart and blood vessels in the x-rays.
• Replace the first tube with another one that has a small, deflated balloon on the end.
• Guide the balloon inside the blockage and inflate it to push the plaque flat against the artery wall. This makes the artery wider and improves blood flow.
• Sometimes put a small, mesh tube into the artery to help keep it open. The tube is called a stent. Some stents have a coating of medicine that helps prevent blood clots from forming.

If you had an angioplasty for chest pain, you'll go to a recovery room for a few hours. You may stay in the hospital overnight. Your doctor will probably prescribe medicines to prevent blood clots. Most people can return to their usual activities after a week.

If you had an emergency angioplasty for a heart attack, you'll need to stay in the hospital for about a few more days.

Angioplasty is very safe, but every invasive procedure comes with risks. You may get a bruise, feel sore, or have some bleeding where the tubes were inserted. More serious problems don't happen very often, but they are possible. They can include serious bleeding, blood clots, and narrowing of the artery again.

NIH: National Heart, Lung, and Blood Institute

If you feel pain and stiffness in your body or have trouble moving around, you might have arthritis. Any disorder that affects the joints is often called arthritis. Joints are places where two bones meet, such as your elbow or knee.

Most types of arthritis can cause joint pain and inflammation (swelling). Over time, a swollen joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such as your eyes or skin. Treatment will depend on the type of arthritis you have.

Common types of arthritis include:

• Osteoarthritis is the most common type of arthritis. It's often related to aging or injury.
• Autoimmune arthritis happens when your body's immune system attacks healthy cells in your body by mistake. Rheumatoid arthritis is the most common form of this type of arthritis.
• Juvenile arthritis is a type of arthritis that happens in children.
• Infectious arthritis is an infection that has spread from another part of your body to the joint. Reactive arthritis is one type.
• Psoriatic arthritis affects people with psoriasis (itchy or sore scaly red and white skin patches).
• Gout is a painful type of arthritis that happens when too much uric acid builds up in your body. It often starts in the big toe. Other joints can also be affected.
• Ankylosing spondylitis is a type of arthritis of the spine that can cause stiffness and make it difficult to move and bend.

Pain, redness, warmth, and joint inflammation are common arthritis symptoms. You may not be able to move your joint as well as it should. Other symptoms could include fever, weight loss, breathing difficulties, or a rash.

Symptoms often get worse as you age. Some symptoms of arthritis may be signs of other illnesses.

A few things that might increase your chance of getting arthritis include:

• Family history. You may be more likely to get certain types of arthritis if a member of your family has the disorder.
• Age. The risk of getting many types of arthritis increases with age.
• Sex. Certain types of arthritis are more common in women, while other types are more common in men.

Other factors that might increase your risk of getting arthritis include having a previous joint injury, obesity, or lupus.

To find out if you have arthritis, your health care provider may:

• Ask you about your medical history, including your symptoms.
• Do a physical exam.
• Order blood tests or take x-rays.

Your provider may refer you to a rheumatologist (a doctor who specializes in arthritis care) for tests, diagnosis, and care.

Treatment depends on the type of arthritis you have. It may include medicine or surgery. Your provider will work with you to improve your symptoms and quality of life.

A few ways to help manage your symptoms include:

• Hot or cold packs
• Relaxation techniques
• Use of splints, braces, and/or assistive devices

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

The brachial plexus is a network of nerves that sends signals from the spine to the shoulder, arm, and hand. Damage to the brachial plexus can cause symptoms such as:

• A limp or paralyzed arm
• Lack of muscle control in the arm, hand, or wrist
• Lack of feeling or sensation in the arm or hand

Brachial plexus injuries can happen because of shoulder trauma, tumors, or inflammation. Sometimes they happen during childbirth when a baby's shoulders become stuck during delivery and the nerves stretch or tear.

Some brachial plexus injuries may heal without treatment. Many children who are injured during birth improve or recover by 3 to 4 months of age. Treatment includes physical therapy and, in some cases, surgery.

NIH: National Institute of Neurological Disorders and Stroke

Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. When any of these structures is hurt or diseased, you have elbow problems.

Many things can make your elbow hurt. A common cause is tendinitis, an inflammation or injury to the tendons that attach muscle to bone. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You may also get tendinitis from overuse of the elbow.

Other causes of elbow pain include sprains and strains, fractures (broken bones), dislocations, bursitis, and arthritis. Treatment depends on the cause.