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Causes & Treatment OptionsHand stiffness can make simple tasks overwhelming. Why are my hands stiff in the morning? What are the treatment options for hand stiff in the morning? Are there new, natural treatment options to treat hands that are stiff in the morning? Let’s dig in. Why are My Hands Stiff in the Morning?Our hands are central to virtually everything we do. Stiffness can compromise function and cause pain. What are the causes of hand stiffness in the morning? There are many which include:
Specific Conditions Associated with Hand StiffnessBasal Joint Arthritis or CMC / Carpometacarpal ArthritisThe thumb is also referred to as the CMC joint. It is composed of two bones. The Carpal bone is denoted by the letter C. The second bone, the MC is the MetaCarpal bone. So your thumb is made up of the Carpal and MetaCarpal bones that come together and form a joint. The joint is lined with cartilage which allows the two bones to slide smoothly against one another. The thumb joint is held together by multiple thick ligaments. Ligaments are thick pieces of connective tissue that connect one bone to another. This joint is a saddle-shaped joint that experiences significant forces through activities of daily living. Read More About Basal Joint Arthritis or CMC / Carpometacarpal Arthritis TFCC tearTFCC stands for Triangular Fibrocartilage Complex. It’s basically a triangular-shaped spacer with ligaments that lives on the pinky finger (ulnar) side of your wrist (1). This complex of ligaments stabilizes the bones on that side and adds cushioning. The TFCC can become torn with a fall on an outstretched hand, other trauma, or just wear and tear. Instability is another feature of TFCC tears (2). The TFCC is part of an extensive group of ligaments that help stabilize both the small wrist bones and the ulna bone. If these become stretched and allow too much movement, this is called instability. Read More About TFCC tear Treatment Options for Hand Stiffness in the MorningThere are multiple treatment options for hand stiffness in the morning which are outlined below. Which treatment is best for you depends upon the underlying cause of stiffness, how long it has been present and the severity of any cartilage or ligament injury. Physical Therapy
Diet Modifications
Pain Medications
Injections
Surgery
New Nonsurgical Treatment for Hands Stiffness in the MorningA novel technique that uses a precise injection of platelets and or bone marrow concentrate is now available. PRP is rich in growth factors that can increase blood flow and reduce inflammation. On a cellular level, for degenerative conditions such as osteoarthritis, PRP has been found to stimulate cartilage producing cells while turning down inflammatory signals (4). Multiple studies exist that demonstrate the effectiveness of PRP in the treatment of early hand osteoarthritis.
Bone marrow concentrate contains many different cells that can repair local damage and inflammation in addition to signaling other remote cells to come and assist in the repair. To learn more about precise PRP and bone marrow concentrate injections please click on the video below which reviews treatment of thumb arthritis. Similar treatments have been successfully used in the treatment of hand arthritis. PRP and bone marrow ultrasound-guided injections into the hands and fingers is a technically challenging procedure that your Primary Care Physician (PCP) or orthopedic surgeon can not perform. It takes years of training to inject PRP and bone marrow concentrate into the different parts of the hand. At the Centeno-Schultz Clinic, we have extensive experience in the treatment of hand injuries. To watch an advanced hand procedure at Centeno-Schultz Clinic please click on the video below. In ConclusionThere are multiple causes for hands stiff in the morning which include excessive wear, trauma, medications, inflammatory diets, and osteoarthritis. Treatment depends on the severity of the stiffness, range of motion and the severity of underlying cartilage, tendon and ligament injuries. Treatment options include physical therapy, diet modifications, oral medications, steroid injections, and surgery. Steroids and NSAIDs both have significant side effects and should be avoided. Surgery is associated with multiple complications including the need for additional surgeries. Injection of PRP and bone marrow concentrate is a novel new, nonsurgical treatment option. In multiple studies, PRP has been demonstrated to be effective in the treatment of mild hand osteoarthritis. Precise, image guided PRP and bone marrow injections can treat the issue using the healing mechanisms of the patients own platelets and stems cells and avoiding the risks associated with oral NSAIDs, steroids and surgery. ___________________________________________________________ 1.Rosenbloom AL. Limitation of finger joint mobility in diabetes mellitus. J Diabet Complications. 1989;3(2):77-87. DOI: 10.1016/0891-6632(89)90016-0. 2.Makkouk AH, Oetgen ME, Swigart CR, Dodds SD. Trigger finger: etiology, evaluation, and treatment. Curr Rev Musculoskelet Med. 2008;1(2):92-6. doi: 10.1007/s12178-007-9012-1. 3.Hustedt JW, Chung A, Bohl DD, Olmschied N, Edwards SG. Comparison of Postoperative Complications Associated With Anesthetic Choice for Surgery of the Hand. J Hand Surg Am. 2017;42(1):1-8.e5.doi: 10.1016/j.jhsa.2016.10.007. 4.Kazemi D, Fakhrjou A (2015) Leukocyte and platelet rich plasma (L-PRP) versus leukocyte and platelet rich fibrin (L-PRF) for articular cartilage repair of the knee: a comparative evaluation in an animal model. Iran Red Crescent Med J 17(10), e19594. 5.Loibl M, Lang S, Dendl LM, et al. Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study. Biomed Res Int. 2016;2016:9262909. doi:10.1155/2016/9262909 6. Malahias MA, Roumeliotis L, Nikolaou VS, Chronopoulos E, Sourlas I, Babis GC. Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial. Cartilage. 10.1177/1947603518805230. Why do my hands hurt after I sleep?Many of the problems that hand therapists treat, such as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, arthritis, or even tendonitis can be exacerbated by pressure while we are sleeping. This pressure can worsen symptoms like swelling, numbness, tingling, and pain.
Why does my hand feel sore for no reason?Arthritis is one of the most common causes of hand pain, affecting millions of people every year. Arthritis develops over time and causes inflammation of the joints. You may have it in a finger, your wrist, or multiple spots along your hand. Osteoarthritis is the most common type.
Why do my hands and wrists hurt when I wake up?Nighttime Wrist Positioning
The main reason you wake up with your wrist hurting due to the carpal tunnel is that your median nerve continues to be pinched while you sleep. As a result, you wake up with numbness, tingling, or pain in your hand, wrist, and fingers.
Why do my hands feel tight and swollen when I wake up?For some people, swollen hands in the morning are a sign of sleep posture. If you sleep on your hands and put the majority of your weight on your side, you could wake up with swollen hands. Treatment: Change your sleeping position throughout the night.
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