Diagnosis & Treatment for Hand, Wrist & Elbow Conditions

Virginia Mason Franciscan Health offers conservative, nonsurgical treatments as well as the latest state-of-the-art surgical procedures for hand, wrist and elbow conditions. Our orthopedic specialists are committed to providing exceptional care for both common and complex conditions of the hand, wrist and elbow. 

Diagnosing your pain

A variety of conditions—from minor to serious—can impact the hands, wrists and elbows. Fortunately, our board-certified orthopedic specialists are experts at diagnosing and treating all of them. After conducting a thorough examination and any necessary imaging tests, our orthopedic specialists will work with you to make a plan for your treatment. While medication or therapy is often recommended as a first course of action, surgery may be required. 

Some of the conditions we treat include:  

  • Arthritis
  • Bicep ruptures
  • Bursitis 
  • Carpal tunnel syndrome
  • Clavicle fractures
  • Cubital tunnel
  • Cysts/masses
  • Dislocations
  • Dupuytren's disease
  • Fractures 
  • Tendon tears/injuries
  • Trigger fingers
  • Ulnar collateral ligament (UCL) injury

Conditions and treatments

Wrist pain

Conditions of the wrist, whether temporary or chronic, can make ordinary activities such as driving a car or typing painful. Self-care can alleviate some pain, but you’ll want to see an orthopedic specialist for persistent injuries or conditions.

  • Injuries

    Falls are a common cause of sprains, strains and fractures of the wrist. Repetitive stress due to a hobby or job can also lead to a wrist injury. A cold compress or ice pack placed on the wrist for about 10 minutes at a time can provide pain relief for a minor wrist injury. As the wrist heals, a splint can help protect the area. Avoid sleeping on your wrists and place warm and cold compresses on the affected area. If nighttime splinting doesn’t help, you may need to wear the splint during the day, too.

    To help alleviate wrist pain, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen can help. Your provider may prescribe a stronger pain reliever if over-the-counter options prove ineffective.

    Repetitive stress injuries may be treatable with ergonomic devices. Keep your wrists from bending upward by using an ergonomic keyboard. A mouse cushion can also reduce the stress placed on your wrist. You may also consider occupational therapy to help with proper positioning of frequently used items. Ruptured tendons or ligaments can be repaired with surgery by stitching together the divided ends.

  • Arthritis

    Osteoarthritis causes the cartilage cushioning your wrist bones to deteriorate over time, while rheumatoid arthritis causes the body’s immune system to attack its own tissues. A cold compress or ice pack applied to the wrist for about 10 minutes at a time can provide pain relief. A warm compress can help relieve swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen can also help with pain. Your provider may prescribe a stronger pain reliever if over-the-counter options prove ineffective.

    Arthritis of the wrist can be lessened with strengthening and stretching exercises taught by a physical therapist.

  • Carpal tunnel syndrome

    The carpal tunnel is a passageway at the base of your hand, made of ligament and bone. The median nerve passes through this tunnel, and if there’s increased pressure on it, carpal tunnel syndrome can occur. You may find some relief from carpal tunnel syndrome by applying a cold compress or warm compress. Pain medication may also provide some relief.

    If nonsurgical treatments are ineffective, carpal tunnel release surgery can “release” the ligament pressing on the median nerve. The success of the surgery depends on how long the nerve has been compressed and the severity of the compression.

  • Ganglion cysts

    These noncancerous cysts can cause pain, which can get worse or better with activity. A brace or splint can help encourage a ganglion cyst to shrink. Another option is for your doctor to use a needle to drain the fluid from the cyst. If nonsurgical options are ineffective, the cyst can be removed and detached from the joint or tendon.

Elbow pain

Conditions of the elbow, whether temporary or chronic, can make ordinary activities such as carrying groceries or using a computer painful. Self-care can alleviate some pain, but you’ll want to see an orthopedic specialist for persistent injuries or conditions.

  • Injuries

    One-off elbow injuries can include a dislocation, fracture, strain or sprain. A fractured elbow requires immediate medical attention to perform any necessary surgery. Similarly, most dislocated elbows should be seen by a provider as soon as possible to determine whether any bones were also broken or if damaged ligaments, nerves or blood vessels need repair. A provider can also help realign the bone.

    Most strains and sprains can be treated with rest, ice and stretching exercises.

  • Arthritis

    Both osteoarthritis, a condition that causes the cartilage cushioning your elbow bones to deteriorate over time, or rheumatoid arthritis, an auto-immune disorder, can affect the elbow joint. The risk for osteoarthritis of the elbow increases if the elbow has been previously injured or repaired. Arthritis in the elbow can cause pain and/or loss of range of motion.

    Home treatment may include pain relief from icing with a cold compress or ice pack for about 10 minutes at a time. If swelling is present, a warm compress may help. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen can also provide temporary relief from pain.

  • Bursitis

    An accident, infection or repetitive movement can cause bursitis, a condition in which sacs in the joints become swollen and cause pain. If an infection caused the condition, you might be prescribed an antibiotic. Otherwise, rest, ice and pain relievers can help most cases of bursitis until it goes away on its own.

    Persistent bursitis may be treatable with steroid injections or physical therapy. In some cases, surgical drainage or removal of the affected sacs may be necessary.

  • Tendinitis

    Tennis elbow and golfer’s elbow are two types of tendinitis and are caused by damage to the tendons from overuse. Most cases can be treated with rest, ice and pain relievers. Steroid injections and physical therapy may also provide some relief.

    In some cases, your provider may recommend dry needling or ultrasonic treatment to help encourage tendon healing. Severe cases of tendinitis may require surgical repair.

    Arthritis of the elbow can also be lessened with strengthening and stretching exercises or through motion modification taught by a physical therapist . Corticosteroid injections may be used to provide relief from symptoms, and in advanced cases, surgery may be a treatment option.

Hand pain

Conditions of the hand, whether temporary or chronic, can make ordinary activities such as holding a pen or opening a jar painful. Self-care can alleviate some pain, but you’ll want to see an orthopedic specialist for persistent injuries or conditions. 

  • Injuries

    The hand is vulnerable to many injuries, including sprains, strains, fractures, dislocated fingers and more. Minor injuries can usually heal with rest, ice and stretching exercises.

    Surgery is generally only necessary with severe hand pain or loss of function.

  • Arthritis

    Osteoarthritis, the most common type of arthritis, causes the lubricating fluids and cartilage in your hand and finger bones to deteriorate over time. Rheumatoid arthritis is a chronic illness that affects many parts of the body, but frequently begins in the hands and feet.

    Treatments focus on pain relief, as the effects of arthritis cannot be reversed. Rest can help to relieve osteoarthritis pain, and use or strain can increase pain. Anti-inflammatory drugs such as aspirin, ibuprofen or naproxen are frequently recommended. Steroidal injections and splinting of the affected joint may be recommended by your doctor if over-the-counter options prove ineffective.

    Joint surgery, arthroscopy or joint replacement are options for people with advanced osteoarthritis.

  • Carpal tunnel syndrome

    The carpal tunnel is a passageway at the base of the hand surrounded by small wrist bones called carpal bones. The structure protects the median nerve and tendons that control the motion of the hand. If the carpal tunnel narrows or the tendons in the passageway swell, it can put pressure on the median nerve, resulting in the pain, numbness, tingling or weakness associated with carpal tunnel syndrome.

    Nonsurgical treatments include bracing to achieve a neutral position and limit movement, rest, activity modification and pain medication.

    If nonsurgical treatments are ineffective, carpal tunnel release surgery can “release” the ligament pressing on the median nerve. The success of the surgery depends on how long the nerve has been compressed and compression severity.

  • Tenosynovitis

    Tenosynovitis occurs when the lining that encloses the tendons becomes inflamed. In the hand, this can take the form of trigger finger or trigger thumb. The finger or thumb may be unable to extend or flex smoothly and instead lock or trigger suddenly. Most cases of tenosynovitis can be treated with rest, ice and pain relievers. A splint or brace can also keep your finger or thumb straight while resting your tendons.

    A physical or occupational therapist may also be able to review how you use your hand and offer exercises and suggestions on how to relieve your hand pain. More serious cases of tenosynovitis may require surgery that cuts open the tendons so they can move with ease.

Find a provider near you

Put your hands in ours. Schedule a consultation with one of Virginia Mason Franciscan Health’s hand, wrist and elbow specialists.