The hands and wrists are essential for virtually every activity Alaskans depend on, from operating fishing equipment and construction tools to gripping ski poles and kayak paddles. Hand and wrist conditions can significantly impact quality of life and the ability to work and enjoy recreational activities. Understanding common hand conditions and treatment options helps Alaskans seek timely, appropriate care.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is the most common nerve compression condition affecting the hand. It occurs when the median nerve is compressed as it passes through the carpal tunnel at the wrist. Symptoms include numbness and tingling in the thumb, index, middle, and ring fingers, particularly at night. Advanced cases can cause hand weakness and muscle wasting.
In Alaska, carpal tunnel syndrome is especially prevalent among commercial fishermen, oil field workers, construction workers, and anyone who performs repetitive hand motions in their occupation. Cold exposure may also exacerbate symptoms.
Treatment begins with wrist splinting, activity modification, and anti-inflammatory measures. Cortisone injection into the carpal tunnel can provide temporary relief. When conservative measures fail, carpal tunnel release surgery is highly effective with success rates exceeding 90 percent. The procedure takes about 10 minutes and is performed under local anesthesia.
Trigger Finger
Trigger finger occurs when a finger tendon catches in its sheath, causing the finger to lock in a bent position before suddenly releasing with a snap. It is caused by inflammation and narrowing of the tendon sheath. Treatment includes splinting, cortisone injection, and surgical release for persistent cases.
De Quervain's Tendinitis
De Quervain's tendinitis causes pain at the base of the thumb on the wrist side, worsened by gripping and twisting motions. It is common in new parents from lifting babies, and in workers and athletes who perform repetitive thumb motions. Treatment includes thumb spica splinting, cortisone injection, and surgical release for refractory cases.
Wrist Fractures
Distal radius fractures (broken wrist) are among the most common fractures in Alaska, frequently resulting from falls on outstretched hands during winter ice, sports activities, and recreational pursuits. Many wrist fractures can be treated with casting, but displaced or unstable fractures may require surgical fixation with plates and screws. Early treatment is important to prevent long-term stiffness and arthritis.
Dupuytren's Contracture
Dupuytren's contracture is a condition where thickened tissue in the palm gradually pulls one or more fingers into a bent position. It is more common in people of Northern European descent, making it relatively prevalent in Alaska. Treatment options include enzyme injection to dissolve the thickened tissue, needle aponeurotomy to release the cord, and surgical fasciectomy for advanced cases.
Hand Arthritis
Arthritis of the hand and fingers, particularly at the base of the thumb (CMC joint), is common and can significantly limit grip strength and fine motor function. Treatment ranges from splinting and therapy to cortisone injections and surgical options including joint fusion and joint replacement.
Finding Hand Specialists in Alaska
Hand surgery is a subspecialty within orthopedic surgery. Fellowship-trained hand surgeons have completed additional specialized training in conditions of the hand, wrist, and forearm. Alaska has several hand surgery specialists, primarily in Anchorage, including providers at ANMC and private orthopedic practices.