Hands are made up of joints, ligaments, tendons, nerve fibers, and 27 bones. So to say the anatomy of the hand is complex is an understatement. When you’re experiencing pain, numbness, or tingling in your hand, it can be quite the task to pinpoint the cause.
Thankfully, there are hand specialists that have spent countless moments learning about the anatomy of the hand, wrist, and nervous system so you don’t have to be an expert.
Nerve damage is serious, can be long-lasting, and should be handled with caution and professional care. While you should seek medical attention, it can help to understand your nerve damage and what you can do to help yourself.
Read on to learn more about the nervous system, nerves, and what hand and wrist nerve damage looks like.
Nerves 101
Nerves carry messages between the brain and the rest of the body and make up the nervous system. These messages are electrical signals that allow you to breathe, to move and to feel sensations.
Nerves are composed of fibers, and when these fibers get damaged, the electrical signals don’t get transmitted properly. These nerve fibers are covered by a myelin sheath and can stretch and bend, but they are indeed fragile and if they break, a damaged nerve cannot send signals.
When trying to understand and imagine the anatomy of nerves in the hand or wrist, it can help to think of nerve fibers like a tightly wound and strong, but thin, rope that splinters out to the extremities from the brain and spinal cord.
The Nervous System
The nervous system is the body’s elaborate messenger system that transmits signals over the body. It is the essence of what makes YOU work!
The nervous system is comprised of the central nervous system, like the brain, nerves, and the spinal cord, and the peripheral nervous system is what branches out to the rest of the body in the form of nerves and sensory nerves that connect back to the central nervous system.
Nerves can also be categorized as autonomic, motor, or sensory.
Autonomic nerves help control functions like breathing, heart rate, and digestion; involuntary actions or actions you don’t need to think about to do.
Motor nerves send messages from your brain and spinal cord to the rest of your body to control voluntary functions like walking, eating, or snapping.
Sensory nerves send messages from different parts of your body like skin or muscles back to your brain and spine. These nerves help you feel pain and send signals back to the central nervous system to figure out what hurts and where.
There are nerves that give you the ability to feel pain and sensation, other nerves facilitate movement, some nerves can do both!
Nerve Damage
When your brain and spinal cord are involved, the word “damage” can sound scary. While it isn’t always severe, nerve damage is always serious.
Nerve damage can range in severity, location, and prognosis. Nerve damage can cause tingling, numbness, weakness, pain, etc., in the hand and wrist.
It is important to get any potential nerve damage checked out by a medical professional.
The Nerves in Hands and Wrist
Understanding the basics of how the hand works, where the nerves are, and what movements they control may provide insight into what type of nerve pain you are experiencing.
There are three nerves that travel through the wrist to the hand: the radial nerve, the median nerve, and the ulnar nerve.
Knowing where these three major nerves in the hand and wrist are and what they control can help you better understand your pain and the potential nerve damage behind it.
Radial Nerve
The radial nerve lies along the inside of your forearm, wrist, and thumb. Its executive function is to control the motor function of the wrist, fingers, and thumb.
The ability to straighten and extend the thumb and fingers is greatly impacted by radial nerve function.
Sensations on the back of the hand near the thumb are sent through the radial nerve sensory pathways.
Median Nerve
The median nerve provides the message path for flexion of the thumb, index as well as the sensations in the tips of the thumb, index, middle, half of the ring finger (closest to the middle finger) and the palm.
Grasping and releasing are just some of the motions that the median nerve facilitates.
Ulnar Nerve
The ulnar nerve provides the sensory pathway for the half of the ring finger (closest to the pinky), the pinky finger, and and part of the palm. The ulnar nerve is responsible for flexion in the pinky and ring fingers and also bending at knuckles. It provides also is responsible for making most of the tiny muscles in between the long bones (metcarpals) move in the hand.
If you were to hold an item in your hand and bend your knuckles and maneuver the object around, the ulnar nerve would have a large role in this manipulation.
Signs and Symptoms
Signs and symptoms of nerve damage in the wrist and hand often include pain, numbness, and limited mobility. The type of symptoms experienced are reflective of which nerve is damaged.
Symptoms can be constant or intermittent depending on the type of nerve damage.
Pain
Pain in the hands is one of the most common signs of nerve damage. There are a lot of other causes of hand and wrist pain such as broken bones, bruising, sprains, etc., so it is essential to proper treatment and healing to sort out the source.
Depending on the extent and type of nerve damage, pain can range from irritating to debilitating.
First ask yourself, where does it hurt? Is it the tip of your fingers? The palm of your hand? What type of sensation is it?
Pain may indicate some sort of sensory nerve damage and medical attention should be pursued.
Loss of Function
Loss of motor and/or sensory function in the hand, wrist, and arm. Any damage to nerves that facilitate motor function can cause twitching or paralysis.
Motor nerve damage Nerve damage may cause limited motion or range of motion. Everyday tasks could be met with some difficulty.
Numbness
Numbness is a common sign of nerve damage, especially recurring numbness. Damage to nerves that transmit sensation would cause numbness.
Tingling
Some nerve damage in your hand or wrist makes it feel like pins and needles are on your hand. Tingling in your fingers, hand, or wrist may indicate
How Will I Know?
If you experience pain, tingling, numbness, burning, weakness, paralysis, or any sensitivity in your hand and wrist, you may have nerve damage. If you have any of these symptoms, see a trusted hand specialist in your area.
Causes
Nerve damage can be caused by illness, injury, overexertion, or extreme lack of nutrition.
Injury
Injury to the nerves can occur when the hand, wrist, or finger is broken, crushed, overstretched, cut, or burned. It is the major cause of nerve damage to the hand and wrist.
Injury to the median nerve will cause difficulties with flexion of the thumb, index, and middle fingers.
Injury to the radial nerve may cause pain or loss of function in the thumb, index, and middle fingers. It may also facilitate numbness or tingling sensations on the back of the hand and the thumb area.
Injury to the ulnar nerve can cause sensations to the outer side of your hand near your pinky, ring, and middle finger, as well as loss of function or pain with bending at the knuckles. If you have limited ability to manipulate objects with your fingers, you may have an injury to this nerve.
Common Nerve Injuries
Whether you’re experiencing tingling, numbness, pain, or immobility, there is something behind that sensation or lack thereof. What is the injury? Where is it?
There are many potential reasons that your fingers, hand, and wrist aren’t functioning properly.
Cut or Torn Nerve
An acute injury can cause a cut or tear in the nerve fibers. When there is a cut in the nerve, the messages are not able to be sent from the central nervous system to the hand, and vice versa. The nerve is not able to transmit its signals and loss of function or sensory issues may present.
A torn or broken nerve fiber may heal itself over time (or it may not), but a cut nerve often needs surgery to assist in regaining function.
Stretched Nerve
Nerves don’t have to tear or cut completely to be damaged. Nerves have the ability to stretch. Often, these stretched nerves have the ability to rebuild, and even more so with supportive care.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is common. Nerve damage/ injury is produced from too much pressure on the median nerve in the carpal tunnel space in your wrist.
Damage can be caused by repeated actions and usage, or from a trauma like a dislocation or fracture. The median nerve passes the nine tendons, and the swelling of the tendons can cause pain.
Carpal tunnel syndrome has many potential causes and can even be caused by fluid build-up in pregnancy! Also anyone with metabolic issues such as diabetes or hypothyroidism may have an increase risk of getting carpal tunnel syndrome.
Common signs and symptoms of carpal tunnel syndrome include weak grip, pain in the wrist and hand, numbness, and tingling. Treatment may include immobilization, physical therapy, or surgery.
Treatment
The best treatment plan for you will be established by you and your medical team, but it can be helpful to have an idea of what types of treatments exist. The types of treatment will vary based on the severity of the nerve damage.
A physician will use tests such as physical examination, X-rays, ultrasounds, emg(electromyelogram) / NCV (nerve conduction velocity) and MRIs to evaluate the possible damage to the hand and wrist. If a nerve damage diagnosis is made, your treatment options will be discussed.
If you have mild or moderate nerve damage, rest, immobilization, and/or physical therapy may be the best initial treatment options. WIth your physician’s approval, it can also help to treat the symptoms of nerve damage with anti-inflammatories, heat, and other at-home treatments.
Carpal tunnel syndrome is an example of nerve damage that may eventually require surgery after mild treatment. If you have an injury and severe nerve damage like a cut nerve, you may immediately require surgery. A paper published by our surgeon Dr. Lopez, showed that even after 6 weeks of nerve compression, you may need surgery.
Surgery
Surgery may be used in cases of pinched or compressed nerves, as well as partially or completely cut nerves.
When approaching the idea of surgery to correct hand or wrist nerve damage, find a trusted doctor. Some surgeons are able to do minimally invasive or no-stitch procedures to correct nerve damage like carpal tunnel syndrome.
Recovery
Recovery is dependent on a multitude of factors: age, health, type of injury, type of nerve damage, and treatment.
If the treatment of nerve damage is rest and immobilization, as in mild or moderate cases of nerve damage, recovery would be brief. If the nerve damage is severe or a surgery is performed, recovery may take months. Of course, the more invasive the surgery, the more complex the recovery.
After surgery, the nerves will heal and grow. In the most ideal condition, a peripheral nerve can grow up to an inch over the span of a month!
Physical therapy after surgery may help regain function and feeling. Even with the best surgery, those with severe nerve damage may not regain total functionality of their hand and wrist.
Do You Have Nerve Damage?
If you are experiencing any pain, sensations, numbness, or loss of function in your hand or wrist, you may have nerve damage. The only way to know for sure is to see a trusted hand specialist and be evaluated.
The best way to combat nerve damage to the wrist or hands is to understand where it is coming from and taking the appropriate steps to fix it. If you think that you may have a hand or wrist injury, contact a medical expert at the Hand Surgery Specialists of Texas.
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