Wrist and hand pain comes from tendons, small joints and nerves packed into a narrow space — and every one of them can be seen on ultrasound. Most are treated with a single precise injection; surgery is reserved for nerve compression with weakness or wasting.
Tendons pass through tight sheaths at the wrist and fingers and swell with repetitive use, catching or compressing what runs alongside. The median nerve shares the carpal tunnel with nine tendons; any swelling there presses on it. The thumb base joint wears early because of the loads it takes.
Examination of sensation, strength and tendon function; ultrasound to measure the nerve, see tendon sheath swelling and guide any injection. Nerve conduction studies when carpal tunnel is moderate or severe.
Conditions treated
Compression of the median nerve at the wrist; night-time tingling, dropping objects, morning stiffness. Mild to moderate cases: an ultrasound-guided steroid injection or hydrodissection (freeing the nerve with fluid) with a night splint. Constant numbness, weakness or thumb muscle wasting: surgical release, referred directly.
Inflammation of the tendon sheath on the thumb side of the wrist, common after childbirth and with repetitive lifting. An ultrasound-guided injection into the sheath resolves most cases in one visit.
A nodule on a flexor tendon catches at the pulley, so the finger clicks or locks. An ultrasound-guided injection at the pulley; release surgery for the few that recur repeatedly.
Wear of the joint where the thumb meets the wrist; pain on pinch and grip. Splinting, then ultrasound-guided injection — steroid for flares, hyaluronic acid or PRP for longer-term management.
Injury to the cartilage and ligaments on the little-finger side of the wrist, usually after a fall or twist. Splinting, then ultrasound-guided PRP for partial injuries; referral for repair when the wrist is unstable.
A fluid-filled lump from a joint or tendon sheath, usually the back of the wrist. Ultrasound-guided aspiration and injection; harmless if left, removed if it recurs and troubles you.
Ten to twenty minutes under ultrasound guidance and local anaesthesia. Hand use resumes the same day, with heavy gripping avoided for a few days.
In mild and moderate cases it often gives months to years of relief, particularly with a night splint. Severe compression is a surgical problem.
No. It is placed beside the nerve, watched on ultrasound throughout.
Light typing the same day; avoid heavy gripping for two to three days.
Overnight the tendon swells and catches at the pulley. An injection at that pulley settles it.
It can, in roughly a third of cases after aspiration. It is harmless and can be treated again or removed.