Top Docs: 5 tips about hand pain

These days, computer keyboards -- along with smartphones, tablets and all the rest -- give fingers and hands a good workout. They can also be a source of pain.

Here's what you need to know:

1. MAKING THE SAME MOTION OVER AND OVER CAN CAUSE TROUBLE

Like any activity that involves repetitive motion, typing -- whether to text, tweet, surf or actually do some work -- can trigger pain and soreness in the hands.

This can strain and inflame tendons, causing tendinitis, or lead to carpal tunnel syndrome or exacerbated arthritis, especially at the base of the thumb, among other conditions, said Dr. Glenn Teplitz, an orthopedic surgeon and chief of the hand service at Winthrop Hospital in Mineola.

Dr. Craig Rosenberg, chairman of rehabilitation medicine at North Shore-LIJ Southside Hospital in Bay Shore, noted, however, that repetitive strain injuries have become somewhat less common over time.

"Initially, there was an epidemic of injuries as we transitioned from manual typewriter to word processing," Rosenberg said. "There were suddenly no breaks to hit the return at the end of a line, or take time to change paper," but now it's "generally not possible to type as fast on an iPad or iPhone." He expects there to be even fewer problems as more people move to voice-activated software.

2. TENDONS CAN PRESS ON NERVES, CAUSING PAIN

The pain people feel from too much typing has to do with tendons, which "are like strings that connect the muscles in your forearm to the bones in your hand," explained Dr. Ken Kamler, an orthopedic surgeon in Ridgewood and New Hyde Park who's affiliated with the North Shore-Long Island Jewish Health System.

"When muscles contract, they pull on the tendons, moving the fingers in the way that marionette strings make a puppet dance," he said. "The tendons pass through a tunnel in the wrist -- the carpal tunnel -- and then into each finger through a series of loops, just as a fishing line is directed along a fishing rod."

Kamler said that tendons swell when they're overused and press on a nerve in the carpal tunnel. "In the fingers they get stuck in the loops, causing pain and stiffness -- tendinitis," he said.

3. VIDEO GAMES CAN CAUSE PAIN IN THE THUMB

Overuse of the thumbs from playing video games can lead to a condition called De Quervain's disease, an inflammation of the sheath that surrounds tendons in the thumb, Rosenberg said.

"Video gaming has the potential to cause the greatest issues due to the high repetition and force with which the buttons are pushed," Rosenberg said.

Physicians use splints and surgery to treat the condition.

4. PREVENTION IS KEY

"One of the obvious things you can do is decrease the activity," Teplitz said. "When it hurts, stop." He said it's also a good idea to take frequent breaks, stretch your fingers and change the position of your hand and wrist while you're typing. And if possible, he said, use voice-recognition software so you don't have to type as much.

Rosenberg said it's important to pay attention not only to how often you're typing but how much force you use. Also, he said, it's a good idea to learn about things such as proper sitting position, avoidance of reaching, and maintaining the wrists in the correct position.

"Stay away from devices that cause the user to maintain the wrist in an awkward position for extended periods of time," he said. "It is also important to slowly work up to activities requiring high-frequency repetitive motion."

5. KNOW WHEN TO SEE A DOCTOR

"If you stop the activity and the symptoms diminish and don't return, then you don't need to see a doctor," Teplitz said. But do seek medical help "if the pain is persistent and not relieved with simple, over-the-counter remedies like Motrin or Advil," he said. "It's always advisable to see a physician sooner rather than later."

Common treatment recommendations include keeping the hands inactive, soaking them in warm water or paraffin wax, splinting to assist with numbness caused by carpel tunnel syndrome, cortisone injections for pain and sometimes surgery to widen the carpal tunnel or finger loops.

Occupational, physical and sports medicine, pain medicine

OCCUPATIONAL MEDICINE

Dr. Sara L. Mendelsohn

800 Woodbury Rd.

Ste. K

Woodbury

516-682-9142

PHYSICAL MEDICINE & REHABILITATION

Dr. Sylvia T. John

301 E. Main St.

Bay Shore

631-232-0057

Dr. Jason S. Lipetz

L.I. Spine Rehab. Medicine

801 Merrick Ave.

East Meadow

516-393-8941

Dr. Barry C. Root

Dept. Physical Med. & Rehab.

101 St. Andrews Ln.

Fl. 1N

Glen Cove

516-674-7501

Dr. Craig H. Rosenberg

Southside Hosp.-Health Inst.

301 E. Main St.

Bay Shore

631-675-4550

Dr. Adam B. Stein

825 Northern Blvd.

Fl. 1

Great Neck

516-465-8609

SPORTS MEDICINE

Dr. Stephen A. Kottmeier

14 Technology Dr., Ste. 11

East Setauket

631-444-4233

Dr. Eric A. Putterman

1800 Walt Whitman Rd.

Ste. 120

Melville

631-293-9540

HAND SURGERY

Dr. Robert I. Gluck

Hand Center Long Island NY

410 Lakeville Rd.

Ste. 310

New Hyde Park

516-280-5844

Dr. Lawrence C. Hurst

14 Technology Dr., Ste. 11

East Setauket

631-444-3145

Dr. Kenneth M. Kamler

410 Lakeville Rd., Ste. 303

New Hyde Park

516-326-2266

Dr. Lewis B. Lane

611 Northern Blvd., Ste. 200

Great Neck

516-723-2663

Dr. Thomas J. Palmieri

1901 New Hyde Park Rd.

New Hyde Park

516-822-4843

Dr. Glenn A. Teplitz

Winthrop Orthopaedic Assocs.

1300 Franklin Ave.

Ste. UL-3A

Garden City

516-747-8900

Dr. David Tuckman

600 Northern Blvd., Ste. 300

Great Neck

516-627-8717

PAIN MEDICINE

Dr. Carole Agin

Integrative Pain Medicine

3 Delaware Dr., Fl. 2

Lake Success

516-622-6105

Dr. Juan Gargiulo

365 County Rd. 39A

Ste. 15-16

Southampton

631-702-2300

Dr. Steven J. Litman

All Island Pain Consultants

387 E. Main St.

Ste. 104

Bay Shore

631-665-0075

Dr. Steven Pinsky

176 N. Village Ave.

Ste. 2D

Rockville Centre

516-764-4875

Dr. Philippe D. Vaillancourt

877 E. Main St.

Ste. 106

Riverhead

631-727-0660

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Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

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