Hands On

Avreeta Singh, MD, has a long-standing fascination with the intricate anatomy of the hand. She understands that painful fingers and wrists can quickly impact a person’s quality of life. We’re fortunate that Dr. Singh is among the expert orthopedic staff serving patients at Providence Little Company of Mary Medical Centers San Pedro and Torrance. Dr. Singh recently provided her insights about common hand problems and methods of treatment that can restore a patient’s quality of life.

What are the different types of common hand injuries?

First, there are degenerative conditions, such as arthritis of the wrist and fingers. Second is trauma, including fractures of the hand and wrist that can occur in both the elderly and pediatric populations. The third common type is nerve problems, or compression neuropathies. This includes carpal tunnel syndrome or cubital tunnel syndrome, in which people get numbness or tingling in their hands and sometimes burning pain that can be very debilitating. I also see a fair amount of people who have lumps and bumps on their hand and wrists—usually benign masses or cysts, which we’ll remove if the patient finds them painful or unsightly.

What sorts of symptoms should prompt a person to come to see you?

If there’s been a trauma and you notice swelling or bruising, it’s a sign you should be evaluated. People often think, I can still move my hand or finger, so it must be OK. That’s not always the case, because hands are pretty resilient and can function well despite fractures or other injuries. Persistent numbness in the hands or burning pain is another good reason. Lastly, any chronic pain in the wrist and hand that does not respond to rest, bracing or anti-inflammatory medication.

What range of treatments do you use? 

Often, we’ll start with the basics, including bracing or casting, activity modification and anti-inflammatory medications. In cases of nerve compression, we sometimes offer surgery for release of pressure on the nerves. In fractures that cannot be treated with bracing or casting alone, we will offer surgery to restore anatomy and function. A variety of degenerative and arthritis-related conditions can also be treated with steroid injections. We’ll initially try rest, ice, heat and using a brace, along with trying to avoid the activity that seems to be aggravating the problem. With pediatric patients, we may spend some time figuring out what sports activities are connected, and what they can and cannot do, to help them through their sports season.

Have there been any recent advances in hand surgery?

Yes. We perform minimally invasive surgery, which leads to less scarring and stiffness. In the past few years, arthroscopy, which uses a camera to guide the procedure, has become a lot more popular for the wrist. It’s also a helpful diagnostic tool.

What are the benefits of going to an experienced hand specialist?

Hand anatomy is intricate and complicated, with a lot of structures packed into a small space. Having training that focuses on this anatomy makes us better at localizing where the problem is coming from. Also, when you’re a hand specialist, you see more patients from beginning to end and have a better sense of the potential outcomes and when surgery may or may not be beneficial. It’s easy to miss injuries or fractures in children, for example, unless you look at those types of X-rays all the time so that you can pick up on the subtleties. We treat every case individually to provide the best possible outcome.

For more information on treatment for hand disorders, call 844-925-0942.