Hand & Wrist Disorders Palm Beach County
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1002 S Old Dixie Hwy Jupiter, FL 33458
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Hand & Wrist Anatomy
The hand and wrist are composed of a complex network of bones, joints, tendons, ligaments, and nerves that enable precise and powerful movement. Together, they allow us to perform a wide range of tasks. The wrist serves as a flexible link between the forearm and hand, while the hand provides fine motor control and strength for countless daily functions.
Whether you’re typing on a keyboard, opening a jar, shaking hands, or playing a sport, the coordination of the wrist and hand is essential to nearly every aspect of life. Unfortunately, the same complexity that allows for such versatility can also make these structures prone to injury, overuse, arthritis, and nerve compression.
Dr. Diaz offers focused, individualized care for a wide range of wrist and hand conditions. During your consultation, she will work with you to diagnose the source of your symptoms and develop a treatment plan tailored to your lifestyle, activity level, and overall health.
Specific Hand Conditions
Thumb CMC (Basal Joint) Arthritis
The carpometacarpal (CMC) joint at the base of the thumb is essential for thumb movement and grip strength. Arthritis here is common, particularly in postmenopausal women. Patients may notice pain, swelling, and tenderness at the base of the thumb, worsening with pinching or grasping. Activities such as opening jars, turning keys, or writing become difficult. Over time, joint deformity and weakness can develop.
Wear and tear over time, previous injuries, or joint instability can contribute to cartilage breakdown. Conservative management includes splinting, anti-inflammatory medications, and corticosteroid injections. Occupational therapy focuses on strengthening and adaptive techniques. For advanced arthritis, surgical options such as trapeziectomy with ligament reconstruction may be recommended.
Post-surgical recovery includes immobilization followed by therapy to restore motion and function. Most patients regain significant pain relief and improved use within 3-6 months.
Dupuytren Contracture
Dupuytren contracture causes thickening of the palmar fascia, resulting in cords that pull the fingers, usually the ring and pinky, into a bent position. The earliest sign is a nodule or lump in the palm that may be painless. Over time, cords develop that limit finger extension, making it hard to straighten fingers fully. This affects hand function, grip, and fine motor tasks.
The exact cause is unclear but is linked to genetics, age, and certain medical conditions like diabetes and alcohol use. Mild cases may be observed. Needle aponeurotomy is a minimally invasive technique to release the cords. More severe contractures require surgical fasciectomy, where the diseased tissue is removed.
Needle procedures allow quick return to activity. Surgery involves a longer recovery, with wound care, splinting, and hand therapy over several weeks to months. Most patients regain finger function and motion.
Trigger Finger (Stenosing Tenosynovitis)
Trigger finger occurs when inflammation thickens the tendon sheath, causing the finger to catch or lock in a bent position. Patients experience stiffness and pain at the base of the affected finger, often worsening in the morning. Finger movement may produce clicking or a sudden release as it “snaps” straight. Locking can interfere with hand function.
Repetitive gripping or underlying conditions like diabetes and rheumatoid arthritis increase risk. Conservative care includes rest, splinting, and corticosteroid injections. Persistent or severe cases may require surgical release of the tendon sheath to restore smooth motion.
Recovery from injection is quick, with symptoms often improving in days to weeks. Surgical release requires a short period of limited use, followed by therapy to restore motion, with most patients recovering full finger function within weeks.
Ganglion Cyst
Ganglion cysts are benign fluid-filled lumps that form near joints or tendon sheaths, most commonly on the wrist. Patients usually report a soft, round lump that may change in size. The cyst can cause pressure, aching, or interfere with wrist or finger motion. Most cysts are painless but can become tender with activity.
The exact cause is unknown but may be related to joint or tendon irritation. Many cysts resolve without treatment. Surgical excision is considered for persistent or symptomatic cysts.
Post-surgical recovery includes a brief immobilization period and gradual return to activity. Physical therapy helps restore wrist motion. Recurrence rates are low after surgery.
Specific Wrist Conditions
Distal Radius Fracture
The distal radius is the larger of the two forearm bones and forms a major part of the wrist joint. Fractures here are common, especially from falls onto an outstretched hand, and can range from simple breaks to complex, displaced fractures that disrupt the wrist joint surface. Patients typically experience immediate pain and swelling around the wrist. The wrist may appear deformed or “bent” if the fracture is displaced. Bruising and tenderness develop quickly. Movement of the wrist is painful and limited, and gripping objects can be difficult.
Falls from standing height, sports injuries, or motor vehicle accidents can cause distal radius fractures. Osteoporosis increases risk in older adults. Non-displaced fractures are usually managed conservatively with casting or splinting to immobilize the wrist while the bone heals. Displaced or unstable fractures often require surgery to realign the bones. Surgery typically involves fixation with plates and screws to restore normal anatomy.
Immobilization usually lasts 4-6 weeks, followed by physical therapy to regain strength and flexibility. Full functional recovery can take 3-6 months, depending on injury severity.
Scaphoid Fracture
The scaphoid is one of the small carpal bones in the wrist and is essential for wrist stability and motion. Fractures here are often missed initially due to subtle symptoms and difficulty visualizing the break on early X-rays. Pain and tenderness may be experienced in the anatomical snuffbox, a small hollow on the thumb side of the wrist. Swelling and difficulty gripping are common. Unlike other fractures, bruising is often minimal.
Scaphoid fractures typically occur after a fall onto an outstretched hand, especially when the wrist is extended. Stable fractures are treated with a long cast that immobilizes the thumb and wrist, often for 6-12 weeks. Displaced fractures or those that fail to heal may require surgery, using screws or pins.
Healing time is longer than most fractures due to the bone’s limited blood supply. Follow-up imaging is important to ensure bone healing. Physical therapy after immobilization helps restore wrist motion and grip strength.
TFCC Tear (Triangular Fibrocartilage Complex)
The TFCC is a network of ligaments and cartilage that stabilizes the wrist on the pinky side and acts as a shock absorber during forearm rotation. When torn, patients often report pain on the ulnar (pinky) side of the wrist, especially with rotation, gripping, or lifting heavy objects. A clicking or popping sensation may be felt. Wrist weakness or instability can develop in chronic cases.
Acute tears can result from a fall or a sudden twisting injury, while repetitive wrist motions or degenerative changes may lead to chronic tears. Initial care involves rest, splinting, and anti-inflammatory medications. In some cases, physical therapy focused on wrist strengthening and stability is effective. If symptoms persist, wrist arthroscopy may be performed to repair or debride the damaged tissue.
Recovery depends on tear severity and treatment. Immobilization usually lasts 4-6 weeks, followed by gradual return to activity with therapy. Full recovery may take several months, especially if surgery is involved.
Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through a narrow tunnel in the wrist, leading to nerve irritation. Patients often experience numbness, tingling, and pain in the thumb, index, middle, and part of the ring finger. Symptoms often worsen at night or with repetitive hand use. Weakness or clumsiness in the hand may develop over time, making it difficult to grasp or perform fine motor tasks.
Repetitive wrist movements, swelling from injury, systemic conditions (like diabetes or thyroid disease), and anatomical variations contribute to nerve compression. Early management includes wrist splinting, corticosteroid injections, and activity modification to reduce nerve irritation. If symptoms persist or worsen, surgical decompression (carpal tunnel release) can relieve pressure on the median nerve.
Non-surgical treatment may improve symptoms within weeks to months. Surgery typically provides more complete relief, with patients regaining strength and sensation over 3-6 months. Rehabilitation includes nerve gliding exercises and gradual return to normal activities.
Treatment & Recovery
Hand and wrist treatment is most effective when tailored to a patient’s individual symptoms, lifestyle, and activity demands. Dr. Diaz provides personalized, evidence-based care for hand and wrist injuries, ranging from repetitive strain conditions to trauma, with a focus on restoring strength, motion, and long-term function.
Non-Surgical Treatments
Conservative care is often the first step and may include:
- Oral or injectable anti-inflammatories
- Activity modification or rest
- Immobilization with splints or braces
- Physical and occupational therapy to restore strength, dexterity, and mobility
- Ice, compression, and ergonomic adjustments for daily tasks
Surgical Treatments
When non-operative care fails to resolve symptoms, or in cases of severe injury, Dr. Diaz offers both minimally invasive and advanced surgical solutions, including:
- Tendon repairs (e.g., flexor or extensor tendon injuries)
- Carpal tunnel release
- Fracture fixation and realignment
- Removal of cysts or inflamed tissues (ganglion cyst excision, synovectomy)
- Nerve decompression or repair (ulnar or radial nerve procedures)
- Joint reconstruction or replacement
Rehabilitation and Recovery
Recovery plans are customized to your procedure and personal goals. These typically involve:
- A guided, staged return to motion and function
- Hand therapy to regain fine motor skills, strength, and flexibility
- Home exercise programs to prevent stiffness and optimize healing
- Gradual return to work, sports, and other daily activities
Most patients can expect steady improvement in hand and wrist function and pain relief with the right treatment plan. Dr. Diaz partners closely with each patient throughout the healing process to ensure optimal recovery and a safe return to the activities that matter most.