Nerve Injuries to the Hand

The hands and fingers are home to complex networks of nerves that allow us to feel and touch. However, these delicate systems can become damaged easily in a finger or hand injury, resulting in permanent complications and nerve injuries to the hand if not treated properly.

Causes

Nerve injuries to the hand are typically the result of several types of injuries, including cutting injuries, stretching injuries, and pressure injuries. Each nerve consists of a bundle of nerve fibers wrapped in a sheath. In a cutting injury, the sheath and fibers will become detached and the nerve fibers will attempt to reattach across the gap as the cut heals. However, in some cases, they do not reconnect properly and will form a painful cluster of nerve endings called a neuroma. With stretching and pressure injuries, the nerve fibers can be stretched or torn. In some cases, the sheath around the fibers will remain intact, allowing the fibers to reconnect.

Symptoms

Symptoms vary widely in nerve injuries to the hand, but the most common indicator is loss of sensation. This means that cold, heat, and pain will not be felt in the hand like it would in other parts of the body, resulting in the potential for burns and other severe injuries. Nerve damage can also lead to strong sensations of pain or even paralysis.

Diagnosis

To properly diagnose nerve injuries to the hand, a physician will conduct a detailed exam to determine what has been injured. This can include a nerve conduction velocity/EMG test to see how well signals are transmitting from the nerve to the brain. An MRI may also be used to see inside the hand and identify damage to the hand and nerves.

Treatment

Nerve injuries to the hand can often heal without surgery; however, other surgery may be required in severe cases. If the nerve is severed, the ends could need surgical reattachment or to be placed in a guide so they can grow back. Physical therapy may also be required.