Hand & Wrist Injections

Some goals of injection treatments and non-surgical therapies are to help improve function for a variety of common painful hand and arm conditions. They can relieve pain by reducing inflammation, irritation, and swelling of nerves, joints, and soft tissue in the hand, wrist, or forearm. By addressing immediate pain, injections can also facilitate participation in hand therapy programs designed to strengthen muscles and resolve the underlying cause of pain.

The type of injection you receive will be based on your symptoms and physical examination. Below are some of the specialized image-guided injections we offer to patients.

Steroid Injections

Our specialists use steroid injections therapeutically and diagnostically. Injections can reduce or eliminate symptoms, making further treatment unnecessary to restore hand function. They can also confirm findings made during the clinical hand exam. 

Thumb, Finger, Wrist, or Elbow Arthritis

Arthritis commonly causes pain in the thumb, wrist, or elbow, as synovial joints, like others in the body, facilitate movement. When arthritis becomes significant, simple hand tasks such as buttoning a shirt or turning a car key can be painful.

The goal of a joint injection is to deliver a small amount of steroid (cortisone or corticosteroid) and local anesthetic into the inflamed joint, aiming to both diagnose and treat. The injected steroid reduces pain and improves movement and activity. In some cases, injections help diagnose the source of pain and determine eligibility for other treatments to alleviate joint pain.

Following a joint injection, patients can resume activity as tolerated, though they may experience increased inflammation in the area for a few days afterward.

While joint injections are generally safe and minimally invasive, there are associated risks and side effects. These may include pain at the injection site, minor infections (less than 1% of cases), increased pain or worsening symptoms, and potential fluctuations in blood sugar levels for diabetic patients. Allergic reactions to medications used in the procedure, such as Lidocaine and corticosteroid (cortisone), are rare but possible.

Carpal Tunnel Syndrome

Carpal tunnel syndrome results from compression of a nerve at the wrist, causing pain and tingling in the thumb, index, middle, and half of the ring finger. Symptoms may worsen at night and affect hand coordination and strength. The injection aims to reduce inflammation in the wrist’s carpal tunnel, providing relief by easing pressure on the median nerve. While generally safe, injections carry rare risks such as pain, minor infections, increased symptoms, and potential blood sugar fluctuations for diabetic patients. Common medications used include Lidocaine and corticosteroid (cortisone).

Platelet-Rich Plasma Injections

In recent years, medical professionals have uncovered the body’s innate ability to heal itself. Platelet-Rich plasma (PRP) therapy represents a breakthrough in regenerative medicine, tapping into these natural healing mechanisms by harnessing the body’s own growth factors to accelerate tissue repair.

PRP therapy involves injecting a concentrated solution of a patient’s own platelets to expedite the healing of injured tendons, ligaments, muscles, and joints. By utilizing each individual’s healing system, PRP injections offer a personalized approach to addressing musculoskeletal issues.

To prepare PRP injections, a small amount of the patient’s blood is drawn and centrifuged to isolate and concentrate the platelets. These activated platelets are then directly injected into the affected tissue, releasing growth factors that stimulate the production of reparative cells. In some cases, ultrasound imaging is employed to precisely guide the injection.

Studies have shown that PRP therapy significantly accelerates the healing process, leading to improved function and reduced pain. Notably, PRP injections offer several advantages, including the potential to reduce the reliance on anti-inflammatory drugs or stronger medications like opioids. Moreover, due to their autologous nature (derived from the patient’s own blood), PRP injections carry minimal risk of side effects as the body does not reject or react adversely to them.

Xiaflex Injections

If your fingers or thumb have become so curled that you cannot flatten your palm on a table, you might qualify for a Xiaflex injection. Xiaflex is an enzyme injection designed to break down the diseased tissue in the palm of your hand, which causes fingers to curl inward. The medication is injected directly into the affected tissue, and the patient typically returns to the clinic in 2-3 days. The goal of a Xiaflex injection is to enable the surgeon to straighten the patient’s fingers without the need for surgery.

Following an Injection
After the injection, your hand will be wrapped in soft gauze or a bandage. It is advisable to limit hand movement and keep the hand elevated for the first day following the injection. Refrain from attempting to straighten the injected finger until instructed by your doctor.

You must return to the clinic for a physician to manipulate or straighten your curled fingers. On the same day as the manipulation, a custom hand splint is crafted for you. You’ll also receive instruction in hand range-of-motion exercises and progressive functional activities.

Short-term hand therapy may be recommended to help maximize motion and function.

Potential Procedure Risks
Common post-injection side effects include:

• Pain
• Swelling
• Bruising
• Redness
• Itching at or around the injection site
• Swollen, painful areas in the elbow and underarm (swollen lymph nodes)

Serious side effects may include:

• Signs of infection (such as fever, chills, increasing redness/swelling)
• Signs of nerve injury (such as numbness/tingling/pain/strange feeling in the treated hand)
• Dizziness

During manipulation, tears in the skin around the injection site (lacerations) may occur. If this happens, you will receive instructions on wound care, and wound care supplies will be provided. Rare side effects include the possibility of the injection causing potentially permanent injury to the tendons/ligaments of the hand, which may require surgery for repair.

Our staff completes paperwork for the company that provides the medication and can guide you as you contact your insurance representative to determine your benefits regarding a Xiaflex injection.