Wrist & Hand Pain Treatment
in Tulsa, Oklahoma

That specific distribution (thumb, index, middle, and the thumb-side of the ring finger) is the classic pattern of median nerve compression at the wrist, which is carpal tunnel syndrome. Classic features also include numbness that wakes you at night, shaking the hand to relieve symptoms, and weakness of grip or pinch. That said, similar symptoms can come from a pinched nerve in the neck (C6 radiculopathy), diabetic neuropathy, or proximal median nerve compression. Dr. Bhakta uses a careful exam (Tinel's, Phalen's, and carpal compression tests) and nerve studies when needed to be sure of the diagnosis before committing to treatment.

No, many patients with mild-to-moderate carpal tunnel syndrome do well with non-surgical care. Night splinting alone helps a meaningful subset of people, particularly when symptoms are intermittent. An ultrasound-guided carpal tunnel corticosteroid injection can provide months of relief and is often diagnostic as well as therapeutic. Ergonomic and activity modification, weight management, and treating underlying contributors like diabetes or hypothyroidism round out the plan. Surgical carpal tunnel release is typically reserved for severe or progressive cases, especially when the exam or nerve studies show advanced involvement.

Trigger finger (stenosing tenosynovitis) is a mismatch between a thickened flexor tendon and the narrow pulley that normally guides it. When the tendon nodule catches on the pulley, the finger snaps, clicks, or locks in flexion, sometimes requiring the other hand to straighten it. It is more common in people with diabetes and in the ring, middle, and thumb. A targeted ultrasound-guided corticosteroid injection into the A1 pulley sheath resolves symptoms in roughly 60-80% of cases, often after a single injection. Surgical release is reserved for persistent or recurrent cases.

Pain at the base of the thumb is most often from arthritis of the carpometacarpal (CMC) joint, the saddle joint where the thumb meets the wrist. It is particularly common in women over 50 and presents with pain during pinching, opening jars, turning keys, and writing. Imaging shows joint space narrowing and sometimes a visible bump. Most patients respond well to a combination of a short neoprene or custom thumb-spica brace, activity modification, and a precise ultrasound-guided injection of corticosteroid or PRP into the CMC joint. Surgery is a reasonable option for severe, refractory disease but is rarely the first step.

De Quervain's tenosynovitis is inflammation of the tendons on the thumb side of the wrist (abductor pollicis longus and extensor pollicis brevis) as they pass through the first dorsal compartment. It classically presents with sharp pain at the thumb-side of the wrist that worsens with grasping or lifting and a positive Finkelstein test. It is common in new parents from repeatedly lifting infants, in people with overuse hand activities, and in pregnancy. Splinting, activity modification, and an ultrasound-guided corticosteroid injection into the first compartment typically resolve symptoms quickly.

Ganglion cysts are the most common benign soft-tissue masses in the hand and wrist. They are fluid-filled sacs arising from a tendon sheath or joint capsule, most often on the back of the wrist or at the base of a finger. The classic feature is a soft, round, movable lump that may change size over time. Most are harmless and do not require treatment. When they are painful, limit motion, or compress a nerve, aspiration (with or without a corticosteroid injection) is a reasonable first step; ultrasound guidance improves accuracy and reduces recurrence. Surgical excision is reserved for persistent, symptomatic cysts.