Hand, Wrist & Elbow Pain Care in Northern Virginia

Pain, numbness, weakness, or stiffness in your hand, wrist, or elbow can interfere with almost everything you do—from typing and gripping to exercising, working, driving, and sleeping comfortably. Because the upper extremity contains many small joints, tendons, ligaments, muscles, and nerves, similar symptoms can come from very different conditions.

At Arthritis & Sports Orthopaedics, our upper-extremity specialists diagnose and treat injuries and conditions affecting the hand, wrist, and elbow. Treatment may include activity changes, medication, custom splinting, occupational hand therapy, injections, minimally invasive procedures, or surgery depending on the cause and severity of your symptoms.

What Can Cause Hand, Wrist & Elbow Pain?

Hand, wrist, and elbow symptoms can develop gradually from arthritis or repetitive activity or begin suddenly after a fall, sports injury, or other trauma.

Some conditions primarily affect a joint or tendon, while others involve nerves that travel from the arm into the hand.

Carpal Tunnel & Cubital Tunnel Syndrome

Carpal tunnel syndrome develops when the median nerve becomes compressed as it passes through the wrist.

Symptoms commonly include numbness, tingling, burning, or an electric-shock sensation involving the thumb, index finger, middle finger, and part of the ring finger. Symptoms often become more noticeable at night, and some people wake up needing to shake their hand to restore feeling.

Cubital tunnel syndrome affects a different nerve—the ulnar nerve—most commonly near the inside of the elbow.

It typically causes numbness or tingling in the ring and little fingers and may become worse when the elbow remains bent for a long period.

The location of numbness can provide an important clue about which nerve may be involved.

Learn more about carpal tunnel, cubital tunnel, and nighttime hand numbness.

Trigger Finger & De Quervain's Tenosynovitis

Trigger finger occurs when a tendon that bends the finger becomes irritated and has difficulty gliding normally.

The affected finger may feel stiff, catch or lock when bending, or become painful near the base of the finger. Some patients notice that the finger is particularly stiff or stuck when they first wake up.

De Quervain's tenosynovitis affects tendons along the thumb side of the wrist. It can cause pain with gripping, lifting, pinching, or moving the thumb.

Treatment depends on the severity of the condition and may range from activity modification and splinting to injections or surgery.

Hand, Wrist & Elbow Arthritis

Arthritis can affect the many small joints of the fingers and hand as well as the wrist and elbow.

Symptoms may include pain, stiffness, swelling, reduced grip strength, loss of motion, or changes in the appearance of a joint.

Treatment depends on which joint is affected and the severity of the arthritis. Many patients begin with nonsurgical options designed to reduce pain while preserving motion and function.

Learn more about arthritis treatment.

Ganglion Cysts & Dupuytren's Disease

Ganglion cysts are fluid-filled lumps that commonly develop near joints or tendons in the wrist or hand.

Some cause little or no discomfort, while others may become painful, interfere with motion, or place pressure on nearby structures.

Dupuytren's disease affects the tissue beneath the skin of the palm. Over time, thickened tissue may form cords that pull one or more fingers toward the palm and make it difficult to straighten them completely.

Treatment for these conditions depends on symptoms, progression, and how much they interfere with normal hand function.

Fractures, Sprains & Ligament Injuries

Falls, sports injuries, workplace accidents, and other trauma can cause fractures or ligament injuries involving the fingers, hand, wrist, or elbow.

Some fractures can be treated with immobilization, while others may require reduction or surgical stabilization.

Persistent pain, swelling, deformity, or difficulty using the hand or arm after an injury should be evaluated to determine whether a fracture or significant soft-tissue injury is present.

Tendon Injuries & Tendonitis

Tendons connect muscles to bones and help create movement in the fingers, wrist, and elbow.

They can become irritated from repetitive activity or damaged by a sudden injury.

Symptoms may include pain with movement, weakness, swelling, or difficulty performing specific motions. Complete tendon injuries may cause a sudden loss of normal finger, wrist, or arm function and require prompt evaluation.

Tennis Elbow & Golfer's Elbow

Tennis elbow and golfer's elbow are forms of tendinopathy involving the tendons around the elbow.

Tennis elbow typically causes pain along the outside of the elbow, while golfer's elbow usually causes discomfort along the inside.

Despite their names, you do not need to play tennis or golf to develop either condition. Repetitive gripping, lifting, tool use, exercise, and occupational activities can also place repeated stress on these tendons.

Most patients begin with nonsurgical treatment.

What Can the Location of Your Symptoms Tell You?

The location of pain or numbness can provide useful clues about which structures may be affected, although symptoms alone cannot confirm a diagnosis.

Numbness in the Thumb, Index & Middle Fingers

Numbness or tingling involving the thumb, index finger, middle finger, and part of the ring finger may suggest compression of the median nerve at the wrist, as occurs with carpal tunnel syndrome.

Symptoms that repeatedly wake you at night or improve temporarily when you shake your hand are also commonly reported with carpal tunnel.

Numbness in the Ring & Little Fingers

Numbness or tingling primarily involving the ring and little fingers may indicate irritation of the ulnar nerve.

Cubital tunnel syndrome is one possible cause, particularly when symptoms become worse with prolonged elbow bending or when leaning on the elbow.

Pain on the Thumb Side of the Wrist

Pain near the base of the thumb or along the thumb side of the wrist may occur with De Quervain's tenosynovitis, arthritis, certain ligament injuries, or other wrist conditions.

An examination can help determine which structure is responsible.

Pain on the Outside or Inside of the Elbow

Pain along the outside of the elbow is commonly associated with tennis elbow, while pain along the inside may occur with golfer's elbow.

Nerve compression, ligament injuries, arthritis, fractures, and other conditions can cause pain in similar areas, so persistent symptoms should not automatically be assumed to be tendonitis.

When Should You See a Hand or Upper-Extremity Specialist?

Consider scheduling an orthopedic evaluation when pain, numbness, tingling, stiffness, or weakness persists, repeatedly returns, or begins interfering with your work, sleep, exercise, or normal daily activities.

An evaluation may be especially helpful if you are dropping objects, losing grip strength, waking repeatedly because of numbness, experiencing a finger that locks or catches, noticing increasing joint stiffness, or having difficulty performing movements that were previously easy.

Seek prompt evaluation after an injury if you notice significant swelling, deformity, inability to move a finger or joint normally, loss of sensation, or severe pain.

Sudden weakness or numbness affecting one side of the body—especially when accompanied by facial drooping, difficulty speaking, confusion, difficulty walking, or vision changes—requires emergency medical attention.

How Are Hand, Wrist & Elbow Problems Diagnosed?

Accurate diagnosis is particularly important in the upper extremity because symptoms from the hand, wrist, elbow, and even the neck can overlap.

Your provider will ask where your symptoms occur, when they began, which activities make them worse, whether an injury occurred, and how they are affecting the use of your arm or hand.

Physical Examination

During the examination, your provider may evaluate motion, strength, sensation, tenderness, stability, swelling, grip, and specific movements that reproduce your symptoms.

For numbness or tingling, the pattern of the affected fingers can help determine whether a nerve may be compressed at the wrist, elbow, neck, or another location.

X-Rays, Ultrasound & MRI

X-rays are commonly used to evaluate suspected fractures, arthritis, joint alignment problems, and other changes involving the bones.

Ultrasound or MRI may be recommended when a tendon, ligament, nerve, cartilage, or other soft-tissue problem is suspected.

Not every patient needs advanced imaging. The appropriate test depends on your symptoms, examination, medical history, and suspected diagnosis.

Nerve Testing When Appropriate

Nerve conduction studies and electromyography, or EMG, can provide information about how a nerve is functioning.

These tests are not required for every patient with suspected carpal tunnel syndrome. They may be particularly helpful when the diagnosis is unclear, symptoms are unusual, or your provider needs to determine whether another nerve condition may be contributing to the problem.

What Are the Nonsurgical Treatments for Hand, Wrist & Elbow Problems?

Many upper-extremity conditions can initially be treated without surgery.

Your treatment plan will depend on the diagnosis, severity of your symptoms, your occupation and activities, and how much the condition is affecting normal function.

Activity Modification & Medication

Temporarily modifying activities that repeatedly aggravate an injured tendon, joint, or nerve may allow symptoms to improve.

Your provider may also discuss appropriate over-the-counter or prescription medication based on your diagnosis, medical history, and individual needs.

Bracing & Custom Splinting

Splints and orthoses can protect an injured area, reduce stress on irritated tissues, position a joint appropriately, or limit movements that aggravate symptoms.

At Arthritis & Sports, our occupational hand therapists can fabricate custom orthoses designed around a patient's specific condition and functional needs.

Custom splints may be used as part of treatment for selected nerve, tendon, arthritis, stiffness, injury, or postoperative conditions.

Learn more about custom splinting.

Occupational Hand Therapy

Specialized hand therapy can help restore motion, strength, dexterity, coordination, and function after an injury, surgery, or chronic upper-extremity condition.

Treatment may include therapeutic exercises, hands-on techniques, education, scar management, custom orthosis fabrication, and activities designed to improve the ability to perform everyday tasks.

Our Sterling rehabilitation clinic includes occupational therapists with advanced training in hand and upper-extremity rehabilitation who work closely with our orthopedic team throughout recovery.

Learn more about occupational hand therapy.

Injections

Injections may be appropriate for selected hand, wrist, or elbow conditions.

Their purpose and expected benefit depend on the specific diagnosis. For example, an injection used for an inflamed tendon condition is not necessarily appropriate for a nerve problem or arthritic joint.

Your orthopedic specialist can discuss whether an injection is appropriate based on your diagnosis and treatment goals.

Treatment for Chronic Elbow Tendon Pain

Most patients with tennis elbow or golfer's elbow begin with nonsurgical treatment.

When chronic tendon pain continues despite an appropriate conservative treatment program, a minimally invasive procedure such as Tenex may be considered for selected patients.

Tenex uses ultrasound guidance to identify and remove damaged tendon tissue through a small incision.

Learn more about the Tenex procedure.

When Is Surgery Considered?

Surgery may be considered when an injury requires repair or stabilization, when nerve compression is causing progressive symptoms, or when pain and loss of function continue despite appropriate nonsurgical treatment.

The procedure recommended depends on the diagnosis.

Carpal & Cubital Tunnel Release

Surgery may be considered for certain patients with significant or persistent nerve compression.

Carpal tunnel release creates more room for the median nerve at the wrist, while cubital tunnel procedures address compression of the ulnar nerve near the elbow.

Whether surgery is appropriate depends on symptoms, examination findings, nerve function, and response to nonsurgical treatment.

Trigger Finger & Tendon Procedures

When trigger finger continues despite appropriate nonsurgical treatment, a trigger finger release can create more space for the affected tendon to move freely.

Other tendon injuries may require surgical repair when normal function cannot be restored adequately without surgery.

Fracture Fixation & Soft-Tissue Repair

Some fractures can heal successfully with splinting or casting, while unstable or displaced injuries may require surgery to restore alignment and stability.

Surgery may also be necessary for certain ligament, tendon, or other traumatic injuries involving the hand, wrist, or elbow.

Surgery for Arthritis & Other Joint Conditions

When severe arthritis or another joint condition causes persistent pain and significant loss of function, surgical options may be considered after nonsurgical treatments are no longer providing enough relief.

The procedure depends on the specific joint, the amount of damage, the patient's activity level, and the goals of treatment.

Which Arthritis & Sports Specialist Should I See?

Our upper-extremity team includes specialists with complementary areas of expertise in hand surgery, elbow care, sports medicine, and rehabilitation.

Elaine J. Ahillen, MD — Hand, Wrist & Upper Extremity

Elaine J. Ahillen, MD, is a board-certified orthopaedic surgeon with fellowship training in hand surgery.

She specializes in conditions affecting the hand, wrist, elbow, and upper extremity and provides both nonsurgical and surgical treatment for nerve compression, tendon disorders, arthritis, fractures, traumatic injuries, and other upper-extremity conditions.

Dr. Ahillen sees patients at our Sterling office.

Meet Dr. Elaine Ahillen.

Matthew H. Griffith, MD — Elbow & Sports Medicine

Matthew H. Griffith, MD, is a board-certified orthopaedic surgeon with fellowship training in sports medicine and shoulder surgery.

He evaluates and treats athletic and other upper-extremity injuries, including conditions affecting the elbow, using both nonsurgical and surgical approaches.

Dr. Griffith sees patients at our Sterling office.

Meet Dr. Matthew Griffith.

David S. Goodwin, MD — Sports Medicine & Elbow Injuries

David S. Goodwin, MD, is a board-certified orthopaedic surgeon specializing in sports medicine, arthroscopy, and joint-preservation techniques.

He treats youth and adult patients with sports-related and other orthopedic injuries, including selected elbow conditions.

Dr. Goodwin sees patients at our South Riding office.

Meet Dr. David Goodwin.

Hand, Wrist & Elbow Care in Northern Virginia

Arthritis & Sports provides hand, wrist, and elbow care for patients throughout Loudoun County and Northern Virginia.

Specialized hand and wrist care with Dr. Elaine Ahillen and occupational hand therapy are available at our Sterling location. Our sports medicine team also provides elbow and upper-extremity care in Sterling and South Riding.

Our integrated approach allows patients to access orthopedic evaluation, diagnostic services, custom splinting, rehabilitation, nonsurgical treatment, and surgical care through one coordinated practice.

Visit our Sterling location.

Visit our South Riding location.

Frequently Asked Questions About Hand, Wrist & Elbow Pain

How can I tell carpal tunnel from cubital tunnel syndrome?

Carpal tunnel syndrome usually causes numbness or tingling in the thumb, index finger, middle finger, and part of the ring finger because it involves the median nerve at the wrist. Cubital tunnel syndrome more commonly affects the ring and little fingers because it involves the ulnar nerve, usually near the elbow. The pattern can provide an important clue, but symptoms sometimes overlap. An examination can help determine where a nerve is being compressed.

Do I need an EMG for carpal tunnel syndrome?

Not everyone with suspected carpal tunnel syndrome needs an EMG or nerve-conduction study. Diagnosis often begins with your symptoms and physical examination. Nerve testing may be helpful when the diagnosis is unclear, symptoms do not follow the expected pattern, another nerve problem is suspected, or additional information about nerve function is needed.

When should I worry about hand numbness?

Repeated numbness should be evaluated when it wakes you from sleep, begins occurring during the day, becomes constant, or occurs along with weakness, clumsiness, or frequent dropping of objects. Progressive nerve compression can eventually affect strength and hand function, so worsening symptoms should not simply be ignored.

Can tennis elbow get better without surgery?

Yes. Most patients with tennis elbow are initially treated without surgery. Treatment may include activity modification, rehabilitation, and other nonsurgical strategies designed to reduce tendon irritation and gradually restore strength and function. For selected patients whose chronic tendon pain continues despite appropriate conservative treatment, other procedures may be considered.

Does trigger finger always require surgery?

No. Treatment depends on the severity and duration of symptoms. Some patients improve with nonsurgical treatment, while others with persistent locking, pain, or loss of function may eventually benefit from trigger finger release.

When should wrist pain be evaluated?

Consider an orthopedic evaluation when wrist pain persists, follows an injury, causes swelling or weakness, limits gripping or lifting, or does not improve with basic home care. Wrist injuries can involve bones, ligaments, tendons, nerves, or joints, and these conditions often require different treatments.

Schedule an Appointment for Hand, Wrist or Elbow Pain

You do not have to determine the cause of your hand, wrist, or elbow symptoms on your own.

Our upper-extremity specialists can evaluate your symptoms, determine which structures may be involved, and recommend treatment based on your diagnosis, activity level, occupation, and goals.

Request an appointment with Arthritis & Sports Orthopaedics today.