Heaviness In The Hands : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 26/09/2022

Heaviness in the hands occurs with fatigue and prolonged physical exertion, as well as under the influence of pathological causes: arthritis, arthrosis or osteochondrosis, dermatomyositis, vascular lesions (venous thrombosis, lymphostasis). Less commonly, the symptom occurs in occupational nervosa. Diagnostic search includes instrumental methods: radiography and CT of the hand, ultrasound of the vessels of the hands and lymphoscintigraphy, ENMG. Laboratory methods help clarify the diagnosis. To stop discomfort, etiotropic drug therapy, physiotherapy (mud therapy, electrotherapy, massage), and surgical interventions are prescribed.

Causes of heaviness in the hands

Physiological factors

The symptom is usually noted after a long load on the hands: carrying and loading objects, wearing heavy bags, sports exercises for the muscles of the shoulder girdle and upper limbs. It is difficult for a person to raise his hands; when trying to move actively, pain and weakness occur. The duration of the discomfort period is from several hours to several days, depending on the degree of fatigue.

Diseases of the musculoskeletal system

An unpleasant feeling of heaviness and awkwardness of the hands develops in the initial stages of arthrosis, damaging the joints of the wrist or fingers. Patients feel moderate pain when making movements, gradually the intensity and duration of the pain syndrome increases. In addition to severity, a person is worried about tingling and numbness of the distal parts of the upper limbs; in advanced cases, bone deformities are formed.

Heaviness in the hands is often detected in patients with osteochondrosis, which affects the upper thoracic vertebrae. A person experiences awkwardness in movements, weakness, difficulty in lifting heavy objects and bags. Discomfort is combined with a feeling of tingling or numbness, periodic pain that radiates from the back to the shoulder and arm. Symptoms are aggravated by sharp bends and turns of the body.

Heaviness in the hands

 

Dermatomyositis

The disease is accompanied by damage to the striated muscles of the hands, because of which patients experience heaviness and weakness in the upper limbs. At the initial stage, there is a slight discomfort, the hands get tired faster when doing physical work. As dermatomyositis progresses, weakness reaches such an extent that the patient cannot comb his hair ("comb symptom"), brush his teeth, and hold a spoon.

vein thrombosis

If the thrombus is localized in the vessels of the upper extremities, venous stasis and edema develops distally to its location. Patients complain of excruciating heaviness, bursting, which intensify when lowering the arm down. The skin becomes purple-cyanotic and dense, when the affected area is felt, the discomfort intensifies. Sometimes sensitivity is disturbed, numbness and paresthesia are noted.

Lymphedema

Swelling of the arm due to lymphostasis most often occurs in women after an extended mastectomy performed for breast cancer. Less often, symptoms are observed against the background of axillary lymphadenitis. A person suffers from heaviness, dull pains in the affected limb, which are aggravated in the evening and after physical exertion. The skin is pasty, pale, with pressure a fossa is formed, which does not straighten out for a long time.

Professional neurosis

Heaviness in the hands occurs in people who are constantly forced to work with their hands - musicians, artists, typists and those who write often and a lot (doctors, teachers). People complain that it becomes more difficult for them to do their usual work, there is a feeling that the fingers "do not obey well." Symptoms are accompanied by tingling, numbness, and occasional soreness.

Diagnostics

Various specialists are involved in the examination of a patient who complains of heaviness in the hands: in addition to the therapist, an orthopedist-traumatologist, a neurologist, and a vascular surgeon are involved in the diagnostic search. During physical examination, attention is paid to skin color (pallor or cyanosis), the presence of edema, deformation of bone structures. For diagnostic purposes, the most informative:

  • Radiography. An x-ray of the hands in 2 projections helps to detect inflammatory or destructive processes in bone tissue, deformations of bones and joints. To clarify the diagnosis, a highly informative computed tomography of the hand is shown. If you need to study the condition of soft tissues and nerves, an MRI of the hand is performed.
  • Vascular ultrasound. Duplex scanning of the veins and arteries of the hands allows you to assess the speed of blood flow, identify blood clots or vasospasm, and visualize the network of collaterals. In order to examine in detail the vascular network of the upper extremities, ultrasound is supplemented by radiopaque angiography.
  • Electrophysiological diagnostics. ENMG is prescribed for suspected neuromuscular origin of heaviness in the hands. During the study, the doctor determines the speed of nerve response to stimuli, determines the localization and prevalence of the problem, and differentiates between nervous and vascular pathology.
  • Laboratory tests. To assess general changes indicating inflammation or systemic diseases of the connective tissue, a hemogram and a biochemical blood test are done. With thrombosis, coagulogram results are required. To confirm dermatomyositis, specialists perform a histological examination of muscle biopsies.
  • Additional methods. To diagnose diseases of the lymphatic system, x-ray lymphography and lymphoscingyrgaphy are performed. Studies show areas of tortuosity, lymphangiectasia, valve insufficiency. With a possible occupational neurosis, a psychiatric consultation is recommended.

Upper limb massage

 

Treatment

Help before diagnosis

If a person feels weakness, discomfort after physical exertion, you need to limit exercises on the muscles of the hands or change jobs, if possible. You can relax the muscles and eliminate the heaviness caused by physiological reasons with the help of a warm bath, light self-massage. It is better to keep the limbs in an elevated position so as not to provoke stagnation of blood and lymph, and not to aggravate unpleasant symptoms.

Given the variety of causes of heaviness in the hands, self-treatment of this problem will be ineffective. If the symptoms appear regularly, lead to impaired performance or a deterioration in the quality of life, do not hesitate to visit a doctor. In cases where heaviness in the hands is accompanied by rapid swelling, cyanosis of the skin, sharp pain, the patient needs urgent medical care.

Conservative therapy

To eliminate unpleasant symptoms, different approaches are used, taking into account etiological factors. With lesions of the venous or lymphatic vessels, the treatment consists in improving the outflow of fluid, for which phlebotonics, angioprotectors, antispasmodics are prescribed. With hypercoagulability, drugs with anticoagulant and antiplatelet action are indicated.

In osteoarticular pathologies, non-steroidal anti-inflammatory drugs are taken to combat discomfort, which quickly relieve pain and heaviness, reduce inflammation activity. If NSAIDs fail, corticosteroids are recommended. To relieve severe pain, drug blockades are made with local anesthetics. With writing spasm and other professional neuroses, botulinum therapy can be performed.

To prevent stagnation in the vascular bed of the hands, physiotherapy methods are used: laser therapy, lymphatic drainage massage, magnetotherapy. Mud therapy, UHF help to reduce pain, discomfort. With neurotic causes of heaviness in the hands, methods of psychoanalysis and cognitive-behavioral therapy are offered, and professional reorientation becomes an extreme measure if necessary.

Surgery

Surgical intervention is performed with lymphostasis and venous stasis, when conservative measures have not yielded results. Vascular surgeons perform a number of operations: thrombectomy, creation of microsurgical lymphovenous anastomoses, dermatofasciolipectomy. If the severity is due to compression of the nerve structures, surgical decompression of the nerve is performed.