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A Guide to Understanding Carpal Boss

Person with hand and wrist pain

If you have a small bump on the back of your hand you’ve always wondered about, you may have a condition known as carpometacarpal boss—carpal boss for short. It’s really nothing to worry about, unless your wrist occasionally becomes swollen and causes you pain. Many people with carpal boss never experience pain. The carpal boss bump is caused by a small immovable mass of bone growth on the back of the hand just above the wrist. Sometimes the bump is confused for a bone spur or early signs of arthritis. The mass can be anywhere on the back of the hand, but they’re most commonly found on the back of the hand just below the index or middle finger where it connects to the carpal bones. The condition usually affects a person’s dominant hand, but can also be seen in the non-dominant hand.

Symptoms

If you feel pain when you touch the bump or by moving your wrist, the source of the pain may be tendons moving over the carpal boss bump. Some people experience carpal boss after a wrist injury or if their job requires repetitive wrist motions. It can also be caused by, or aggravated by, playing racquet sports, such as tennis, racquetball or pickleball, or by playing golf.

Treatment

If you feel pain around the bump, or experience a loss of motion of the hand or wrist, there are treatment options to help. A hand and wrist specialist in Atlanta can meet with you to diagnose your condition and explore treatment options. The specialist will want to know the extent of your pain, physical movements that cause the pain, and how long you’ve been experiencing painful symptoms. If the pain or limited movement gets in the way of your employment or activity level in sports you enjoy, the specialist can explore surgical options to have the carpal boss bump removed.

In some cases, the bump may not actually be carpal boss, but rather be ganglion cysts of the hand (video). These cysts can mimic a carpal boss because of the cyst’s hard, outer shell. A ganglion cyst is actually filled with fluid that comes from the wrist joint. It can occasionally be aspirated, but more commonly requires surgical excision if the patient wishes to have it removed. To be sure if the bump is carpal boss or a cyst, the specialist will recommend an X-ray or MRI of your hand and wrist.

If you do have a carpal boss bump, nonsurgical treatments include wearing a splint to immobilize your wrist as well as icing the bump to reduce swelling and pain. The wrist and hand specialist may also recommend administering corticosteroid injections into the bump to reduce the inflammation. If these treatments don’t offer relief, your next option may be surgery.

Reviewing X-ray of hand

Surgery for Carpal Boss

Surgery to remove a carpal boss bump is among the more common types of hand surgery performed by a hand surgery specialist in Atlanta. A surgeon will make a small incision on the back your hand and shave down or cut out the bump. Sometimes other areas of damaged bone and cartilage are removed during the surgery. This is a simple one-day outpatient procedure that doesn’t require a hospital stay. The procedure can be completed in under one hour. You’ll need to wear a splint for about a week while your hand and incision heals. Depending on the healing process, you can typically use your hand for normal activity anywhere between two and six weeks after the procedure.

Surgery is an extreme action taken by people living with carpal boss. If pain is mild, most people live with the condition and treat it with light pain medication and by limiting wrist activity that causes pain. To learn more about carpal boss, call Piedmont Orthopedics | OrthoAtlanta at 770-953-6929.

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