Hand numb or aching?Wrist, thumb or finger.Get your grip back.

They are problems of the nerves, tendons and joints of the wrist and hand: carpal tunnel syndrome, De Quervain's tenosynovitis at the thumb side of the wrist, trigger finger or thumb, arthritis at the base of the thumb, sprains, and a weak grip. They overlap and can look alike, so an assessment matters more than the label.

Numbness or tingling in the thumb, index, middle and half of the ring finger, often waking you at night, is typical of carpal tunnel syndrome, where the median nerve is squeezed under a ligament at the wrist. Wrists curl while we sleep, which narrows the tunnel. Shaking the hand often eases it. It is more common in women, in pregnancy and around the menopause.

No. Numbness can also come from the neck, the elbow (the ulnar nerve, which supplies the little finger and half of the ring finger) or other conditions such as diabetes or thyroid disease. Carpal tunnel spares the little finger. Neck movement that brings it on, or numbness in the whole hand, points elsewhere, and an examination separates them.

The evidence is weaker than most people expect. Work with a lot of forceful, repetitive or vibrating hand use is linked with it, but ordinary keyboard and phone use has not been shown to be a clear cause. Pregnancy, diabetes, thyroid disease, inflammatory arthritis and family tendency matter more. Changing how you work still helps the symptoms.

For carpal tunnel syndrome, a night splint that holds the wrist straight (neutral) is the most useful first step and is supported by research. Wearing it all day is rarely needed. For De Quervain's a thumb splint that rests the thumb side of the wrist helps, and for thumb-base arthritis a thumb support helps with heavy tasks. Splints work best alongside exercises.

Two thumb tendons pass through a tight tunnel on the thumb side of the wrist. Repeated lifting, gripping and twisting, such as lifting a baby, can irritate them, which is called De Quervain's tenosynovitis. It is common in new mothers and in midlife, and responds well to resting the thumb in a splint, changing how you lift and gradual strengthening.

In trigger finger, a small nodule forms on a finger's bending tendon and catches at the pulley at the base of the finger, so the finger clicks, catches or locks bent, often worse in the morning. It is common in women in midlife and in people with diabetes. Splinting, gentle stretching and a graded plan help many people; an injection or a small release is used if it persists.

Wear of the saddle joint at the base of the thumb causes an ache with pinching, gripping, opening jars and turning keys, and a bony enlargement at the base. It is more common in women after the age of 50. Education, a thumb support for heavy tasks, hand exercises and joint protection are the first steps; an injection or surgery is considered if function stays poor.

For carpal tunnel syndrome, De Quervain's and trigger finger an injection can give relief that lasts weeks to months, and helps many people. It does not change the underlying cause, so it works best with a splint, exercises and changes to the tasks that irritate it. It is a decision to make with your doctor, including the small risks.

Most people with these conditions improve without surgery. For carpal tunnel syndrome, a release operation is considered if symptoms are constant, there is weakness or wasting of the thumb muscles, or a good trial of splinting and an injection has not helped. Trigger finger release and thumb-base surgery are options when other measures have not worked. After surgery, your surgeon's protocol overrides general advice.

Yes, get it checked. A fall onto an outstretched hand can break the scaphoid, a small wrist bone, and a break may not show on the first X-ray. Tenderness at the base of the thumb in the hollow on the thumb side of the wrist, swelling, or pain on gripping after a fall needs a medical assessment and sometimes a repeat X-ray.

There is no single timetable. Mild carpal tunnel symptoms often ease within weeks of night splinting, glides and task changes; a first programme usually runs 6 to 12 weeks. Longer-standing numbness, arthritis or a stubborn trigger finger can take longer. Steady progress in what you can grip, carry and sleep through matters more than a date.

Sometimes. Swelling and morning stiffness lasting more than half an hour in several small joints on both hands may be inflammatory arthritis such as rheumatoid arthritis, which needs a doctor. A red, hot, swollen finger after a cut or puncture may be an infection and is an emergency. An assessment checks for these before any exercise plan.

Yes. Munaza Physio Studio in Allama Iqbal Town, Lahore, is a women-only practice. Your assessment and treatment are one-to-one with a female physiotherapist in a private room, at the studio or at home across Lahore.