Have you ever noticed that you sometimes have a small bone bump , like a tumor, on your hand, especially on the upper side of your wrist? Some people get a little worried when they see this, thinking, “Oh, what’s wrong with me?” But in reality, most of the time, this is not something to be afraid of. Today, we are going to talk about a bone bump like this. In medical terms, we call this a (Carpal Boss) .
What is this bony bump on the carpal bone (Carpal Boss)?
Simply put, a carpal boss is an extra bone growth on the outside of your wrist. It's where your index and middle fingers meet at the base of your wrist. It feels very hard , like a bone, and you can't move it . Most people don't feel any pain from it. Some people also call it a carpometacarpal boss .
Sometimes people confuse this (Carpal Boss) with another condition, for example ( Ganglion Cyst). (Ganglion Cyst) is also a lump that appears on the carpal bone, but it is not as hard as this one, it is a soft lump filled with fluid inside. So if you have this lump, it is best to see a doctor to find out exactly what it is. However, if you do not have pain or any other problems, this (Carpal Boss) does not require special treatment.
What are the symptoms of this?
Most of the time, this condition (Carpal Bossing) is seen in the hand you use the most (dominant hand). That means if you are right-handed, it is in the right hand, and if you are left-handed, it is in the left hand. However, it can occur in the other hand, and sometimes even in both hands.
The main symptom is, as I mentioned before, a hard, immovable lump on the top of the collarbone. Most people don't experience any pain, but some people may experience pain when they move or bend the collarbone. Also, you may feel a slight tenderness when you touch the lump.
Another thing is that this bone spur can irritate the tendons that run over the hand. If that happens, you may feel a " snapping" sensation as the tendon passes over the spur when you move your hand.
Why does this kind of knot occur? (Causes of Carpal Bossing)
To be honest, doctors still can't say exactly why some people develop carpal tunnel syndrome. However, there are a few factors that are thought to contribute to it:
- Osteoarthritis : Simply put, when the cartilage in your joints wears down, the bones start to rub against each other. This can also cause a carpal boss.
- Congenital issue: Sometimes this condition can occur because the bones of the skull are not properly formed at birth.
- Overuse: Imagine, if you have a job that uses your wrist in the same way all day long (for example, working in the construction industry), or play a sport that puts constant pressure on your wrist, such as tennis or badminton, this knot is also likely to occur due to overuse.
- Trauma : If you have ever had an injury to your hand or wrist, such as a broken bone or a wrist sprain, this can also be a cause of developing a carpal boss later on.
Who is most at risk for this condition?
It has been found that this condition (Carpal Boss) is most commonly seen in people between the ages of 20 and 40 .
How do doctors diagnose this? (Identifying a Carpal Boss)
When you go to see a doctor with a lump like this, he or she will first ask you about your symptoms . How long have you had the lump, is it painful, when is the pain worse, and how it has affected your daily activities.
Then, the doctor will examine your wrist . They will move your arm back and forth to see how far you can move it (range of motion). They will feel the joint and see if it is tight, loose, or moving.
In addition, your doctor may order a few special tests to determine if this is a carpal boss, a ganglion cyst, or another condition (e.g. tendonitis, fractures). Some of these tests include:
- Wrist X-ray
- Ultrasound scan
- CT scan (CT – Computed Tomography scan)
- MRI – Magnetic Resonance Imaging scan
- EMG (Electromyography) test (this checks the function of nerves and muscles)
After these tests, the doctor can tell you exactly what you have.
How to get rid of this bone knot? (Treatment for Carpal Boss)
Let's say you have a carpometacarpal boss, but it doesn't cause any pain , and you don't have any major concerns about it. In that case, the doctor will probably say, "Let's not do anything about it for now, but we'll see if it makes a difference." That is, they will just observe it without treating it.
However, if you have pain or other symptoms , then treatment is necessary. Nonsurgical treatments are usually the first choice. These include:
- Wearing a wrist splint: Wearing this splint keeps the wrist in one place, giving it rest and reducing pain.
- Ice: Applying ice constricts the blood vessels in the area, reducing swelling and inflammation.
- Pain relievers : Taking pain relievers like acetaminophen can reduce pain and swelling.
- Steroid injections: If ice and painkillers don't help, your doctor may inject a steroid injection into the area to reduce pain and swelling.
These simple non-surgical treatments provide relief in 70% to 80% of cases . This means that most people will be able to get relief from these treatments. However, if these treatments do not provide relief, then surgery is the next safest option.
Will surgery (Carpal Boss Surgery) be necessary?
Carpal Boss Surgery is a surgery that removes the bone spur from your wrist. It's not a major operation . It takes about an hour.
First, you will be given local anesthesia . This means that you will be conscious, but the area where the surgery will be performed will be numb, so you will not feel any pain. Then, the surgeon will make a small incision on the upper side of your arm and either remove or cut out the bone spur. Sometimes, if there is any damaged bone or cartilage around the spur, it may also be removed during the surgery.
After surgery, you will need to wear a splint for about a week until your ankle heals. You will usually be able to return to your normal activities within two to six weeks.
What happens if I have this (Carpal Boss)?
Most of the time, these lumps are harmless . They are benign, usually painless, and do not lead to any complications. If you have a lump, but it is not bothering you, you can leave it alone and not worry about treatment. However, your doctor may want to watch it for a while to see if it changes or gets bigger.
However, sometimes this (Carpal Boss) can cause pain or discomfort . This can happen if the lump is pressing on a nerve or if it is rubbing against another bone. If this happens, you may have difficulty using your hand or bending your wrist in certain ways. In such cases, you should definitely talk to a doctor and learn about treatment options. You may find that the non-surgical treatments mentioned above will provide you with relief. If these do not help, your doctor may suggest surgery.
Can this (Carpal Bossing) be prevented?
To be honest, it's hard to prevent most carpal tunnel syndrome because we don't know exactly what causes it. However, carpal tunnel syndrome, which is caused by overuse, can be prevented to some extent. How can you do that? You need to protect your wrist when you play sports. You should stretch your muscles well before playing, and you may even need to wear a wrist brace. You can also ask your doctor what else you can do to keep your wrist healthy.
When should I see a doctor?
If you notice a new lump or bump on your wrist, you should definitely see a doctor to talk about it. Because what you may think is a carpal boss could actually be something else, like the ganglion cyst I mentioned earlier. The symptoms of a ganglion cyst are very similar to those of a carpal boss. Both are usually painless lumps on the wrist. However, while a carpal boss is hard, a ganglion cyst is soft and filled with fluid. Your doctor can determine what it is and whether you need treatment. It's also important to make sure it 's not something more serious .
What should I ask the doctor?
If you find out you have a carpal boss, you can ask your doctor questions like these:
- Do I need treatment right away?
- What are the chances of this (Carpal Boss) coming back after treatment?
- Under what circumstances do you think I should have surgery on my (Carpal Boss) joint?
- What are the risks and benefits of surgery to remove this (Carpal Boss)?
So, the final take-home message is:
What is that bony bump on the back of your hand? That's your carpal boss. Just like the boss in the office, this carpal boss can be a bit annoying at times. But, fortunately, most of the time, they are harmless and don't require treatment . If they are asymptomatic, most people can live a normal life with these bumps.
However, if it causes pain or other discomfort, there are treatment options to help relieve it . So, if that lump in your hand is bothering you, definitely talk to a doctor. Don't worry, most of the time it's something that can be easily fixed!
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