What’s Causing My Hand Pain?

Medically reviewed by William Morrison, MD on September 26, 2017Written by Corinne O’Keefe Osborn on September 26, 2017

Overview

The human hands are complex and delicate structures that contain 27 bones. The muscles and joints in the hand allow for strong, precise, and dexterous movements, but they are vulnerable to injury.

There are many different causes and types of hand pain. Hand pain can originate in different parts of the complex skeletal structure, including the:

  • bones
  • joints
  • connective tissues
  • tendons
  • nerves

Hand pain can stem from:

  • inflammation
  • nerve damage
  • repetitive motion injuries
  • sprains and fractures
  • several chronic health conditions

Many conditions contributing to hand pain can be treated. Depending on the cause of your hand pain, you may benefit from medications, exercises, or lifestyle changes.

1. Arthritis

Arthritis (the inflammation of one or more joints) is the leading cause of hand pain. It can occur anywhere in the body but is particularly common in the hands and wrist. There are more than 100 different types of arthritis, but the most common are osteoarthritis and rheumatoid arthritis.

Osteoarthritis typically affects older adults. Over the years, joints in the hands experience a lot of wear and tear. Articular cartilage is a slippery tissue that covers the ends of bones, allowing joints to move smoothly. As it gradually decreases, painful symptoms may begin to appear.

Rheumatoid arthritis is a chronic disease that can affect many parts of the body. It causes the joints to become inflamed, which leads to pain and stiffness. It often begins in the hands or feet, affecting the same joints on both sides of your body. Learn how to naturally relieve arthritis pain.

Arthritis symptoms include:

  • dull or burning pain in joints of fingers or wrist
  • pain after overuse (such as heavy gripping or repetitive motion)
  • morning pain and stiffness in joints
  • swelling around joints
  • changes in surrounding thumb joints (overextension)
  • warmth at site of the affected joint (resulting from inflammation)
  • sensations of grinding, grating, or looseness around finger joints
  • small cysts on the end of fingers

Common arthritis treatments include:

  • medications to treat symptoms of pain and swelling
  • injections of long-lasting anesthetics or steroids
  • splinting of joints during times of overuse
  • surgery
  • occupational therapy/physical therapy modalities

2. Carpal tunnel syndrome

The carpal tunnel is a narrow passageway of ligament and bone located at the base of your hand. It contains the median nerve (a nerve running from your forearm to the palm of your hand) and the tendons responsible for moving your fingers.

Carpal tunnel syndrome occurs when the median nerve gets squeezed by a narrowing carpal tunnel. This narrowing can be caused by the thickening of irritated tendons, inflammation, or anything that might cause swelling in this area.

Symptoms of carpal tunnel syndrome begin gradually and can reach varying degrees of severity. Symptoms include frequent burning, tingling, or itching numbness in the palm of the hand and the fingers. Pain is often felt around the thumb, index finger, and middle finger.

Other carpal tunnel symptoms include:

  • feeling like fingers are swollen even when no swelling is present
  • pain during the night
  • pain and stiffness of hand or wrist in the morning
  • decreased grip strength
  • trouble grasping small objects or preforming certain tasks
  • wasting away of the muscles at the base of thumb (severe cases)
  • difficulty feeling the difference between hot and cold

Common treatments:

  • splinting
  • avoiding uncomfortable activities
  • using ice or cool packs
  • taking over-the-counter (OTC) pain medications
  • getting injections of anesthetic or steroids
  • taking oral steroids
  • exercising and stretching
  • having acupuncture
  • having surgery

3. De Quervain’s tenosynovitis

De Quervain’s tenosynovitis is a painful condition affecting the tendons around your thumb. Swelling in the two tendons around the base of your thumb causes the area around your tendons to become inflamed. This inflammation puts pressure on nearby nerves, causing pain and numbness around the base of your thumb.

Other symptoms of de Quervain’s tenosynovitis include:

  • pain around the thumb-side of your wrist
  • swelling near the base of your thumb
  • trouble grasping something or making a pinching motion
  • a sticking or popping feeling when moving your thumb

Common treatments for De Quervain’s tenosynovitis include:

  • splinting
  • applying ice or cold packs
  • taking OTC pain relievers, like ibuprofen or aspirin
  • avoiding painful tasks and pinching motions
  • having physical therapy or occupational therapy
  • having surgery
  • injecting the area with a steroid

4. Ganglion cysts

Ganglion cysts of the wrist and hand are not typically painful, but they can be unsightly. They most often appear as a large mass or lump coming out of the back of the wrist. They can also appear in varying sizes on the underside of the wrist, the end joint of the finger, or the base of the finger.

These cysts are filled with fluid and can quickly appear, disappear, or change size. If your ganglion cyst becomes large enough to put pressure on nearby nerves, you may experience pain, tingling, or numbness around the wrist or hand.

Ganglion cysts can often go without treatment. Rest and splinting can reduce the size of the cyst and it may go away with time. If it’s causing pain, your doctor may choose to drain the fluid from the cyst or remove it entirely.

5. Gout

Gout, which is a complex form of arthritis, is an extremely painful condition that can affect anyone. People with gout experience sudden, severe attacks of pain in their joints. Gout most often affects the joint at the base of the big toe, but it can occur anywhere in the feet, knees, hands, and wrists.

If you have gout in your hands or wrists, you’ll experience intense attacks of pain, burning, redness, and tenderness. Gout often wakes people in the night. You may feel like your hand is on fire. The weight of a bed sheet can feel intolerable.

There are several medications available to treat painful gout attacks, including nonsteroidal anti-inflammatories (NSAIDs) and colchicine. There are also medications that help prevent future attacks and complications. Learn more about managing gout with both traditional and alternative treatments.

6. Lupus

Lupus is an autoimmune disease, which means your immune system mistakenly attacks healthy cells and damages healthy tissue. Joint pain and stiffness are often the first signs of lupus.

When lupus flares, there is inflammation throughout the body. This inflammation causes a thin lining around the joints to thicken, leading to pain and swelling in the hands, wrists, and feet.

Other symptoms of lupus include:

  • muscle pain
  • an unexplained fever
  • red rashes, often on the face
  • hair loss
  • pale or purple fingers or toes
  • pain when taking deep breaths
  • fatigue
  • swelling in the legs or around eyes

There is no cure for lupus, but there are many treatments available that can help you manage symptoms. For pain and stiffness in the hand and wrist joints, try:

  • a warm or cold compress
  • OTC pain medications
  • NSAIDs
  • physical or occupational therapy
  • resting painful joints and avoiding painful activities

7. Peripheral neuropathy

Peripheral neuropathy is a condition that causes numbness, pain, and weakness in your hands and feet. Peripheral neuropathy in your hands occurs when your peripheral nerves are damaged.

There are a number of things that can cause peripheral nerve damage, including diabetes, traumatic injuries, infections, and metabolic problems.

Peripheral neuropathy can affect one nerve or many different nerves throughout the body. Your hands and wrists have different types of nerves, including sensory nerves that feel things like touch, temperature, and pain, and motor nerves that control muscle movement.

The type and location of your neuropathic pain will depend on which nerves are affected.

Common symptoms of peripheral neuropathy include:

  • numbness, prickling, or tingling in your feet or hands that comes on gradually
  • sharp, jabbing, throbbing, freezing, or burning pain in hands or feet
  • extreme sensitivity in hands or feet
  • muscle weakness or paralysis
  • lack of coordination; falling

Common treatments for peripheral neuropathy include:

  • prescription medications that treat nerve pain
  • OTC pain relievers
  • prescription painkillers
  • anti-seizure medication
  • antidepressants

8. Raynaud’s phenomenon

Raynaud’s phenomenon, also known as Raynaud’s disease, causes certain areas (particularly the fingers and toes) to become numb and cold when you’re stressed or exposed to cold temperatures.

When you get cold, it’s normal for your body to save heat by slowing the supply of blood to the skin. It achieves this by narrowing the blood vessels.

For people with Raynaud’s, the body’s reaction to cold or stress is more intense. Blood vessels in the hands can narrow much faster and tighter than normal.

The symptoms of a Raynaud’s attack might include:

  • cold fingers and toes
  • fingers and toes changing colors (red, white, blue)
  • numbness or a tingling, throbbing, prickly feeling
  • sores, gangrene, ulcers, and tissue damage (in severe cases)

Primary Raynaud’s is usually so mild that no treatment is required. But secondary Raynaud’s, which results from another health condition, can be more severe and may require surgery.

Treatment focuses on preventing further attacks and reducing the likelihood of tissue damage.

This primarily means keeping hands and feet warm in cold temperatures with gloves, socks, boots, and chemical heaters.

9. Stenosing tenosynovitis

Trigger finger, also known as stenosing tenosynovitis, is a painful condition that occurs when your finger or thumb gets stuck in a bent position.

When you move your fingers, your tendons slide through tunnels called tendon sheaths. When these tunnels swell, the tendon can no longer slide through, and it gets stuck.

If you have trigger finger, you may feel a tender bump and heat on the top of your palm, at the base of your finger, where the tendon sheath is located. Other symptoms include:

  • a popping or snapping feeling as you straighten and bend your finger
  • one or more fingers stuck in a bent position
  • stiffness and inability to straighten your finger in the morning
  • severe pain at the base of the finger

Common treatments for trigger finger include:

  • NSAIDs
  • a steroid injection directly into the tendon sheath
  • surgery to release the tendon sheath

10. Traumatic injury

Hand injuries are extremely common. The complex structure of the hand is delicate and vulnerable. Your hands are constantly exposed to danger. Hand injuries are common in sports, construction, and falls.

There are 27 small bones in each hand that can be broken in a number of different ways. Fractures in the hand can heal poorly when not treated properly. A poorly healed fracture can permanently change the structure and dexterity of your hand.

There are also muscles in the hand that can be sprained or strained. Always go to your doctor for an X-ray to ensure there are no fractures. Physical or occupational therapy is an essential component of treating any serious hand injury.

Treatments for fractures and sprains will vary depending on the type and location of the injury. Splinting is a common treatment option. Here’s how to make a temporary splint from materials you have.

In severe cases, surgery may be necessary to prevent long-term damage.

General tips for relief

There are a few strategies you can use to relieve hand pain:

Tips

  • Apply heat and cold. Use a hot compress for stiffness and a cold compress for swelling.
  • Take over-the-counter pain medication. This can provide occasional or short-term relief. Check with your doctor about longer-term solutions.
  • Use a splint to stabilize your joints and avoid further injury.

When to see a doctor

There are many different causes of hand pain. Generally, you should see your doctor when you have any new pain or when pain suddenly worsens.

Some hand problems develop gradually. Talk to your doctor if gradually worsening pain has been bothering you for some time. In the event of a traumatic injury, go to your local emergency room or critical care center for an X-ray.

CMS Id: 132772