What To Know and Do About Hand Pain

Medically reviewed by Forest Miller, OTR/L

Hand pain can be aching, throbbing, numbness, tenderness, stiffness, or weakness. Mild to severe hand pain can make simple tasks like opening a jar, carrying groceries, or tying your shoes painful, frustrating, or impossible.

Hand pain has many possible causes, including acute and overuse injuries, chronic conditions like arthritis, and infections. Regardless of the cause, persistent hand pain that interferes with your ability to carry out daily tasks requires medical attention. Early diagnosis and treatment can relieve pain, prevent complications, and help improve the function and strength of your hand.

How Hand Pain Presents

Hands are the most frequently used body parts in daily life. Whether typing on a keyboard, preparing food, buttoning a shirt, or gesturing in conversation, your hands are almost always in motion. Any structure in your hand can be a source of pain, including:

• Bones: Each hand has 27 bones. Eight carpal bones form the wrist, connecting to the two forearm bones (radius and ulna). Five metacarpal bones create the palm and fourteen phalanges (finger bones).

• Joints: Joints, where two or more bones connect, help your hands move. These connections between bones allow for movement. The wrist joint provides flexibility for bending and rotation. Each finger has multiple joints, which allow for bending and straightening.

• Muscles: Each hand has over 30 muscles that work together with forearm muscles to allow for movements such as zipping a jacket, turning a doorknob, writing, and picking up objects.

• Ligaments: These are strong, fibrous tissues that connect and stabilize bones.

• Tendons: These are cord-like bands of tissue that connect muscles to bones and allow muscles to move the bones. Tendon sheaths surround tendons in some regions of the hand, providing lubrication and reducing friction.

• Nerves: Three major nerves, over 17,000 nerve endings, and touch receptors support muscle movement and provide sensation to the hand, including touch, temperature changes, pressure, and pain.

• Blood vessels: Arteries and veins in the hand deliver oxygenated blood to the hand's tissues.
  

Pain can originate from or affect any of your hand's structures. Hand pain can range from mild to severe and may come and go, worsen during certain activities, or remain constant throughout the day. You may feel it in one specific area (e.g., the base of your thumb) or experience widespread pain throughout your entire hand. Depending on the cause, hand pain may feel like:

• Burning

• Aching

• Sharp and stabbing

• Tingling

• Numbness or "pins and needles" sensation

• Electric shocks

• Stiffness

• Weakness

• Tenderness

• Throbbing 
  

Potential Causes of Hand Pain

Many things can contribute to hand pain, including traumatic or overuse injuries and chronic inflammatory conditions.

Arthritis

Arthritis is inflammation in one or more joints. It's one of the leading causes of hand pain. While many forms of arthritis can cause hand pain, the most common types include:

• Osteoarthritis: Also known as "wear and tear" arthritis, osteoarthritis is when cartilage (cushioning between bones) breaks down. This causes pain, stiffness, and loss of motion at the base of your thumb or the joints closest to your fingernail and the middle of your fingers.

• Rheumatoid Arthritis  (RA): RA is an autoimmune disease that causes your immune system to attack your joints. It can cause pain, swelling, stiffness, and joint deformities that may make it difficult to use the affected fingers or hand.

• Lupus: This is an autoimmune form of arthritis that causes your immune system to create antibodies that attack healthy tissues. Lupus affects the small joints in the hand and wrist and often causes joint pain that occurs with red rashes.

• Psoriatic arthritis (PsA): PsA is an autoimmune condition that affects your joints, skin, and fingernails. It can cause pain, swelling, nail changes, and inflamed red or silvery-white patches on your skin.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is compression of the median nerve, one of the major nerves in your hand. Repetitive hand motions—like typing—over a long period can cause tissues surrounding the carpal tunnel to swell and narrow the tunnel, putting pressure on the median nerve.

Carpal tunnel pain can radiate from your forearm and wrist into your palm and fingers. It's often accompanied by numbness, tingling, and weakness in your hand and fingers. Symptoms often worsen at night or during certain activities, such as holding a phone or driving.

De Quervain's Tenosynovitis

De Quervain's tenosynovitis is inflammation of the two tendons that run along the thumb side of your wrist. It can cause pain at the base of your thumb and where the thumb meets your wrist.

Pain often worsens during certain activities, such as:

• Making a fist

• Gripping or grasping objects

• Moving your thumb

• Turning your wrist

• Lifting something (e.g., a child) in front of your body with your thumbs pointed up.

The pain usually starts in your wrist and moves up your forearm. You may also notice swelling and snapping sensations when moving your thumb, making it difficult to use the affected hand.

Ganglion Cysts

Ganglion cysts are fluid-filled sacs that often develop on the back of the wrist or base of the finger joints. A ganglion cyst grows from connective tissues surrounding a joint (for example, a tendon or ligament). The cause isn't always known, but they are common in people assigned female at birth and among people who consistently apply stress to their wrists (e.g., gymnasts).

A ganglion cyst won't always cause pain, but if the cyst presses on a nerve that passes along the affected joint, you may experience pain, tingling, and muscle weakness.

Stenosing Tenosynovitis (Trigger Finger)

Stenosing tenosynovitis, or trigger finger, is a condition that affects the flexor tendons in your fingers and thumb. Inflammation in the tissues surrounding the tendon sheath makes it difficult for the tendon to glide smoothly over the bone as you bend your finger. As a result, your finger can catch or lock into a bent position when you bend and straighten your fingers.

Forceful use of your fingers and thumb can lead to trigger finger. People with diabetes and rheumatoid arthritis are at an increased risk of the condition. Symptoms include:

• Pain

• A catching, popping, or locking sensation as you bend or straighten your finger

• A tender lump at the base of the thumb or finger near your palm

Peripheral Neuropathy

Peripheral neuropathy is nerve damage that can affect the nerves in your hands, leading to symptoms like burning pain, numbness, tingling, and weakness. The pain can range from mild to debilitating and may be constant or come and go.

There are many possible causes of peripheral neuropathy, including injury to the affected nerve, infections, metabolic conditions like diabetes, vitamin deficiencies, autoimmune disorders, and exposure to toxins.

Raynaud's Syndrome

Raynaud's syndrome—also known as Raynaud's disease or Raynaud's phenomenon—causes blood vessels in your hands and fingers to narrow, restricting blood flow. Triggers like exposure to cold temperatures and emotional stress can cause the blood vessels to narrow.

Your fingers may turn white and then blue as blood flow to the fingers decreases, and they may feel cold and numb. As circulation returns, your fingers may turn red and swollen, and you may experience tingling, burning, or throbbing sensations.

Acute Injury

Your hands are vulnerable to injury during daily activities because you use them so much. Accidents like falls, crushing injuries, and traumatic blows to your hand can damage bones, ligaments, and muscles in the hand. Possible injuries include:

• Fractures: A broken bone in your hand can cause significant pain, swelling, bruising, inability to move your finger, and deformity. Common fractures involve the small bones in the fingers and the metacarpal bones in the palm.

• Dislocations: A dislocation is a joint injury that forces the ends of your bones out of their normal position. Symptoms include intense pain, swelling, and a finger that is noticeably out of place.

• Sprains: A ligament sprain occurs when the ligament is stretched or torn beyond its normal range. A sprained thumb is a common injury that can cause pain, tenderness, swelling, bruising, and feeling like your thumb is "loose" or unstable.

• Strains: Muscle and tendon strains in your hand happen when the muscles or tendons are overstretched or torn. Strains to the muscles and tendons in the hand can cause pain, weakness, bruising, and swelling.

Infection

Bacterial infections can affect your hand after an insect or animal bite or when bacteria enter your body through an open wound (e.g., scratch or puncture wound) on your hand. A hand infection can cause intense, throbbing pain and swelling, redness, and warmth on your hand.

When To See a Healthcare Provider

Hand pain sometimes resolves with time and self-care measures like rest. However, certain situations warrant a trip to a healthcare provider to determine what's causing hand pain and whether it requires treatment. Make an appointment with a healthcare provider when hand pain:

• Persists for one week or longer despite at-home treatment measures (e.g., icing)

• Develops suddenly after a traumatic event such as a fall, accident, or blow to the hand

• Worsens or new symptoms develop

• Interferes with your ability to use your hands to carry out daily activities

• Occurs with numbness or tingling "pins and needles" sensations

Seek emergency medical care as soon as possible if you have hand pain and:

• Numbness or tingling "pins and needles" sensations

• You cannot use or move your hand

• Any part of your hand makes a "popping" sound and moves in and out of its normal position

• You develop signs of a hand infection, such as fever, red streaks, pus, or increased pain, swelling, redness, and warmth

How Is Hand Pain Diagnosed?

Healthcare providers use a combination of a medical history review, physical examination, and diagnostic tests to determine the cause of hand pain. At your appointment, your healthcare provider will discuss your symptoms and may ask questions like:

• When did the hand pain begin?

• Did you experience a recent or previous hand injury?

• What activities worsen or relieve the pain?

Your healthcare provider will closely examine your hand to check for swelling, tenderness, warmth, and visible signs of injury. They will also test the range of motion and strength in your hand by asking you to move your hand in certain ways, such as:

• Making a fist around their fingers and squeezing

• Extending and spreading your fingers against resistance (your provider's hand)

• Gripping and grasping objects with your fingers and thumb

Depending on the physical examination findings, your healthcare provider may order diagnostic tests, including:

• Imaging tests: X-rays, magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, and ultrasounds take pictures of the bones, tendons, nerves, and ligaments in your hand to identify abnormalities, such as fractures, nerve compression, and soft tissue injuries.

• Electromyography (EMG) and nerve conduction studies: These tests assess nerve and muscle function when your hand is in motion and at rest.

• Blood tests: Blood samples (taken from a vein in your arm) test for inflammation markers and blood cell counts to help diagnose inflammatory conditions (e.g., arthritis) and infections.
  

How Is Hand Pain Treated?

Treatment approaches for hand pain depend on the severity and cause of pain. Your healthcare provider will develop a treatment plan that may include at-home treatments, medications, physical therapy, surgery, or a combination of these options.

At-Home Treatments

Self-care strategies may be enough to treat some causes of hand pain, such as acute (short-term) hand injuries. At-home treatments may help relieve pain and promote healing, including:

• Rest: Limit or avoid activities that worsen or aggravate hand pain for a few days

• Ice therapy: Apply ice packs covered in a thin cloth for up to 20 minutes at a time, several times daily

• Compression: Wear an elastic bandage or supportive brace to reduce inflammation and swelling

• Elevation: Use pillows or cushions to keep your injured hand above your heart and reduce swelling

• Over-the-counter (OTC) pain relievers: Try pain relievers like Advil (ibuprofen) and Aleve (naproxen) to temporarily relieve pain and reduce swelling

Medical Treatments

Some causes of hand pain may require prescription-strength medications or medical therapies to relieve pain, reduce inflammation, and promote healing. Your healthcare provider may prescribe or recommend: 

• Prescription medications: Prescription-strength pain relievers, such as naproxen, Celebrex (celecoxib), and Toradol (ketorolac), can temporarily reduce hand pain.

• Cortisone injections: Cortisone is a powerful anti-inflammatory drug that works by injecting the medicine directly into the affected area of the hand for longer-lasting pain relief (up to a few months).

• Orthotics: Wearing a customized brace, cast, or wrap can help treat hand injuries and arthritis. Your healthcare provider may prescribe a customized orthosis to immobilize (keep still), increase motion, decrease pain, or improve the function of the affected hand.

• Hand therapy: Acute or overuse injuries and chronic conditions causing hand pain may benefit from hand therapy. A physical or occupational therapist with special training in hand therapy will design a personalized treatment program to manage pain and increase the strength and motion in your hand.

• Surgery: Damaged or injured bones, ligaments, tendons, and nerves may require hand surgery to repair the injury, promote healing, and improve the hand's physical function.
  

A Quick Review

Hand pain can affect your hand's bones, muscles, tendons, ligaments, and nerves. There are many possible causes of hand pain, ranging from acute and overuse injuries to underlying conditions like arthritis and carpal tunnel syndrome.

While some causes of hand pain resolve with rest and at-home treatments, persistent or severe pain warrants a visit with your healthcare provider. Early diagnosis and treatment can provide pain relief, improve the function of your hand, and promote recovery.

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