Hand Pain

Sorry to hear you have hand pain.

The goal of this guide is to provide information while awaiting evaluation with your doctor, or for additional information after you have seen him or her. Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor.

Hand pain may develop for a number of reasons -- fracture and infection are among the most serious while sprains and strains are among the most common. There are rare causes of symptoms that will not be included here and would require more detailed evaluation than this guide can provide.

Certain symptoms suggest a serious cause of hand pain that requires prompt attention. It's important to ask questions about these symptoms first.

Did your pain start following significant injury, such as a fall or an auto accident?

Yes, my pain began after a significant injury.

No, my pain did not begin after a significant injury

Good. That makes a fracture or serious ligament injury much less likely. Next are some questions that could help determine whether an infection or joint inflammation might be present.

Can you see swelling and/or redness in either (or both) of your hands?

Yes, I do have swelling and/or redness in my hand(s).

No, I do not have swelling or redness in my hand(s).

Good! Now comes a question about the appearance of your fingers. This information is helpful because some types of arthritis tend to affect certain joints, while others do not.

Have you noticed hard, bony enlargement of the two finger joints closest to the finger nail?

Yes, I have noticed bony enlargement of my finger joints.

No, there's no bony enlargement of my finger joints.

That's good. Now comes a question that deals with the possibility of a nerve problem.

Have you noticed tingling and/or numbness (often called "pins and needles") in your hand, wrist or forearm?

Yes, I have noticed tingling and/or numbness.

No, I do not have tingling and/or numbness.

So far your answers do not suggest an injury, infection or major joint problem. Pain in the fingers can sometimes be related to altered circulation.

When exposed to cold, do your fingers hurt and change color? For example, do they turn white, blue, and/or red?

Yes, I do notice my fingers changing color when cold.

No, my fingers don't change color when cold.

So, your hand pain did not start after a significant injury, there's no swelling, redness or stiffness, there's no bony enlargement of the joints, no numbness, tingling or color changes.

That's good! You have no symptoms that suggest a serious cause of hand pain, but you also have none of the more common symptoms that might suggest the cause. The most likely explanation is tendonitis, an inflammation of one or more tendons in the hand which often causes no swelling or redness. Overuse related to repetitive motion is a common cause, but often no cause can be found. Rest is probably the best treatment. And unless you have been instructed to avoid them, try over-the-counter aspirin, ibuprofen, naproxen or acetaminophen.

Contact your doctor if your symptoms persist for more than two weeks.

You may have Raynaud's phenomenon. In this condition, blood vessels in the fingers narrow more than normal when exposed to cold. The color changes (typically white, then blue, then red) tend to reverse after a few minutes or with warming.

This is a very common condition and affects women more than men. In fact, up to ten percent of women report these symptoms. In nine out of ten cases, Raynaud's is not associated with any other type of disease. In the other one out of ten cases, it may accompany a rheumatic disease such as lupus or scleroderma. These conditions would be rare causes of hand pain as the only symptom.

Contact your physician to see if you have Raynaud's phenomenon or an associated condition.

Okay, the problem could be one or more irritated nerves.

Do you have neck pain, arm pain, and/or numbness and tingling in the arm?

Yes, I do have those neck and/or arm symptoms.

No, I do not have those neck or arm symptoms.

Okay.

Your symptoms suggest the possibility of carpal tunnel syndrome or another nerve problem in the hand. Carpal tunnel syndrome is a common condition and occurs because a major nerve in the wrist (called the median nerve) travels through a narrow area (called the carpal tunnel) where it can be easily compressed. The median nerve provides sensation to the fingers (particularly the thumb, index, middle and half the ring finger) and controls the muscles in the thumb. The usual symptoms are numbness and tingling; weakness and shrinkage (or atrophy) of the large thumb muscle near the wrist may follow.

If your symptoms persist, see your doctor for evaluation that can confirm the diagnosis.

Your symptoms suggest the possibility that a nerve in your neck is being pinched, causing hand pain with numbness and/or tingling. If you have noticed neck pain that actually radiates into the arm and forearm or causes numbness and tingling of the upper and lower arm, a pinched nerve in the neck is particularly likely. This condition, usually due to an injured or compressed disc between the bones of the spine, is called cervical radiculopathy.

However, your neck pain could be coincidental and have nothing to do with your hand symptoms. Contact your doctor's office, especially if it persists for more than a few days.

Your symptoms suggest osteoarthritis (also called degenerative arthritis), a condition that is particularly common in people over the age of 40, especially women, and it can run in families. Unless you have been instructed to avoid these medicines, try over-the-counter acetaminophen, ibuprofen or naproxen as needed for pain. Contact your doctor if it does not improve over a few weeks or if it is affecting your function or quality of life.

If you haven't checked your temperature already, do so now. Then consider whether any of the following statements is true for you:

  • My temperature is more than 100F.

  • I have noticed a new rash recently.

  • In addition to hand pain, I have felt generally ill.

Yes, one or more of those statements is true for me.

No, none of those statements is true for me.

Your answers suggest inflammation of the joints, as may be seen in a hand or joint infection, gout, rheumatoid arthritis or related conditions. It is important that you have an examination of the hand to establish a diagnosis of arthritis or infection, so contact your doctor for evaluation.

Although there are a number of potential causes of your symptoms, your answers raise the possibility of a joint infection or a skin infection. Contact your physician now for evaluation.

Are you unable to move your hand, or is there significant swelling or bruising?

Yes, I have one or more of those problems.

No, none of those is true for me.

The most likely diagnosis is a sprain or strain, though there are other possibilities. You can read more about common causes of hand pain at the end of this guide.

For now, it would be reasonable to follow the RICE routine -- this stands for:

Rest - avoid using the hand as much as possible for at least a day or two

Ice - an ice pack, or a bag of frozen vegetable wrapped in a towel can reduce swelling when applied to the injured area for the first 24 hours

Compression - an elastic bandage is helpful to contain the swelling, but be careful not to wrap the area too tightly

Elevation - for the first 24 hours, keep the sore hand elevated; this can also reduce swelling.

Contact your doctor if your symptoms persist.

You might have a broken bone (also called a fracture) or a dislocated joint. While it could turn out to be a sprain or strain instead, an examination and, perhaps, an x-ray are required to be sure. Contact your doctor right away for evaluation.