By Medicover Hospitals / 20 Feb 2021

The pain in the hand is more than irritating. The stiffness and swelling that accompany hand pain can sap strength and decrease the ability to perform routine tasks, such as buttoning clothes. A common cause of hand pain is Osteoarthritis when the shock-absorbing cartilage between the bones in the joints of the fingers and at the base of the thumb is worn or damaged.

What is Hand Pain?

Hand pain includes any type of discomfort in the tissues or joints of the hand or fingers. Hand pain can be described as a throbbing, increased heat, tingling, soreness, or stiffness. The burning or tingling sensations in the hand or fingers, often called pins and needles, are paresthesias. Paresthesias are often caused by the temporary or permanent damage or pressure on the nerves that transmit sensation messages from the hand and fingers to the spinal cord.
The hand is made up of nerves, bones, blood vessels, muscles, and skin. Muscles provide movement, and tendons anchor the muscles in your hand to the bones. The nerves control the sensation and movement of the hand and fingers, and the blood vessels provide continuous blood flow to and from the fingertips through the hand and arm.
The joints of the hand, such as the knuckles, are where the bones meet. Joints are complex structures and comprise cartilage, ligaments that hold bones together, bursa (bags filled with fluid that help cushion the joint), and synovial membranes and fluid, which lubricate the joints. Each of these structures in the hand or joints can become injured, irritated, inflamed, and painful in response to a variety of illnesses, disorders, and conditions ranging from mild to severe.
Common causes of hand pain include injury or trauma, such as a broken hand by a boxer, or repeated use, such as long periods of keyboard input, which can lead to tenosynovitis and carpal tunnel. Arthritis is another very common cause of hand pain. More serious conditions, such as diabetes and peripheral neuropathy, can also cause pain or a burning sensation in the hand and fingers.
Since hand pain can be a sign of a serious illness, such as an infection or a fracture, contact your doctor about your symptoms. See a doctor promptly if you have unexplained, persistent, or recurring hand pain. Seek immediate medical attention if your hands have been exposed to freezing temperatures and have changed color or have lost sensation, or if you have severe pain in your hands, severe burning, deformity, or uncontrolled bleeding. Other serious symptoms include a high fever accompanied by swelling, redness, the warmth of the hand, or red streaks along the arm.

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Causes

Arthritis

Arthritis is the main cause of hand pain. It can occur anywhere in the body but is common in the hands and wrist. There are over 100 different types of arthritis, but the most common are osteoarthritis and rheumatoid arthritis.
Osteoarthritis usually affects older people. Over the years, the joints of the hands undergo heavy wear. Joint cartilage is a slippery tissue that covers the ends of bones, allowing joints to move smoothly. As it is reduced, painful symptoms may develop.
Rheumatoid arthritis is a chronic disease that may affect many parts of the body. This causes inflammation of the joints, which leads to pain and stiffness. It often starts in the hands or feet, affecting the same joints on both sides of your body.

Carpal Tunnel Syndrome

The carpal tunnel is a narrow passage of ligament, and bone located at the base of your hand. It contains the median nerve and the tendons responsible for finger movement.
Carpal tunnel syndrome occurs when the median nerve is compressed by a narrowing of the carpal tunnel. This narrowing can be caused by thickening of the irritated tendons, inflammation, or anything that could cause swelling in that area.
The signs of carpal tunnel syndrome begin gradually and can reach varying degrees of severity. Signs include frequent burning, stinging, or itching in the palm and fingers. Pain is often felt around the thumb, index, and middle fingers.

De Quervain's Tenosynovitis

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

Ganglion Cysts

Ganglion cysts in the wrist and hand are usually not painful, but they can be unsightly. They most often appear as a lump or large mass protruding from the back of the wrist. They can also appear in different sizes on the underside of the wrist, the finger end joint, or the base of the finger.
These cysts are filled with fluid and can quickly appear, disappear, or change in size. If your ganglion cyst grows large enough to put pressure on nearby nerves, you may feel pain, tingling, or numbness around your wrist or hand.

Gout

Gout, which is a complex form of Arthritis, is an extremely painful disease that can affect anyone. People with gout experience sudden, severe attacks of pain in their joints. Gout most commonly 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 will experience intense attacks of pain, burning, redness, and tenderness. Gout often wakes people up at night. You may feel like your hand is on fire. The weight of a bedsheet can seem intolerable.

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 breaks out, there is inflammation all over the body. This inflammation causes a thin lining around the joints to thicken, causing pain and swelling in the hands, wrists, and feet.

Peripheral Neuropathy

Peripheral neuropathy is a disease that causes numbness, pain, and weakness in the hands and feet. Peripheral neuropathy in your hands occurs when your peripheral nerves are damaged.
Several factors can cause peripheral nerve damage, including diabetes, traumatic injuries, infections, and metabolic problems.
Peripheral neuropathy can affect one or several 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 the nerves affected.

Raynaud's Phenomenon

Raynaud's phenomenon, also known as Raynaud's disease, causes numbness and coldness in certain areas (especially the fingers and toes) when you are stressed or exposed to cold temperatures.
When you are cold, it is normal for your body to conserve heat by slowing the blood supply to the skin. It does 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 more tightly than normal.

Stenosing Tenosynovitis

Trigger finger, also called stenosing tenosynovitis, is a painful condition that occurs when the finger or thumb gets stuck in a bent position.
When you move your fingers, your tendons slide through tunnels known as tendon sheaths. When these tunnels swell, the tendon can no longer slip and get stuck.

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 different ways. Hand fractures can heal poorly when not treated properly. A poorly healed fracture can permanently change the structure and capability of the hand.

Diagnosis

The examination of the hand is a complex and in-depth subject. An experienced examiner can isolate specific joints, tendons, and ligaments to assess their function. Dozens of specific tests have been described to assess the different issues that can cause hand pain.
That said, most clinicians will perform a baseline assessment and then select specific tests focused on your problem. A typical exam will begin with an assessment of the following characteristics of your hand:
Appearance
Tenderness
Mobility
Stability
Strength
Many imaging tests can be done to assess hand function. The most common test is an x-ray of the hand. Taking an x-ray can help determine bone and joint health, alignment, and deformities in the hand.
When additional imaging is needed, tests may include ultrasounds, CT scans, or MRI studies. Laboratory studies can be useful in cases of infection or autoimmune disease.

Treatment

Arthritis Common treatments for arthritis include:
- Medicines to treat signs of pain and swelling
- Long-lasting anesthetic or steroid injections
- Joint splint during times of overuse
- Surgery
- Occupational therapy/physiotherapy modalities
Carpal Tunnel Syndrome Common treatments for Carpal tunnel syndrome include:
- Splint
- Avoiding uncomfortable activities
- Using ice or ice packs
- Taking over-the-counter (OTC) pain relievers
- Receiving anesthetic or steroid injections
- Take oral steroids
- Exercise and stretch
- Acupuncture
- Surgery
De Quervain's Tenosynovitis Common treatments for De Quervain's tenosynovitis include:
- Splint
- Applying ice or cold compresses
- Taking over-the-counter pain relievers, such as ibuprofen or aspirin
- Avoid painful spots and pinching movements
- Having physiotherapy or occupational therapy
- Surgery
- Injecting the area with a steroid
Ganglion Cysts Ganglion cysts can often go without treatment. Rest and the splint can reduce the size of the cyst and may go away. If this is causing pain, your doctor may choose to drain the fluid from the cyst or remove it entirely.
Gout There are several drugs available to treat painful gout attacks, including nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine. Some medications help prevent future seizures and complications. Find out more about managing gout with traditional and alternative treatments.
Lupus There is no cure for lupus, but there are many treatments available that can help you manage the symptoms. For pain and stiffness in the hand and wrist joints, include:
- A hot or cold compress
- Over-the-counter pain medications
- NSAIDs
- Physiotherapy or occupational therapy
- Rest painful joints and avoid painful activities
Peripheral Neuropathy Common treatments for peripheral neuropathy include:
- Prescription drugs that treat nerve pain
- Over-the-counter pain relievers
- Prescription pain relievers
- Anti-seizure medication
- Antidepressants
Raynaud's Phenomenon
- Raynaud Primary is usually so gentle that no treatment is necessary. But secondary Raynaud, which results from another health problem, can be more serious and 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 weather with gloves, socks, boots, and chemical heaters.
Stenosing Tenosynovitis Common treatments for trigger finger include:
- NSAIDs
- An injection of steroids directly into the tendon sheath
- Surgery to free the tendon sheath
Traumatic Injury
- There are also muscles in the hand that can be strained or sprained. Always see your doctor for an x-ray to make sure there are no fractures. Physiotherapy or occupational therapy is an essential part of the treatment of any serious hand injury.
- Treatments for fractures and sprains will vary depending on the type and location of the injury. The splint is a common treatment option. Here's how to make a temporary splint from the materials you have.
- In severe cases, surgery may be necessary to avoid long-term damage.

When to visit a Doctor?

A person should see a doctor for severe, persistent, or recurring pain in the hands or wrists.

See a doctor for hand pain that:

Does not improve with home treatment
Getting worse and worse
Does not respond to treatment recommended by a doctor
Maybe from a fall or other injury
Occurs along with other symptoms, such as arm pain, fever, or exhaustion

Go to the emergency room to:

Severe, sudden, unbearable hand pain
A suspected broken wrist or arm
A visible injury to the hand that causes very severe pain

Home Remedies

Hand pain sometimes improves with gentle stretching exercises.

To relieve pain in the hands, a person can:

Rotate the wrists counterclockwise, then clockwise. Repeat each movement 10 times.
Open your hands as wide as you can, spread your fingers apart, then close your hands into a tight fist. Repeat 10 times.
Use one hand to gently extend the fingers of the other hand towards the chest for a gentle stretch of the wrist. Repeat 5 to 10 times.

A doctor or physiotherapist may recommend additional stretching of the hands and wrists.

RICE therapy can help with a range of minor injuries, including hand and wrist pain. RICE stands for rest, ice, compression, and elevation:

Rest Avoid using the affected hand as much as possible.
Ice Apply ice or a cold compress to the injured hand for 20 minutes several times a day.
Compression Wrap the affected area in a soft bandage, splint, or cast.
Elevation Keep the affected hand raised, for example by using a sling above heart level.

Other home remedies for hand and wrist pain include:

Massage Try to massage the painful area and surrounding muscles. Sometimes massaging the arms or shoulders can help relieve pain in the hand.
Heat Some pains respond well to heat. Consider alternating between hot and cold compresses, 20 minutes of walking, and 20 minutes off for each.
Over-the-counter medications Taking nonsteroidal anti-inflammatory drugs such as ibuprofen can help relieve pain and inflammation from a wide variety of conditions.

Citations

Arteriovenous Access and Hand Pain: The Distal Hypoperfusion Ischemic Syndrome : Clinical Journal of the American Society of Nephrology

Hand Pain and Impairment : Plastic and Reconstructive Surgery

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Frequently Asked Questions

1. Why do my hands hurt every day?

Arthritis is one of the most common causes of hand pain, affecting millions of people each year. Arthritis develops over time and causes inflammation in the joints. You can have it in a finger, your wrist, or multiple places with your hand. Osteoarthritis is the most common type.

2. What happens if my hand hurts?

Disease or injury affecting any of the structures of the hand, including bones, muscles, joints, tendons, blood vessels, or connective tissue are causes of hand pain. Hand pain is a hallmark of joint inflammation (arthritis) that can be felt in the hand.

3. Is right-hand pain related to the heart?

Many people associate a heart attack with pain in the left arm. However, some people may experience pain in the right shoulder and arm, or on both sides of the body. Anyone who experiences unexplained arm and shoulder pain along with any of the following symptoms should call emergency immediately.

4. What causes hand pain while sleeping?

Carpal tunnel syndrome is the most common cause of people complaining of pain in their hands, which wakes them up at night. This pain is often associated with numbness and pins and needles in the fingers.