Finger Pain

Causes of finger pain

Injuries

• Sprains and jammed fingers: a ball or fall bends the finger, stretching the joint ligaments. Swelling and pain at the middle knuckle are typical.
• Dislocations: the joint looks clearly out of line. Do not try to pop it back; get it reduced and X-rayed.
• Finger fractures: swelling, bruising, deformity, pain on gentle pressure, or a finger that overlaps its neighbor when you make a fist (rotational deformity).
• Mallet finger: the fingertip droops after a blow, because the extensor tendon has torn or pulled off a bone fragment.
• Skier's thumb: a sprain of the ligament at the base of the thumb from a fall on an outstretched hand while holding something.
• Crush injuries and bleeding under the nail: painful pressure that can be released by a clinician.

Arthritis

• Osteoarthritis: the most common cause in people over 50. It affects the joints nearest the fingertips (Heberden's nodes), the middle joints (Bouchard's nodes) and the base of the thumb. Pain is worse with pinching, gripping and turning keys.
• Rheumatoid arthritis: warm, soft swelling of the knuckles and middle joints on both hands, with morning stiffness over 1 hour.
• Psoriatic arthritis: a whole finger can swell like a sausage, often with nail pitting.
• Gout: a sudden, red, hot, very painful joint, sometimes with chalky lumps (tophi).

Tendon problems

• Trigger finger: the tendon catches in its sheath, causing a painful click, catching or locking of the finger in a bent position, often worst in the morning. Common in diabetes and in people over 40.
• De Quervain's tenosynovitis: pain on the thumb side of the wrist extending into the thumb, worse with lifting a baby or gripping.
• Tendon sheath infection: see the urgent signs above.

Nerve causes

• Carpal tunnel syndrome: numbness, tingling and burning in the thumb, index, middle and half of the ring finger, often waking you at night.
• Ulnar nerve compression: tingling in the ring and little fingers, worse with elbows bent.
• Neck nerve compression: finger pain or numbness with neck pain.
• Diabetic or other neuropathy: burning or tingling in both hands.

Infections

• Paronychia: red, swollen, painful skin beside a nail, often after nail-biting or a hangnail, sometimes with pus.
• Felon: a deep abscess in the fingertip pad causing severe throbbing and tense swelling.
• Herpetic whitlow: painful blisters on a fingertip from the herpes virus.

Circulation and other causes

• Raynaud's phenomenon: fingers turn white, then blue, then red in cold or stress, with numbness and throbbing on rewarming.
• Ganglion cysts: small, firm lumps on a finger joint or tendon sheath (mucous cysts near the nail).
• Dupuytren's contracture: thick cords in the palm gradually pull fingers bent, usually painless.
• Chilblains, frostbite and burns.

Finger pain by location

How finger pain is diagnosed

Your doctor will ask about injury, which fingers hurt, swelling, stiffness, numbness and color changes. They check movement, tendon function, sensation and circulation. Tests may include an X-ray for fractures and arthritis, blood tests for inflammatory arthritis or gout, ultrasound for tendons and cysts, and nerve conduction studies for carpal tunnel syndrome.

Treatment and home care

• Rest and ice: apply a wrapped cold pack for 15 minutes several times a day in the first 48 hours after an injury, and keep the hand raised.
• Buddy taping: taping a minor sprained finger to the neighboring finger with padding between them gives support while allowing movement. Do not use it for fractures or dislocations unless advised.
• Splints: for mallet finger (usually 6 to 8 weeks continuous), trigger finger, thumb arthritis and De Quervain's.
• Pain relief: acetaminophen (paracetamol), ibuprofen tablets, or a topical NSAID gel for arthritis, following the label dose.
• Warm soaks: 10 to 15 minutes in warm water several times a day for early paronychia and for arthritis stiffness.
• Hand exercises prescribed by a hand therapist for arthritis and after injuries.
• Medical treatments: steroid injection for trigger finger, De Quervain's and thumb arthritis; drainage and antibiotics for infections; disease-modifying medicines for rheumatoid arthritis; surgery for some fractures, tendon injuries, carpal tunnel and trigger finger.

Remove rings promptly after any finger injury, before swelling makes this impossible.

Frequently asked questions

What causes finger joint pain without injury?

The most common causes are osteoarthritis (especially over 50), rheumatoid arthritis, psoriatic arthritis, gout and trigger finger. Carpal tunnel syndrome can cause pain with tingling. Swelling of several joints on both hands, with long morning stiffness, needs a check for inflammatory arthritis.

When should I worry about finger pain?

Seek urgent care for deformity, a finger you cannot straighten or bend, a cold or pale finger, spreading redness or fever, a deep cut or bite, or severe swelling along the whole finger. See a doctor if pain without injury lasts more than 2 weeks.

How do I know if my finger is broken or sprained?

You cannot always tell without an X-ray. A fracture is more likely with deformity, severe swelling and bruising, pain on pressing over the bone, a finger that twists or overlaps when you make a fist, or loss of movement. If in doubt, get an X-ray.

Why does my finger hurt and click when I bend it?

Pain with clicking, catching or locking when you bend and straighten a finger is typical of trigger finger, where the tendon catches in a narrowed sheath at the base of the finger. It often responds to splinting, a steroid injection or minor surgery.

Can carpal tunnel cause finger pain?

Yes. Carpal tunnel syndrome compresses the median nerve at the wrist, causing pain, numbness and tingling in the thumb, index, middle and part of the ring finger. Symptoms are often worse at night and with gripping. Wrist splints at night are the first treatment.