Hand and Finger Pain: Causes and Treatment

Hand and finger pain by location

Common causes of hand and finger pain

Osteoarthritis

Osteoarthritis is the most common cause of finger joint pain after age 50. Cartilage wears thin, causing aching that worsens with use, brief morning stiffness, and hard bony lumps at the finger joints. Thumb base arthritis makes gripping, pinching and turning keys or jar lids painful.

Carpal tunnel syndrome

Carpal tunnel syndrome is compression of the median nerve at the wrist. It causes tingling, numbness and pain in the thumb, index, middle and half of the ring finger, often waking people at night. Shaking the hand often brings relief. Weak grip and dropping things develop later.

Tendon problems

• Trigger finger: a thickened tendon catches in its tunnel, so a finger clicks, locks bent, or snaps straight. Pain is felt at the base of the finger in the palm.
• De Quervain tenosynovitis: pain on the thumb side of the wrist, worse when lifting a baby or gripping. Common in new parents.
• Tendinitis from overuse: repetitive gripping, typing or tool use.

Injuries

Sprains (such as a jammed finger or skier's thumb), fractures and dislocations cause pain, swelling and bruising. Mallet finger, where the fingertip droops after a blow to the end of the finger, needs splinting to heal properly.

Inflammatory causes

Rheumatoid arthritis

Rheumatoid arthritis typically affects the knuckles and middle finger joints of both hands symmetrically. Joints are swollen, warm and tender, and morning stiffness lasts more than 30 minutes. Fatigue is common. Early treatment prevents permanent joint damage.

Psoriatic arthritis

Causes swollen joints, sometimes an entire "sausage" finger, often with skin psoriasis and nail pitting. The end finger joints are commonly affected.

Gout and pseudogout

Gout can affect the fingers and wrist with sudden, severe pain, redness and swelling. Chalky lumps (tophi) may form over years.

Other causes

• Ganglion cysts: smooth fluid-filled lumps on the wrist or finger base, sometimes painful.
• Raynaud's phenomenon: fingers turn white, blue then red in the cold with throbbing pain.
• Infections: a paronychia (infection beside the nail), felon (fingertip pulp abscess) or tendon sheath infection.
• Dupuytren contracture: thickening in the palm that slowly pulls fingers into a bent position; usually painless.
• Ulnar nerve compression: tingling in the little and ring fingers. See ulnar nerve compression.
• Diabetes: stiff hands, trigger finger, carpal tunnel and nerve pain are all more common.
• Referred pain: a trapped nerve in the neck can cause pain and tingling in the hand.

When to see a doctor

See a doctor for hand pain that persists beyond 2 weeks, keeps returning, is affecting work or sleep, or comes with swelling of several joints, numbness or weakness. Seek urgent care for signs of infection, deformity after injury, or a hot, swollen joint.

How the cause is found

Your doctor will ask where and when it hurts, about injuries, repetitive activities, morning stiffness and other joint problems. They will examine each joint, test grip, sensation and specific signs, such as tapping over the carpal tunnel. Tests may include:

• X-rays for arthritis and fractures
• Blood tests: inflammatory markers, rheumatoid factor, anti-CCP antibodies, uric acid
• Ultrasound for tendons, cysts and inflamed joints
• Nerve conduction studies for carpal tunnel or ulnar nerve compression

Treatment and home care

Self-care

• Rest and modify activities: take frequent breaks from gripping, typing and phone use.
• Ice for 15 minutes for a fresh injury or flare; warm water soaks for arthritis stiffness.
• Topical NSAID gel (such as diclofenac) is effective for hand osteoarthritis with fewer side effects than tablets.
• Oral pain relief: acetaminophen (paracetamol) or ibuprofen, following the label dose. Avoid regular NSAIDs if you have kidney problems, stomach ulcers or heart disease without medical advice.
• Hand exercises: gentle range-of-motion exercises keep joints moving.
• Tools: jar openers, thick-handled pens and utensils, and ergonomic keyboards reduce strain.

Medical treatment

• Splints: night wrist splints for carpal tunnel, thumb splints for arthritis and De Quervain, finger splints for injuries.
• Hand therapy: an occupational therapist or hand therapist can design exercises and joint protection strategies.
• Steroid injections: for trigger finger, De Quervain, carpal tunnel and thumb arthritis flares.
• Disease-modifying medicines: for rheumatoid and psoriatic arthritis, started early by a rheumatologist.
• Surgery: carpal tunnel release, trigger finger release, thumb joint reconstruction, repair of tendons or fractures.

Frequently asked questions

What causes pain in the hands and fingers?

The most common causes are osteoarthritis, carpal tunnel syndrome, tendinitis, trigger finger and injuries. Rheumatoid arthritis, psoriatic arthritis, gout, infections and Raynaud's phenomenon are other causes. Where the pain is and whether there is swelling or numbness help identify the cause.

How can I tell if hand pain is arthritis?

Osteoarthritis causes aching that worsens with use, short morning stiffness and hard bony lumps at the finger joints. Rheumatoid arthritis causes soft, warm swelling of the knuckles and middle joints in both hands, with morning stiffness over 30 minutes. X-rays and blood tests confirm the type.

Why do my fingers hurt in the morning?

Morning finger pain and stiffness are common in arthritis. Stiffness that eases within 30 minutes suggests osteoarthritis. Stiffness lasting longer, with swelling, suggests inflammatory arthritis such as rheumatoid arthritis. Carpal tunnel syndrome also causes pain and tingling that is worst at night and on waking.

What is the best treatment for finger joint pain?

For osteoarthritis, combine hand exercises, warm soaks, splints and a topical anti-inflammatory gel. Acetaminophen or ibuprofen can help flares. Inflammatory arthritis needs prescription medicines from a rheumatologist. Steroid injections and surgery are options for persistent pain.

When should I see a doctor for hand pain?

See a doctor if pain lasts more than 2 weeks, if several joints are swollen, if you have numbness, weakness or a finger that locks, or if your hand is red, hot and swollen. Seek emergency care for injuries with deformity, deep cuts or a cold, pale finger.