Hand and wrist pain (2024)

There are a number of conditions that can affect the hand and wrist.

Carpal tunnel syndrome

Carpal tunnel syndrome occurs when there’s pressure on the median nerve as it passes through the carpal tunnel.

This can cause tingling, numbness and pain, mainly in your hand and fingers. It can also cause similar symptoms in the wrist and forearm. Often the symptoms are worse at night.

If you think you have carpal tunnel syndrome, you should get an appointment at your GP surgery.

Carpal tunnel syndrome can go away in a few weeks or months. Using a splint or having a steroid injection can help.

If symptoms don’t go away, a minor operation to relieve the pressure in the carpal tunnel can solve the problem.

De Quervain’s tendinopathy

Problems can develop with tendons in the hand and wrist.

Tendons have a protective covering, or sheath, with synovial fluid in. This thick fluid protects the tendon and allows it to move easier.

Sometimes tendons or tendon sheaths can become inflamed. This can cause pain, swelling and stiffness and is called tendinopathy.

It can happen if tendons are overused, for example after playing a lot of sport.

Arthritis can lead to tendinopathy, and in rare cases so can an infection. Sometimes, there might not be an apparent cause.

De Quervain’s (Dey kwer-veins) tendinopathy is a common condition that can affect tendons in the wrist, causing pain around the wrist and at the base of the thumb. Pain normally eases with rest and can get worse with activity.

Applying ice wrapped in a damp towel and taking an NSAID can help. If your condition is not improving and is affecting your quality of life, steroid injections, splints, hand therapy or surgery might also be helpful.

Trigger finger

Trigger finger is the name of a condition in which you can’t straighten a finger or thumb properly. You might even need to use your other hand to straighten it. Very occasionally, a finger may become too painful to straighten and may stay stuck in the same position.

Trigger finger most commonly affects the thumb, ring and middle finger. More than one finger can be affected at the same time.

The affected finger might swell, and it can be painful.

There can be a clicking or popping sensation that comes from the finger, especially in the morning.

It’s thought to be caused by swelling of a tendon or tendon sheath.

Sometimes the swelling can cause nodules to form. These are small lumps that form under the skin.

Trigger finger can happen to otherwise healthy people for no clear reason. It’s more common among women over the age of 40.

It’s more likely if you’ve had a previous injury to the palm of the hand. Other medical conditions such as diabetes, gout, rheumatoid arthritis and an underactive thyroid may also increase someone’s risk of getting it.

Trigger finger can get better without the need for treatment. You may need to avoid certain activities if it’s thought they’re making your symptoms worse.

NSAIDs, like ibuprofen, can help.

If it doesn’t get better on its own and it isn’t treated, it’s possible for an affected thumb or finger to become permanently bent. Treatment can involve steroid injections. In most cases this will sort out the problem.

In some cases, a small operation can be carried out to stop the tendon from catching.

Dupuytren’s contracture

Dupuytren’s (due-per-trens) contracture can cause the fingers to bend in towards the palm of the hand.

It’s caused by tissues in the palms of the hands gradually thickening, which then pulls the fingers towards the palm.

This condition is often mild and might not need specific treatment. It’s more common in men in their middle age. Some heavy, repetitive tasks, such as those that are performed in mining, are thought to increase the risk of Dupuytren’s.

It normally affects the middle, ring and little finger.

It’s not often painful, but it can make it difficult to straighten out fingers and use your hands properly.

It may affect just one hand, but often affects both hands.

Treatment is only needed if fingers have started to bend, or if you can’t use your hand properly.

Treatment options available in the earlier stages, include injections of a medicine called collagenase (colla-gen-ayse). This can break down the thickened tissues. This is a quick and easy treatment that doesn’t need to be done as an operation. You will need to have your fingers straightened and stretched afterwards by a healthcare professional, which might be a bit uncomfortable.

There are surgical options including cutting the thickened tissue or cutting it out. This can be done as an operation or using a needle in an outpatient clinic.

Talk to your doctor to discuss your options if your symptoms aren’t improving.

Osteoarthritis

Osteoarthritis is the most common type of arthritis. It can affect hands and wrists, particularly the joints at the ends of the fingers or at the base of the thumb.

It can cause pain and stiffness, and make it difficult to use your hands and wrists properly.

Osteoarthritis can cause bony lumps to develop on the hands, particularly on the fingers.

If possible, it can help to avoid tasks that make the pain worse and put strain on your hands and wrists.

Keeping your hands and wrists moving as much as possible can help ease symptoms. There are some examples of simple exercises you could do, try to do these every day.

Taking painkillers, such as paracetamol, or NSAIDs such as ibuprofen can help ease pain and help you to keep moving your hands.

Capsaicin cream, which is made from extracts from chilli plants, has helped some people with osteoarthritis of the hand. It can help block pain messages sent to nerves.

In some cases, if symptoms don’t improve then surgery might be an option. Finger joints can be fused. This can improve symptoms, but it will lead to a loss of movement.

It’s also possible to have joint replacements for hand osteoarthritis. Another option could be arthroscopy, also known as key-hole surgery, to clean out a joint using a small cut, rather than open surgery.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune condition that can cause inflammation in joints.

This condition can sometimes start in the hands and wrists, with symptoms of pain, swelling and stiffness. This is often worse first thing in the morning. The stiffness can last for longer than half an hour and tends not to ease with movement. Joints can feel warm, and they can sometimes be red.

Rheumatoid arthritis can affect both hands and wrists in the same way at the same time. The symptoms can start quite gradually.

This is an uncommon condition in the general population. But if you do get any of these symptoms in your hands, especially if you also have an overall feeling of being unwell and very tired, see a doctor as soon as you can.

There are drugs that can treat the underlying cause of rheumatoid arthritis, and these can help prevent damage to your joints. The earlier treatment is started, the more effective it’s likely to be.

Hand-arm vibration syndrome

A condition called hand-arm vibration syndrome can affect people who have regularly used vibrating tools and machinery over a period of around 10 years or more. Such tools include pneumatic drills, power drills and chainsaws.

The early symptoms are loss of feeling, numbness and pins and needles in the fingers. Symptoms can often be mild, and just affect the ends of the fingers.

It might cause whole fingers to go numb. For some people this can make tasks such as doing up buttons and picking up small objects like coins difficult.

It’s thought that it could be caused by repeated minor injuries to the small nerves and blood vessels in the fingers.

Hand-arm vibration syndrome can lead to another condition called Raynaud’s phenomenon. See below.

If you think you have symptoms of hand-arm vibration syndrome see a doctor and report it to your manager if you think it’s being caused by something you do at work.

You might need to stop using vibrating tools and machinery to stop your condition getting worse.

Raynaud’s phenomenon

Raynaud’s phenomenon is a condition that causes a reduction in blood supply to the outer parts of the body, including the fingers.

It can happen in the cold or in stressful situations. It can also occur as a result of using hand-held vibrating tools.

During an attack of Raynaud’s, the fingers can change colour. They may first go white or look waxy. They can then go blue, and possibly even purple or black in severe cases. They are then likely to go red, and can be painful, tingly and numb when the blood rushes back.

Keeping warm in cold weather can help reduce the chances of an attack of Raynaud’s. Wearing several layers of clothing, as well as a hat, scarf and gloves will help. Reusable or disposable hand warmers and heated gloves can help.

It’s good to keep the skin of your fingers as healthy as possible by using a moisturiser at least once or twice a day. Your pharmacist will be able to tell you which ones are good for people with Raynaud’s.

Exercising regularly is also good for your circulation.

Smoking is very bad for your circulation and can make Raynaud’s much worse. If you smoke, quitting can be the best thing you do. Your GP will be able to offer advice and support, and there’s useful information on the NHS Smokefree website.

There are drugs available, such as nifedipine, which can improve your blood flow. These will need to be prescribed by a doctor.