What is wrist or hand pain?
Your wrist and hand are made up of a complex system of bones, ligaments, tendons, muscles, nerves and blood vessels. Any one of these can get injured and cause pain.
An accident or trauma that leads to wrist or hand pain is considered an “acute injury.” By contrast, a “chronic injury” develops over time, generally from overuse. Typing, playing tennis or driving for hours can all place stress on the hand and wrist, leading to a chronic problem.
You can successfully treat minor injuries, such as a mild sprain or strain, at home, but you should see a doctor for serious injuries such as fractures or severe sprains.
Your doctor can accurately diagnose the cause of the problem, suggest treatments to relieve symptoms and help the injury heal properly. Otherwise, you could have ongoing stiffness, pain or – eventually – disability.
What are common hand and wrist injuries?
This occurs when the end of your finger gets hit while fully straight. Icing and “buddy taping” the finger to its neighbor are frequently successful in treating jammed fingers.
A fracture can result when something hits your finger or you fall on your hand with enough force to break the bone. See your doctor to treat a broken finger so it stays aligned and heals properly.
Tendons in the hand and wrist can get injured in several ways: getting a deep cut on your hand or wrist, hitting the tip of your finger while it is straight (rupturing the tendon and causing “mallet finger,” in which you can't straighten your finger), or grabbing an object that is moving away (sometimes called “jersey finger” because of athletes who grab on to the jersey of another player). See your doctor if you think you have a tendon tear.
Nail bed injury or infection
If an object falls on or hits the tip of your finger, or if you have an injury around the nail, you can temporarily or permanently damage the nail and nail bed. In some cases, blood may collect under the nail. Paronychia, a common nail infection, can lead to redness, swelling and sometimes a pus-filled abscess around the cuticle and side of the nail.
A significant amount of force on the finger can stretch the ligaments and force a joint out of position. Dislocations are painful, and your finger usually looks deformed. If you suspect your finger is dislocated, see your doctor for treatment; otherwise, you risk further damage.
Wrist fractures commonly occur when someone falls and lands on an outstretched hand. Typical symptoms include pain when using the wrist or tenderness at the base of the thumb. Your doctor can properly align the bones and check for other injuries that might have occurred at the same time.
Sprain or strain
Sprains are injuries to the ligaments. You can tear a ligament in your wrist by falling and trying to catch yourself. Ulnar collateral ligament tear, or “skier’s thumb,” is a type of injury in which an object (such as a ski pole) hits your thumb joint with force. Strains are injuries to the muscles and tendons, which can occur from injury or overuse.
Repetitively using your hands and wrists can irritate the tendons, leading to tendon inflammation, or tendinitis. Rest, ice, over-the-counter anti-inflammatory medication and avoiding or limiting repetitive motions are frequently successful in treating tendinitis.
This condition is caused by pressure and compression on the medial nerve, which runs down the arm, through the wrist and into the hand. Classic symptoms include pain, tingling or numbness in the thumb, index, middle and ring fingers, especially at night. Prolonged gripping or repetitive motions that bend and flex the wrist are often associated with carpal tunnel syndrome.
Lump or tumor in the wrist
Lumps, such as ganglion cysts, or, less commonly, tumors in the wrist can cause pain, numbness, tingling or other symptoms. The exact cause of a ganglion cyst is not known, but it is thought that chronic wrist irritation or stress may play a role. Ganglion cysts are fluid-filled lumps. They are noncancerous and often painless, but they can put pressure on nerves near the wrist. Tumors in the wrist are rare but can be caused by types of cancer.
Pain, swelling and loss of motion are common signs of arthritis in the wrist. Osteoarthritis in the wrist is rare, unless you have had a wrist injury in the past. Rheumatoid arthritis in the wrist is more common.
What are the symptoms of hand or wrist pain?
Symptoms depend on the cause and severity of the injury or condition. Some common signs of a wrist or hand injury include:
- Vague ache
- Moderate or severe pain
- Swelling at or around the site of the injury
- Stiffness or inability to use your wrist, hand, fingers or thumb
- Numbness, tingling or weakness in the wrist, hand or fingers
- Cold and pale or gray-looking wrist, hand or fingers
- Deformity, such as twisting or an abnormally bent wrist or finger
- Trouble pinching or grasping objects between your thumb and index finger
- Tenderness around the joints of a particular part of the hand or wrist
- Difficulty or inability to bend your finger(s)
- Pain when trying to grasp something or trying to turn your wrist
- A finger that is stuck in the bent position
What should I do if I have hand or wrist pain?
Call your doctor immediately or go an emergency room if you have an injury accompanied by:
- Severe pain
- Severe swelling
- Numbness in your wrist, hand or fingers
- Cold or gray fingers, hands or skin around the wrist
- Twisted, deformed or oddly bent fingers or hand
- A clicking, grating or shifting sensation or noise when you move your finger, hand or wrist
- Bleeding that does not slow after about 15 minutes
- Bone that sticks through the skin, or a deep gash that allows you to see the tendons and bone
If you have ongoing pain (lasting more than two weeks), numbness or weakness, swelling or other symptoms that weren’t triggered by an injury, call your doctor. He or she may recommend a treatment or refer you to an orthopedic surgeon, a rheumatologist (joint specialist) or a sports medicine expert.
How are hand and wrist injuries diagnosed?
Wrist and hand injuries can be difficult to diagnose because many different problems could be causing your symptoms. Your doctor will ask when you first noticed pain, what you were doing at the time, how long you’ve had the symptoms and what activities make the pain worse or better.
He or she will then examine your wrist: Specific points of tenderness or swollen areas, decreased range of motion, or weak grip or forearm strength are all clues that can help your doctor make an accurate diagnosis.
After examining your hand and wrist, your doctor may need to do some tests to help pinpoint the exact cause of your problem:
- An X-ray can reveal any fractures and show signs of osteoarthritis.
- An MRI produces detailed images of your bones and soft tissues, revealing small fractures and ligament injuries.
- CT scans take X-rays from several different directions, which can provide more detailed images of the bones in your hand and wrist.
- A bone scan can be useful in detecting stress fractures. This test involves injecting a small amount of radioactive material into the bloodstream, which makes the scan images brighter.
- Arthroscopy may be used if your doctor can’t determine the cause of your symptoms after a physical exam and imaging tests. Your doctor makes a small incision in your skin and inserts an instrument with a camera and light into your hand or wrist. The images from the camera are projected onto a monitor that you doctor uses to guide the tool and identify possible causes of your pain.
- A nerve conduction study or an electromyogram (EMG) measures nerve activity. Certain injuries, such as carpal tunnel syndrome, can slow the electrical impulses in parts of the hand and wrist. An EMG or nerve conduction study can determine if the electrical impulse is slower than it should be.
How is hand or wrist pain treated?
Treatment varies depending on the cause, location and severity of the injury, as well as your activity level, occupation, age and overall health. Some remedies or treatment options may include:
- Over-the-counter medication such as acetaminophen (e.g., Tylenol), ibuprofen (e.g., Advil, Motrin) and naproxen (e.g., Aleve), which can relieve pain and inflammation
- Resting your wrist and hand and avoiding motions that cause pain
- Ice to ease pain and swelling
- Compressing your wrist with an elastic bandage to minimize swelling
- Elevating the injured part above the level of your heart to reduce swelling
- Prescription pain medication
- Injections of cortisone (corticosteroid), a powerful anti-inflammatory medication
- A cast, brace, splint or “buddy taping” – Your bones need to stay aligned to heal, and they need time to mend. A cast or splint keeps the area immobilized while protecting injured ligaments and tendons. “Buddy taping” involves taping the injured finger to its neighboring finger. Splints, including wrist braces, are often used for carpal tunnel syndrome and other overuse injuries.
- Surgery to repair severe fractures, carpal tunnel syndrome or tendon or ligament injuries
- Alternative medicine, such as acupuncture, chiropractic treatment or massage. Talk to your doctor about the benefits and risks.
What can you do to prevent hand and wrist injuries?
- Get medical help if you have worrisome symptoms or pain or swelling that lasts more than a couple weeks. If you delay care, your injury may not heal properly and could potentially cause long-term disability.
- Use protective athletic gear. Wear wrist guards if you snowboard, rollerblade or play football.
- Learn proper technique. If you have an office job, make sure your keyboard and mouse are in proper position to limit wrist and hand strain. If you’re new to a sport or notice that certain activities, such as tennis, hurt your hand or wrist, read up on proper technique or work with a coach.
- Stretch your hand and wrist before activity. Taking frequent breaks during repetitive activities can also help prevent overuse injuries.
- Keep your bones strong. Eat calcium- and vitamin-D rich foods and get enough weight-bearing exercise.
- Prevent falls. Wear sensible shoes, watch where you step, and keep your home and work space free from tripping hazards.
Questions to Ask Your Doctor
- What could be wrong with my wrist or hand?
- Is this problem typically considered minor or severe?
- Will you do any tests to verify the diagnosis or rule out other problems?
- What does treatment typically involve?
- How long does treatment usually take?
- Will I need to take any time off from work? How much time?
- What can I do to care for this injury at home? What should I avoid?
- Do you recommend any follow-up treatment?
- Do you think surgery could be necessary? At what point is surgery done?
- How long will it take for my symptoms to go away? How long do you think full recovery will take?
- Will I need rehabilitation to regain full motion?
- Will I be working with you or with a physical therapist?
- When should I see you again?
- What are the chances that I will re-injure my wrist or hand?
- What can I do to prevent re-injury?
- What happens if I don't do anything to treat this problem? Will it get worse? Stay the same?
- How could wrist or hand pain affect me in the short and long term?
Our Medical Advisory Board
Wiser Motion's physician advisors review all information on the site to ensure its accuracy, relevance, and consistency with medical best practices.
James Herndon, MD
Orthopaedic surgeon at Massachusetts General Hospital (Boston, MA) and Professor at Harvard Medical School
Leslie Scott Matthews, MD
Chief of Orthopaedic surgery at the Union Memorial Hospital (Baltimore, MD) and Asst. Professor at Johns Hopkins Hospital
Peter Johnson, MD
Medical Director of occupational medicine and employee health at the McLeod Regional Medical Center (Florence, SC)