Rheumatology

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Hand Pain

Why Is the Hand So Important?

The human hand is a highly complex and powerful structure made for precision and strength. It allows us to hold and carry objects, perform fine tasks like writing and typing.

Hand Anatomy

The hand has 27 bones, between these bones are joints, which allow movement. The hand is supported by muscles and tendons.

Common Causes of Hand Pain

1. Carpal Tunnel Syndrome

Caused by compression of the median nerve at the base of the palm

Symptoms:

  • Tingling or numbness in fingers (especially thumb, index, middle)
  • Symptoms are worse at night or early morning
  • Difficulty holding objects

2. Trigger Finger

A condition where the finger gets stuck in a bent position and then suddenly straightens with a snap caused by inflammation of the tendon sheath

Common in:

  • Manual workers
  • People with diabetes

3. De Quervain’s Tenosynovitis

Painful condition near the base of the thumb caused by inflammation of tendons used to move the thumb

Common in:

  • Lifting objects
  • New mothers or people with repetitive wrist use

4. Osteoarthritis (OA) of the Hand

Age-related wear and tear of joints common in older adults and families

Symptoms:

  • Bony swelling in finger joints
  • Pain, stiffness, and reduced grip
  • Often affects the end joints of the fingers
  • Heberden’s and Bouchard’s nodes may be seen

5. Rheumatoid or Psoriatic Arthritis

Autoimmune diseases where the body’s immune system attacks its own joints

Symptoms:

  • Pain and swelling in multiple finger joints
  • Morning stiffness lasting more than 30 minutes
  • May be associated with skin psoriasis or other systemic symptoms
How Is It Treated?

Carpal Tunnel Syndrome

  • Avoid repetitive activity
  • Night splints to reduce pressure on the nerve
  • Steroid injections
  • Surgery if symptoms are severe or persistent

Trigger Finger / De Quervain’s

  • Reduce repetitive hand use
  • Anti-inflammatory medications
  • Physiotherapy
  • Steroid injections (very effective)
  • Surgery if injections fail
Osteoarthritis (Hands)

Management strategies include:

  • Keep the joints mobile through regular, gentle movements and hand exercises.
  • Apply topical gels or creams (e.g., topical NSAIDs) to relieve pain.
  • Practice joint protection techniques, use assistive devices, and adapt daily activities.
  • Use simple measures like heat or cold treatment (e.g., paraffin baths) to ease discomfort.

Osteoarthritis in the hands tends to stabilize over time. While nodes remain, the focus is on maintaining comfort and function rather than curing the condition. Pain often decreases and does not necessarily worsen continuously.

Rheumatoid and Psoriatic Arthritis

Unlike osteoarthritis, rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are inflammatory arthritis’s that require disease-modifying antirheumatic drugs (DMARDs) to suppress the underlying immune-driven inflammation, prevent joint damage, and preserve long-term function.

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