Hand and wrist pain

What is hand and wrist pain?

Your hands and wrists let you grip, pinch and move with precision, so pain here – whether it's a dull ache or a sharp twinge – can make everyday tasks difficult. They're made up of dozens of small bones, joints, tendons and nerves working together, so pain can come from any one of these parts.

What are the common causes of hand and wrist pain?

Hand and wrist pain often comes from an injury, such as:

• a sprain or strain, where ligaments are stretched or torn, often from a fall onto an outstretched hand
• a fracture, which is a break in one of the bones
• overuse from repetitive movements, such as typing, gripping tools, or repeated hand use at work.

It can also build up gradually from an underlying condition, such as:

• osteoarthritis or rheumatoid arthritis, which affect the joints of the hand and wrist
• carpal tunnel syndrome, where a nerve is compressed as it passes through the wrist
• tendon problems, including De Quervain's tenosynovitis, which is pain at the base of the thumb, and trigger finger, where a finger catches or locks as it bends
• Dupuytren's contracture, a thickening of tissue in the palm that can pull one or more fingers inwards
• a ganglion cyst, a fluid-filled lump that can develop over a joint or tendon.

Are there different types of hand and wrist pain?

Hand and wrist pain is often grouped by where it's felt:

• Pain on the thumb side of the wrist, known as radial, or the little-finger side, known as ulnar
• Pain in the fingers or thumb
• Pain in the palm or on the back of the hand.

It's also useful to know the pattern some conditions follow:

• Carpal tunnel syndrome usually causes tingling, numbness or pain in the thumb and first two fingers, which is often worse at night
• Osteoarthritis tends to affect the base of the thumb or the finger joints, with stiffness and bony lumps
• De Quervain's tenosynovitis causes pain and swelling at the base of the thumb, worse when gripping or twisting the wrist.

How is hand and wrist pain diagnosed?

A GP will usually ask about your symptoms, such as where the pain is, what makes it better or worse, and whether you've had a recent injury. They'll examine your hand and wrist, checking movement, strength and any swelling.

If needed, they may refer you for an X-ray to check for a fracture or arthritis, or for other tests to look more closely at the nerves, tendons or joints.

How is hand and wrist pain treated?

For minor injuries and most mild pain, home treatment is a good place to start:

• Rest the hand and wrist, avoiding the activity that caused the pain
• Cool the area with an ice pack or a bag of frozen peas over a thin cloth – apply for 15 minutes a few times per day as feels comfortable
• Raise your hand above the level of your heart to help with swelling
• Take paracetamol or ibuprofen, or use ibuprofen gel, for pain relief*
• Wear a wrist splint for extra support, particularly at night if you have tingling or numbness.

* Ibuprofen should always be taken with food and only if it does not interact with any other medicines you take. You should seek a medical review if you get indigestion or side effects. Do not use both ibuprofen gel and ibuprofen tablets at the same time.

Treatment beyond this depends on the cause. Here are some examples:

• Carpal tunnel syndrome is often treated with a night splint and sometimes a steroid injection or surgery to release pressure on the nerve
• Tendon problems, such as De Quervain's tenosynovitis or trigger finger, may be treated with a splint, anti-inflammatory medicines, a steroid injection or surgery if these don't help
• Arthritis is managed with pain relief, splints, heat or cold therapy and sometimes surgery for severe cases
• A ganglion cyst may need no treatment at all if it's small and painless, though a GP or specialist may drain it or remove it surgically if it's causing problems.

When should I see a doctor?

See a GP if:

• pain is stopping you from doing normal activities, or keeps coming back
• the pain hasn't improved after 2 weeks of home treatment
• you have tingling or loss of feeling in your hand or fingers
• your hand, wrist or fingers are hot, swollen or an unusual colour
• you feel generally unwell alongside the pain, with a fever, night sweats or weight loss
• the pain wakes you at night, or you have early morning stiffness lasting more than 30 minutes.

Call NHS 111, or go to A&E, if:

• the pain is severe
• you heard or felt a snap, a grinding sensation or a pop at the time of injury
• your hand, wrist or fingers have changed shape or colour
• you can't move your hand or wrist, or hold anything
• you've lost feeling in part or all of your hand.

These can be signs of a broken bone or an infection.