Health Library Finger, Hand, and Wrist Problems, NoninjuryFrom Healthwise

Everyone has had a minor problem with a finger, hand, or wrist. Most of the time our body movements do not cause problems, but it's not surprising that symptoms occur from everyday wear and tear, or overuse. Finger, hand, or wrist problems can also be caused by injuries or the natural process of aging.

Your fingers, hands, or wrists may burn, sting, hurt, feel tired, sore, stiff, numb, tingly, hot, or cold. Maybe you can't move them as well as usual, or they are swollen. Perhaps your hands have turned a different color, such as red, pale, or blue. A lump or bump might have appeared on your wrist, palm, or fingers. Home treatment is often all that is needed to relieve your symptoms.

Finger, hand, or wrist problems may be caused by an injury. If you think an injury caused your problem, see the topic Finger, Hand, and Wrist Injuries. However, there are many other causes of finger, hand, or wrist problems.

Overuse problems

• Carpal tunnel syndrome is caused by pressure on a nerve ( median nerve) in the wrist. The symptoms include tingling, numbness, weakness, or pain of the fingers and hand. See an illustration of carpal tunnel syndrome.
• Tendon pain is actually a symptom of tendinosis, a series of very small tears (microtears) in the tissue in or around the tendon. In addition to pain and tenderness, common symptoms of tendon injury include decreased strength and movement in the affected area.
• De Quervain's disease can occur in the hand and wrist when tendons and the tendon covering (sheath) on the thumb side of the wrist swell and become inflamed. See an illustration of de Quervain's disease.
• Repetitive motion syndrome is a term used to describe symptoms such as pain, swelling, or tenderness that occur from repeating the same motion over and over.
• Writer's cramps develop with repeated hand or finger motion, such as writing or typing.

Bone, muscle, or joint problems

• Dupuytren's disease is an abnormal thickening of tissue beneath the skin in the palm of the hand or hands and occasionally the soles of the feet. The thickened skin and tendons (palmar fascia) may eventually limit movement or cause the fingers to bend so that they cannot be straightened. See an illustration of Dupuytren's contracture.
• Trigger finger or trigger thumb occur when the flexor tendon and its sheath in a finger or thumb thicken or swell.
• Ganglion cysts are small sacs (cysts) filled with clear, jellylike fluid that often appear as bumps on the hands and wrists but can also develop on feet, ankles, knees, or shoulders. See an illustration of a ganglion.

Problems from medical conditions

• Tingling or pain in the fingers or hand (especially the left hand) may be signs of a heart attack.
• Diabetes may change how the hands normally feel or sense touch. Decreased feeling in the hands is common because of decreased blood flow to the hands or damage to nerves of the hand.
• Pregnancy may cause redness, itching, swelling, numbness, or tingling that often goes away after delivery.
• Osteoarthritis is the progressive breakdown of the tissue that protects and cushions joints (cartilage). It may cause stiffness and pain with movement.
• Rheumatoid arthritis may cause stiffness and pain with movement. Over time, deformity of the fingers may occur. See an illustration of rheumatoid arthritis.
• Lupus is a long-lasting autoimmune disease in which the immune system attacks normal body tissues as though they were foreign substances. It may cause joint pain.
• Gout is an inflammatory joint disease that causes acute pain and swelling. It is a form of arthritis that develops when uric acid crystals form in and around the joints, commonly affecting the big toe joint.
• Raynaud's phenomenon is a condition in which some areas of the body, usually the fingers or toes, have an exaggerated response to cold temperature or emotional stress. During an attack of Raynaud's, the blood vessels in the affected areas tighten, severely limiting the flow of blood to the skin, causing a numbness, tingling, swelling, and pain.
• Infection can cause pain, redness, and swelling that occur with red streaking, heat, fever, or the drainage of pus. An infection often causes tenderness to the touch or pain with movement at the site of the infection.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• Hand pain or tingling with chest pain or pressure and any other symptoms of a heart attack
• Sudden hand weakness or numbness with other signs of loss of function
• Sudden hand pain with numbness and cold or pale skin that has lasted for more than a few minutes

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• An injury to your finger, hand, or wrist: Go to the topic Finger, Hand, and Wrist Injuries.
• Injury from cold exposure: Go to the topic Cold Temperature Exposure.
• Sudden hand swelling: Go to the topic Allergic Reaction.
• A fingernail problem or injury: Go to the topic Nail Problems and Injuries.
• A rash on your hands: Go to the topic Rash, Age 11 and Younger or Rash, Age 12 and Older.
• Swelling of your hand and you are pregnant: Go to the topic Pregnancy-Related Problems.

	Yes	Do you have pain or stiffness in your finger, hand, or wrist?
When to See a Doctor See significance of pain or stiffness in a finger, hand, or wrist if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have severe pain? Call your health professional today if you answer "Yes" to the following question. Yes Is a young child unwilling or unable to use a finger, hand, or wrist, or protecting a hand carefully? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you have mild to moderate pain or stiffness in your finger, hand, or wrist after 24 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have swelling in your finger, hand, or wrist?
When to See a Doctor See significance of swelling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have swelling with pale, white, blue, or cold skin? Yes Do you have sudden swelling of both palms? Call your health professional today if you answer "Yes" to the following question. Yes Has swelling that is usual for you gotten worse in the past 24 hours? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Has mild swelling without other symptoms not improved after 1 week of home treatment? Yes Have you had swelling for a long time that has been checked by your doctor, but the swelling is not getting better or is getting worse? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have numbness or tingling in your finger, hand, or wrist?
When to See a Doctor See significance of numbness or tingling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have new numbness or tingling and the hand is more pale, white, blue, or cold than your other hand? Yes Do you have new numbness or tingling and you are unable to move your finger or hand? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had steady numbness or tingling that has lasted for 1 hour or longer? Yes Have you had numbness or tingling for a long time that has been checked by your doctor, but the numbness or tingling is not getting better or is getting worse? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had numbness or tingling that comes and goes for 24 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have pale, white, blue, or cold fingers or hands?
When to See a Doctor See significance of pale, white, blue, or cold fingers or hands if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Have your fingers or hands become pale, white, blue, or cold? Yes Are your fingers or hand pale, white, blue, or cold after having a brace, cast, or splint applied? Note: See first aid for a cast or splint that may be too tight. Call your health professional today if you answer "Yes" to the following question. Yes Have your symptoms gotten worse since being evaluated by your health professional? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had pale, white, blue, or cold fingers or hands off and on for short periods of time in the past 24 hours, but you do not have these symptoms now? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Did you have or do you now have weakness or decreased movement or strength in a finger, hand, or wrist?
When to See a Doctor See significance of weakness or decreased movement or strength if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Have you had sudden weakness of a finger, hand, or wrist with any loss of function, but your symptoms are gone now? Yes Are you unable to move your finger, hand, or wrist at all, but you do not have any other symptoms? Call your health professional today if you answer "Yes" to any of the following questions. Yes Is it hard for you to make a fist? Yes Is it hard for you to straighten all your fingers? Yes Is it hard for you to bend or straighten your wrist? Yes Is it hard for you to grasp an object? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Are you unable to move your hand or wrist normally or do you have decreased strength after 48 hours of home treatment? Yes Have your ongoing problems moving your fingers, hand, or wrist gotten worse in the past 48 hours? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had ongoing (but not worsening) trouble moving a finger, hand, or wrist? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have signs of infection in your finger, hand, or wrist?
When to See a Doctor See significance of signs of infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have diabetes? Yes Do you have peripheral arterial disease? Yes Do you have a disease that causes problems with your immune system? Yes Do you have red streaks extending from your hand or wrist? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have increased pain, swelling, redness, or warmth around your hand or wrist? Yes Is your finger, hand, or wrist increasingly tender to the touch? Yes Do you have any drainage of pus? Yes Do you know or think you have a fever? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild pain and swelling with redness less than 1 in. (2.5 cm) around the affected area for 24 hours or longer? Yes Have you had a swollen gland (lymph node) in the neck, armpit, or the bend of the elbow for 24 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a finger or thumb that snaps, pops, or locks during normal movement?
When to See a Doctor See significance of a finger or thumb that snaps, pops, or locks if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you have a finger or thumb that has locked in one position and you cannot move it? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had a painful finger or thumb that snaps, pops, or locks during normal movement for 24 hours or longer? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Do you have a finger or thumb that repeatedly snaps, pops, or locks during normal movement but you do not have pain? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a lump or bump on your finger, hand, or wrist?
When to See a Doctor See significance of a lump or bump if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had a lump or bump without signs of infection for longer than 48 hours? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had a painless lump or bump for 2 weeks or longer that has not been checked by a health professional? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home treatment may be all that is needed for a finger, hand, or wrist problem.

• Remove all rings, bracelets, watches, or any other jewelry from your finger, wrist, or arm as soon as you notice swelling. It will be more difficult to remove the jewelry once swelling increases.
• Use rest, ice, compression, and elevation (RICE) for pain and swelling.
• Treat hands sensitive to cold by avoiding and protecting your hands from the cold.
• Avoid sleeping on your hands, which may decrease blood flow to your fingers.
• Cut down on the salt (sodium) in your diet. Sodium can hide in foods such as cheese, canned soups, and salad dressing.
• Treat blisters on fingers or hands.
• Stop, change, or take a break from your activities.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Signs of infection develop.
• Numbness, tingling, or cool, pale skin develops.
• Symptoms continue despite home treatment.
• Symptoms become more severe or frequent.

The following tips may prevent finger, hand, and wrist problems.

General tips

• Do exercises that strengthen your hand and arm muscles.
• Stop, change, or take a break from activities that cause your symptoms.
• Reduce the speed and force of repetitive movements in activities such as hammering, typing, knitting, quilting, sweeping, raking, racquetball sports, or rowing.
• Change positions when holding objects, such as a book or playing cards, for any length of time.
• Use your whole hand to grasp an object. Gripping with only your thumb and index finger can stress your wrist.
• When working with tools that vibrate, consider using special gloves that support the wrist and have vibration-absorbing padding.
• Wear protective gear, such as wrist guards, in sports activities.

Protect your hands from cold

• Wear gloves anytime it is cool outside.
• Use an insulated cover when you drink from a cold glass.
• Avoid caffeine (coffee, cola, tea, chocolate) and tobacco products. Nicotine and caffeine cause blood vessels to narrow, which decreases blood flow to the hands.
• Eat a hot meal before going out. Eating raises your body temperature and helps keep you warm.

Work posture and body mechanics

• Organize your work so that you can change your position occasionally while maintaining a comfortable posture.
• Position your work so you do not have to turn excessively to either side.
• Keep your shoulders relaxed when your arms are hanging by your sides.
• When using a keyboard, keep your forearms parallel to the floor or slightly lowered and keep your fingers lower than your wrists. Allow your arms and hands to move freely. Take frequent breaks to stretch your fingers, hands, wrist, shoulders, and neck. If you use a wrist pad during breaks from typing, it's best to rest your palm or the heel of your hand on the support, rather than your wrist.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms? How long have you had your symptoms?
• Have you had this problem in the past? If so, do you know what caused the problem at that time? How was it treated? What do you think is causing your symptoms now?
• What activities make your symptoms better or worse? Have you started any new activities, sports, or training techniques?
• Do you think that activities related to your job or hobbies caused your symptoms?
• What home treatment have you tried? Did it help? Be sure to include any nonprescription medications you have taken. Did they help?
• Have you started any new medications, or have you had a change in the dosage of a medication?
• Do you have any health risks?

• Allergic Reaction
• Carpal Tunnel Syndrome
• Cold Temperature Exposure
• Dupuytren's Disease
• Finger, Hand, and Wrist Injuries
• Ganglions
• Nail Problems and Injuries
• Pregnancy-Related Problems
• Rash, Age 11 and Younger
• Rash, Age 12 and Older

Author:	Susan Van Houten, RN, BSN, MBA	Last Updated: January 12, 2007
Medical Review:	Martin Gabica, MD - Family Medicine William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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