Hand and wrist pain can arise after an injury (e.g a fall), or develop with no known injury (e.g a flare of arthritis). Common reasons include aggravation of muscles, tendons, ligaments, arthritis in the joints and/or irritation of nerves.
You should see your doctor if you:
Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
You have any tingling or loss of sensation in your hand or wrist
You notice changes to your grip strength and are frequently dropping things
You have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
If you do not have any of the above, you may be able to effectively self manage your condition
There are several ways you can help yourself including:
Keeping active - find a balance between rest and some activity, try not to overdo things (alter activities that make it worse so they are less painful)
Osteoarthritis (OA) is a natural degenerative process where the cartilage that spaces a joint start to change and over time thin, meaning the bones gets closer together, and can occur in any joint in the body. Osteoarthritis is a part of the normal ageing process and is most commonly seen in people over the age of 40.
The fingers, thumb, hand and wrist joints are among the most commonly affected by Osteoarthritis. OA of the fingers can go through “flare-up” periods in which your joints may become stiff and painful.
Common signs and symptoms
Limited function in daily tasks
Pain
Reduced movement of the finger joint
Pain is worse with or after activity
Stiffness worse with inactivity
Symptoms can flare or settle with changing seasons
Lumps and bumps on the finger joints can be seen. These are known as Herbeden's or Bouchard's nodes
Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
What can I do to help myself?
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments. Other treatment can include:
Reducing the strain on your hands if you have to complete very repetitive tasks/heavy lifting at work
Warm water soaks for your hands and fingers
Wearing gloves when going outside to reduce the impact of the cold
Once your pain is under control, working on the movement and strength of your fingers and hand is what will help long term.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your fingers to get you started.
It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.
The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.
Finger Flexion/Extension
Place your affected arm and hand flat on a table. Try to make a fist, curling your fingers on to your palm, then fully straightening your fingers back out.
Thumb Opposition (thumb to every fingertip)
Place elbow or back of your hand on a table. Put your thumb against each fingertip in turn. Practice picking up small objects.
Grip squeeze
Hold a ball in your hand. Squeeze the ball as hard as you can and hold. Allow your wrist to move in whichever direction feels natural.
AROM wrist flexion/extension
Start in a seated position with your forearm resting on a table and your thumb facing upright to the ceiling. Bend your wrist forwards, and then extend your wrist backwards, keeping your fingers relaxed throughout the whole movement.
AROM forearm pronation/supination
Sit up straight with your forearm resting on a table. Try to turn your palm to face upwards. Then try to turn your palm to face down. Continue this movement. It is important the movement only comes from your forearm, so ensure you do not allow your upper arm or body to twist.
When should I see a doctor or healthcare professional?
Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have any tingling or loss of sensation in your hand or wrist
Notice changes to your grip strength and are frequently dropping things
Have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
Notice your fingers becomes acutely red hot and swollen without any prior explanation of activity/overuse
If you do not have any of the above, you may be able to effectively self manage your condition.
Carpal tunnel syndrome (often shortened to CTS) is a condition caused by compression of a nerve in the carpal tunnel of the wrist. Compression of the nerve can lead to a combination of pain, pins & needles, tingling, numbness and weakness to the hand and fingers. Carpal tunnel is a common nerve condition of the upper limb.
You are more at risk of developing carpal tunnel syndrome if:
You already have any form of arthritis in the wrist, especially if there’s swelling of the wrist joint or the tendons that run through the carpal tunnel
Suffer hormonal changes, for instance during pregnancy, which can sometimes affect connective tissues and put pressure on the nerve (please see treatment for pregnancy below)
The thyroid gland not producing enough hormones, sometimes called hypothyroidism or an underactive thyroid gland
Have additional medical conditions such as Diabetes, Menopause, Systemic lupus erythematosus, Scleroderma, Dermatomyositis Renal failure, Long-term, haemodialysis Acromegaly, Multiple myeloma, Sarcoidosis, Leukaemia, Alcoholism, Haemophilia
Suffered previous wrist fracture
Genetics (parent, brother, sister previously diagnosed with CTS)
Age (40 plus)
Gender (female)
Obesity
Work in environments that places heavy demand on your wrist
Work using vibrating tools
Common signs and symptoms
An ache or pain in your fingers, hand/s or arm/s
Numbness in the hand/s
Tingling or pins and needles in the hand/s
Muscle weakness when making a fist
Difficulty gripping or holding onto items
Muscle wastage in the palm of the hand
Symptoms increase or are worse of a night
Relief of symptoms when shaking your hands
How is a diagnosis made?
Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
Further tests such as nerve conduction studies may be performed if the Health Care Professional needs further information to finalise the diagnosis or if surgery is being considered.
Take Pain relief Pain medication, like paracetamol or ibuprofen, may help carpal tunnel pain short-term.
Wear a wrist splint
A futura wrist splint is something you wear on your hand to keep your wrist straight. It helps to relieve pressure on the nerve. You wear it at night while you sleep. It may take some time before symptoms start to improve. You can buy futura wrist splints online or from pharmacies.
Activity modification
Stop or cut down on anything that causes symptoms to increase. This may be caused by frequently bending your wrist or griping hard, such as when using vibrating tools for work, typing or playing an instrument.
Recommended exercises
Thumb Opposition (thumb to every fingertip)
Place elbow or back of your hand on a table. Put your thumb against each fingertip in turn. Practice picking up small objects.
AROM wrist flexion/extension
Start in a seated position with your forearm resting on a table and your thumb facing upright to the ceiling. Bend your wrist forwards, and then extend your wrist backwards, keeping your fingers relaxed throughout the whole movement.
AROM forearm pronation/supination
Sit up straight with your forearm resting on a table. Try to turn your palm to face upwards. Then try to turn your palm to face down. Continue this movement. It is important the movement only comes from your forearm, so ensure you do not allow your upper arm or body to twist.
When should I see a Healthcare Professional?
You should see a Healthcare Professional if you:
Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have any tingling or loss of sensation in your hand or wrist
Notice changes to your grip strength and are frequently dropping things
Have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
Notice your fingers becomes acutely red hot and swollen without any prior explanation of activity/overuse.
Carpal Tunnel Syndrome (CTS) can be common during pregnancy. It is a result of having more fluid in the body during pregnancy and this then results in a build-up of pressure on the nerves in the hand and wrist.
Symptoms can vary and can affect one or both hands. CTS cannot hurt the baby and symptoms usually resolve after giving birth.
Treatment: Follow conservative management options outlined above. It is important to inform your GP and or midwife if you develop CTS symptoms during your pregnancy at your next check-up. Injection therapy should not be considered during pregnancy.
A wrist sprain occurs when the wrist moves to a position where it is overstretched. If the ligaments around the wrist reach their limit and the movement continues, the ligament can then become damaged. The most common way your wrist is sprained is a fall onto your wrist when it is in a bent position, however some pulling and pushing movements may also sprain the wrist.
Common signs and symptoms
Pain, around the wrist joint
Tenderness when you touch the hand, wrist or lower arm
Swelling around the wrist joint
Bruising around the wrist joint
Pain restricting normal range of movement
Weakness or pain on use of the hand / wrist in activities such as carrying, pushing or pulling
A diagnosis is usually made from a consultation with your healthcare professional which will involve a detailed history of the onset of symptoms, current pattern of symptoms and current functional ability.
What can I do to help myself?
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.
Other treatment can include:
Reducing the strain on your hands if you have to complete very repetitive tasks/heavy lifting at work
Warm water soaks for your hands and fingers
Wearing gloves when going outside to reduce the impact of the cold
Once your pain is under control, working on the movement and strength of your fingers and hand is what will help long term.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your fingers to get you started.
Grip squeeze
Hold a ball in your hand. Squeeze the ball as hard as you can and hold. Allow your wrist to move in whichever direction feels natural.
AROM wrist flexion/extension
Start in a seated position with your forearm resting on a table and your thumb facing upright to the ceiling. Bend your wrist forwards, and then extend your wrist backwards, keeping your fingers relaxed throughout the whole movement.
AROM forearm pronation/supination
Sit up straight with your forearm resting on a table. Try to turn your palm to face upwards. Then try to turn your palm to face down. Continue this movement. It is important the movement only comes from your forearm, so ensure you do not allow your upper arm or body to twist.
Isometric wrist flexion
Start in a seated position with your forearm resting on a table and your palm facing up. Place your other hand on the palm of your affected hand. Attempt to lift your affected wrist up, whilst resisting the movement with your good hand. Ensure you keep your forearm in contact with the table. Hold this position.
Isometric wrist extension
Start in a seated position with your forearm resting on a table and your palm facing down. Place your other hand on the back of your affected hand. Attempt to lift your affected wrist up, whilst resisting the movement with your good hand. Ensure you keep your forearm in contact with the table. Hold this position.
When should I see a GP or Healthcare Professional?
Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have any tingling or loss of sensation in your hand or wrist
Notice changes to your grip strength and are frequently dropping things
Have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
Notice your fingers becomes acutely red hot and swollen without any prior explanation of activity/overuse
If you do not have any of the above, you may be able to effectively self manage your condition.
De Quervain's is a painful condition affecting the tendons on the side of the wrist at the base of the thumb. Pain, which is the main complaint, gets worse with gripping activities and movement of the wrist and thumb. Swelling can sometimes be present at the base of the thumb and wrist.
Common signs and symptoms
Pain is commonly located where your forearm joins the base of your thumb
0.5% of men and 1.3% of women report having De Quervain's
Its most common among individuals between the ages of 40-50 years
More commonly found in people with other tendon issues, such as tennis elbow/golfer’s elbow
New mothers or childcare providers often experience symptoms in both hands, but these symptoms usually subside once the child is lifted less often
A diagnosis is usually made from a consultation involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability. Further tests such as ultrasound scans or x-rays may be performed if the healthcare professional needs further information to finalise the diagnosis.
What can I do to help myself?
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments. But can also include:
Reducing any activity that makes the pain worse, most often gripping/grasping activities
Use of a thumb Spica/support during the night time and during aggravating activities. You can buy a thumb spica online or from pharmacies
Use of Anti-inflammatory gels/medications
Once your pain is under control, working on the movement and strength of your thumb is what will help long term.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your thumb to get you started.
Isometric thumb extension
Sit upright in a chair with your forearm and palm flat on the table and the tip of your thumb fully bent. Place a finger from your opposite hand on the back of your thumb between the knuckle and end joint of your thumb. Try to lift your thumb back from the table, using your opposite hand to resist the movement. Try to hold this position without moving, making sure that you keep the tip of your thumb bent.
Isometric wrist radial deviation
Start in a seated position with your forearm resting on a table and your palm facing down. Place your other hand by the thumb side of your affected hand. Attempt to turn your hand inwards, whilst resisting the movement with your good hand. Ensure you keep your forearm still and the palm of your hand in contact with the table. Hold this position.
Thumb circumduction
Sit upright in a chair. Place your forearm and hand on a table with your hand on its side. Keeping your fingers and the tip of your thumb straight, move your thumb in a circular motion. Create as big a circle as you can with your thumb and try to move it in both directions.
When should I see a GP or Healthcare Professional?
Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have any tingling or loss of sensation in your hand or wrist
Notice changes to your grip strength and are frequently dropping things
Have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
Notice your thumb becomes acutely red hot and swollen without any prior explanation of activity/overuse
If you do not have any of the above, you may be able to effectively self manage your condition.
Trigger finger/thumb is a condition in which a finger or thumb catches or sticks when in a bent position. This is due to inflammation or thickening of the tendon.
The finger/thumb may bend or straighten with a snap or in more severe cases, the finger/ thumb will remain in a locked bent position.
The exact reason why these problems occur is not known, but several factors may increase the likelihood of trigger finger developing. For example:
It's more common in women
It's more common in people over 40 years old
It's more common in people with certain medical conditions such as diabetes and rheumatoid arthritis
It is reported to affect around 2% of the population
People who use their hands regularly for work are more likely to get trigger finger/thumb
Common signs and symptoms
Finger/thumb stiffness, particularly in the morning
A popping or clicking sensation on finger/thumb movement
A bump (nodule) in the palm at the base of the affected finger/ thumb
Finger/thumb catching or locking in a flexed position, which suddenly pops straight
Finger/thumb locked in a flexed position, which is unable to straighten
Tenderness and/or pain at the base of the affected finger/thumb
A diagnosis is usually made from a consultation involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability. Further tests such as X-ray, MRI or ultrasound scan are rarely required but may be performed to finalise a diagnosis or if surgery is considered.
What can I do to help myself?
In some cases trigger finger can resolve without treatment, however recovery can be aided by:
Avoiding certain activities that are making the problem worse
Movement – gentle bending and straightening of the finger to maintained movement / function
Self-Massage – gentle massage applied to the tender region on the palm of the hand
Splinting – where the affected finger is strapped to a plastic splint to reduce movement (Oval8 splint). You can buy Oval8, and other finger splints online or from pharmacies.
Soft tissue release in palm
Sit upright on a stable chair or wheelchair with your back supported. Ensure both feet are placed flat. Place a pillow on your lap and rest your affected arm onto it, palm facing up. Ensure your wrist is as straight as possible. Support the back of your hand with the fingers of your other hand. Using the flat of your thumb, firmly massage across the palm, stretching the width of the palm.
When should I see a GP or Healthcare Professional?
You should see a Healthcare Professional if you:
Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have any tingling or loss of sensation in your hand or wrist
Notice changes to your grip strength and are frequently dropping things
Have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
Notice your fingers becomes acutely red hot and swollen without any prior explanation of activity/overuse
If you do not have any of the above, you may be able to effectively self manage your condition.
Dupuytren’s affects the tissue under the skin of your palm or fingers called the fascia. The fascia becomes thicker and less flexible. Over months or years, it can make your fingers bend towards your palm. This bending is called a contracture. Dupuytren’s can sometimes be uncomfortable or painful. There is no cure yet for Dupuytren’s disease. Treatment can help to straighten your fingers and may improve the use of your hand, but it does not get rid of the disease.
The cause of Dupuytren’s contracture is unknown. However, there are certain risk factors such as age, lifestyle factors and certain medical conditions (e.g. diabetes), that may increase your chance of developing the condition.
Common signs and symptoms
Not being able to straighten your finger(s)
Not being able to lay your hand flat on a table, palm down (called the tabletop test)
One or more small, tender lumps (nodules) at the base of the fingers on the palm. Over time, the tenderness usually goes away
The nodules may thicken and contract or tighten
Pits or grooves appear in the skin caused by the bent (contracted) finger. These areas can become very sore and can lead to skin loss if they don’t heal properly
You can't use your hand as you normally would
A diagnosis is usually made from a consultation involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
Further tests such as X-ray, MRI or ultrasound scan are rarely required, but may be to finalise the diagnosis or if surgery is being considered.
What can I do to help myself?
There are a few things you can try to help you manage your Dupuytrens Contracture:
Heat Therapy: Applying heat to the palms of the hand prior to massage or exercise can help to loosen the tissues
Massage: Gently massage the thickened tissues of the palm
Exercises: Gently straighten the fingers and feel the stretch in the palm of the hand
Soft tissue release in palm
Sit upright on a stable chair or wheelchair with your back supported. Ensure both feet are placed flat. Place a pillow on your lap and rest your affected arm onto it, palm facing up. Ensure your wrist is as straight as possible. Support the back of your hand with the fingers of your other hand. Using the flat of your thumb, firmly massage across the palm, stretching the width of the palm.
Finger extension stretch against a table
Place your hand on the table, palm down.
Gently straighten your fingers as flat as you can against the table.
Hold the stretch for a moment and then relax.
When should I see a GP or Healthcare Professional?
You should see a Health Care Professional if you:
Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have any tingling or loss of sensation in your hand or wrist
Notice changes to your grip strength and are frequently dropping things
Have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
Notice your fingers becomes acutely red hot and swollen without any prior explanation of activity/overuse
If you do not have any of the above, you may be able to effectively self manage your condition.
Useful links for more detailed information
We are all individuals, "one size does not fit all", the links below may offer more detailed information and advice, but may not be suitable for everyone.
