Causes of Hand, Finger and Wrist Pain

Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis is the most common chronic condition of the joints, affecting approximately 27 million Americans. The most common symptoms¹ are pain and stiffness, particularly first thing in the morning or after resting. Affected joints may get swollen, especially after extended activity. These symptoms tend to build over time rather than show up suddenly.

Some other common symptoms include:

• Sore or stiff joints after inactivity or overuse.
• Limited range of motion or stiffness that goes away after movement.
• Clicking or cracking sound when a joint bends.
• Mild swelling around a joint, pain that is worse after activity or toward the end of the day.

Rheumatoid arthritis is an autoimmune disease that attacks and destroys the protective cartilage that covers the surface of the joints, eventually leading to inflammation of the surrounding tissues.

In rheumatoid arthritis, the fingers also become deformed as the disease progresses. The joint at the base of the finger begins to point sideways toward the thumb, pointing the fingers towards the little fingers. This is commonly referred to as "ulnar drift". Ulnar drift can cause weakness as well as pain and make daily activities difficult.

The carpal tunnel² - a narrow, rigid passageway of ligament and bones at the base of the hand - houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized.

Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Symptoms often first appear during the night, since many people sleep with flexed wrists.

Some other common symptoms include:

• Fingers may feel useless and swollen, even though little or no swelling is apparent.
• Feeling the need to "shake out" the hand or wrist.
• Tingling during the day.
• Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks.
• In chronic and/or untreated cases, the muscles at the base of the thumb may waste away, which may cause the inability to tell between hot and cold by touch.

De Quervain's tendinosis³ occurs when the tendons around the base of the thumb are irritated or constricted. The word "tendinosis" refers to a swelling of the tendons. Swelling of the tendons, and the tendon sheath, can cause pain and tenderness along the thumb side of the wrist. This is particularly noticeable when forming a fist, grasping or gripping something, or when turning the wrist.

The main symptom is pain felt over the thumb side of the wrist. The pain may appear either gradually or suddenly and is felt in the wrist and can travel up the forearm.

Some other symptoms include:

• Pain is usually worse when the hand and thumb are in use and is especially true when forcefully grasping objects or twisting the wrist, swelling may be seen over the thumb side of the wrist.
• Swelling may accompany a fluid-filled cyst in this region.
• A "catching" or "snapping" sensation may be felt when moving the thumb, pain and swelling may make it difficult to move the thumb and wrist.