Hand pain can be described as any pain extending from your wrist to the base of your fingers, and for this purpose be divided between the palm and the back of your hand. To establish where exactly your hand pain is coming from it can be very helpful identifying what structure is causing your pain. Hand pain is our field of specialty, we are the experts. Your hand is complex due to its small size, and close proximity of these small structures.
Any pain or problem in your hand will have a ripple effect on the fingers, wrist and elbow. So if you are uncertain what the cause may be, rather let us have a look at it before you cause even more problems. Hand pain can be caused by any of the muscles, joints, tendons or nerves in your hand, so let’s look at each of these anatomical structures, and how hand pain and other problems may arise:
There are only a few small muscles in the hand that bridge the spaces between the bones called the Metacarpal bones. These muscles are the Intrinsic muscles which are mainly responsible to bring the metacarpal bones together like making a tight fist as well as opening the ‘web spaces’ between these bones.
Lumbricals are mainly on the palm side of the hand and the Interosseous muscles on the back of your hand. These muscles are the first to get strained with repetitive punching, or they can be cut through when a pole or knife is driven through the web spaces between the metacarpals.
On the palm side of the hand there are two groups of rope-like tendons that run across the hand from the forearm to your fingertips. The Flexor Digitorum Superficialis, and Flexor Digitorum Profundus, that gives you the ability to close your fingers into a fist. On the back of your hand we have the Extensor Digitorum Communis that allows you to open your hand.
These tendons gets cut by either glass or a knife. The Flexor group on the palm side of the hand is more prone to injury. An example is washing dishes and the glass breaks in your hand. Defending yourself against an knife attack, or even trying to catch a falling sharp object.
There are three branches of nerves that supply the power and feeling to your hand. The Median nerve supplies the Thumb, Index and middle finger. The Ulnar nerve supplies Ring and Little finger. The Radial nerve gives feeling to the back of your hand and Thumb.
Nerve pain in the hand is caused by damage or disease that affects the power cables of the hand. These power cables control all your hand’s movement and communication such as feeling to the skin and muscles, this includes touch, temperature and a variety of other feelings.
Hand pain due to nerve injury may cause you to feel: Pins & needles, numbness, burning tingling, weakness, electrical shock traveling from the palm of the hand to the finger. There are numerous ways in which the nerves may be injured, compressed or irritated. Click the link for a more in depth discussion.
Carpal tunnel syndrome is a frequent problem patients consult us about. This is when the Median nerve is compressed at the base of the hand and wrist.
One of the most common signs of damage to these nerve is a deformity called “ the Claw”, where the fingers and hands stays in a contracted position and unable to willingly move your hand or fingers.
There are two sets of joints in the hand, the one group connects to your wrist and the others form your knuckles of your fist. The Metacarpal bones connect to the Carpal bones (wrist side) forming the Carpometacarpal Joints(MPJ) at the base of your hand. On the other side, your fingers connect to the first phalanx called the Proximal Phalanx to form the Metacarpal Phalangeal Joints (MPJ).
Arthritis is the most common cause of hand pain in these joints. The Metacarpophalangeal joints are more vulnerable to dislocate due to the relative instability of the fingers connecting to the hand at this point.
There are 4 tightly arranged long bones in the hand called the Metacarpal bones, that fits parallel next to each other. These Metacarpal bones may fracture at high force or impact like when boxing, hitting a wall, or falling with your hand on a rock.
‘Boxer’s fracture” Hence the name, is a fracture of the 5th Metacarpal bone (Below the Little finger) The forces during a punch concentrate on the outside of the fist, and absorbs most of the impact, therefore its the first to crack, break and fracture.
Repetitive stress on the Metacarpal bones may cause the outer edge of the bone to crack that leads to a stress fracture in your hand.
- Finger Dx
- Thumb Dx
- Wrist Dx
- Elbow Dx
What needs to be tested to determine the source of your hand pain
- Grip Strength
- Joint alignment
- Nerve tension test
- Tendon gliding test