Finger Pain

Finger pain can be described as any pain from your knuckles to the tip of your fingers. For the purpose of this article we will be discussing the index, middle, ring and little fingers. To establish where exactly your finger pain is coming from it can be very helpful identifying what structure is causing your pain. Finger pain is our field of speciality, we are the experts.

Any pain or problem in your finger will have a ripple effect on the hand, 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. Finger pain can be caused by any of the muscles, joints, tendons or nerves in your finger, so let’s look at each of these structures:

Click here if you have pain in your thumb, the thumb will be discussed separately.

Muscle pain

There are only two groups of muscles that extend into the fingers from the hand.

One group bend the knuckles forward (lumbricals) and the other spreads the fingers apart as wells as bring them back together (interosseous).

Both groups of muscles attach onto the first bone in the fingers (closest to the palm). The lumbricals are on the palm side of the hand and the interosseous muscles are more towards back side of your hand.

Injury to these muscles can occur due to forcefully splitting the fingers apart or from trauma such as a cut to the side of the fingers.

Tendon pain

On the palm side of the finger there are two groups of rope-like tendons that run 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 the finger we have the Extensor Digitorum Communis that allows you to straighten your fingers. If these tendons are injured you will be unable to straighten your fingers.

The Flexor group on the palm side of the hand is more prone to injury. These tendons gets cut by either glass or a knife. Defending yourself against an incoming knife by shielding yourself with an open hand may lead to your flexor tendon group being severed. Another scenario may be washing dishes and the glass breaks in your hand, or even trying to catch a falling sharp object.

Trigger finger is a common phenomenon that involves the tendon running in the finger. This is when the finger gets stuck in a bent position.

A Mallet finger is when the tendon (EDC) that anchors onto the tip of the finger, rips out a piece of bone (avulsion fracture) that leaves the last joint of the finger to stay bent.

Nerve pain

There are three branches of nerves that supply the power and feeling to your fingers. The Median nerve supplies the palm side of the Thumb, Index and middle finger. The Ulnar nerve supplies the palm side of the Ring and Little fingers. The Radial nerve gives feeling to the back of your Thumb and fingers.

In most cases nerves are compressed, irritated or injured closer to the wrist, but the dominant pain, burning, shocks, cramps, tingling, pins & needles or any other nerve pain is felt at your fingertips.

There is a web of nerves that spreads out over your finger to give your skin feeling. These digital nerves are always involved when a tendon is severed, which cuts off the sensation to the skin after the laceration.

Joint pain

The first joint of your finger is where the finger and the hand meet, commonly known as your knuckles but medically known as the Metacarpal phalangeal joint (MCPJ for short). After that the finger can bend at two points the first is called the Proximal Interphalangeal Joint (PIPJ) and the second is the Distal Interphalangeal Joint (DIPJ).

One of the clear signs of osteoarthritis is enlarged or swollen DIPJ’s or PIPJ’s. A nodule that forms on the DIPJ or PIPJ is known as a Heberden’s node which is distinctively different from rheumatoid nodules.

When the MCPJ’s deviate from a straight position, drifting towards the outside this may be a sign of Rheumatoid arthritis.

Ligament Injuries

Volar Plate is a ligament that prevents your finger  from hyperextending. Trying to catch a ball but the ball overextends your fingers, may rupture these sensitive yet vital ligaments.

Ulnar Collateral ligaments are ligaments on the side of the pinky that prevents your fingers dislocating towards your Thumb’s side. Radial Collateral ligaments are on the Thumb’s side of your fingers that prevent the fingers deviating towards the pinky finger. These ligaments are at every joint MCP, PIP and DIP joints.

The finger joints are more vulnerable to dislocate. Any overload and force to any of the fingers may dislocate the finger in any direction. During a dislocation it is important to note that there will always be torn ligaments. These ligaments are responsible to keep the MCPJ, PIPJ and DIPJ stable, if these are injured, the risk of you dislocating your finger again is high.

Finger fracture

The bones in your fingers are called phalanges. Each finger has three phalanges. The bones in your fingers starting at the tips are called the Distal Phalanx, then the Middle Phalanx, and your Proximal phalanx that connect to your knuckles.

Finger fractures involve the crack or splinter of any of the three bones that makes up your finger. You may not always be sure if your finger is broken. If it’s broken and you try to bend it, it will be painful, but you’ll still be able to move it. Don’t be fooled if you can still move the finger, this does not mean the finger in not broken.

When an egg is in an upright position it is able to hold a much greater weight than when it’s turned onto its side. In the same way, when a force is applied to the finger bones at the wrong angle, it can be very fragile to break.

Finger Injuries

Thumb Dx

Hand Dx

Wrist Dx

Elbow Dx

What needs to be tested to determine the source of your finger pain
  • Grip Strength
  • ROM
  • Sensation
  • Stability
  • Joint alignment
  • Nerve tension test
  • Tendon gliding test
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