Why is my hand painful?

Hand and wrist pain is common; it may affect 1 in 5 people.

The hand is anatomically complex there are 27 bones, 20 tendons, many ligaments, muscles, nerves, and blood vessels; most of these are designed to move very precisely and smoothly as we go about our daily lives. Pain can arise from any of these different structures and causes. It can be caused by injuries and it can also develop more slowly as a result of chronic conditions.

Commonly an injury of some kind can reveal an underlying condition such as arthritis. Because of the range of conditions which can affect the hand, it is not uncommon to see patients who have more than one single diagnosis affecting one or both hands.

The hand and wrist are essential to almost every activity of daily life. Mr Harley specialises in a full range of hand and wrist conditions, offering expert assessment and personalised treatment plan to help you return to the activities you value.

Common Causes of Hand Pain

Carpal Tunnel Syndrome

Compression of the median nerve through the wrist commonly develops and this will usually cause combinations of tingling, pain or numbness — particularly to the thumb, index, and middle fingers. This is often worse at night or with certain activities.

Thumb Arthritis

Osteoarthritis at the base of the thumb (CMC joint) causing aching, stiffness, and difficulty gripping or pinching. One of the most common forms of hand arthritis.

Trigger Finger

Inflammation of the tendon sheath causes a finger to lock or catch when bent, then snap straight. Can be painful and tends to affect the ring finger or thumb most frequently.

Tendonitis

Inflammation of a tendon from repetitive use or overload. De Quervain’s tendonitis affects the thumb side of the wrist, causing pain with gripping, pinching, or wrist movement.

Ganglion Cysts

Fluid-filled lumps that develop from tendons or joints. Often these are on the back of the wrist or at tips of fingers. These can stretch adjacent ligaments and nerves to cause pain.

Tennis Elbow + Golfers Elbow

Pain arises from the side of the elbow and it is often felt in the forearm. It is an inflammation of the zone of attachment between forearm muscles and the bone at the elbow. You do not have to be a tennis player or a golfer to have this condition.

Arthritis of finger and wrist joints

Each of the fingers has 3 joints and any of these can become painful from arthritis; this is often associated with some swelling or lumpiness around the joint. Similarly there are 8 wrist bones and arthritis can develop between these.

Nerve conditions

Carpal tunnel syndrome is by far the most common nerve condition but there are several other nerves in the hand and arm which can become painful; in addition, all the nerves to the hand emerge from the spinal cord in the neck – if there is pressure on the nerves in the neck, this can be felt in the forearm or hand.

How Is Hand Pain Diagnosed

Consultation & Physical Examination

Mr Harley will take a detailed history — when the pain began, what aggravates or relieves it, your occupation, pastimes, and any previous injuries. He will then carefully examine your hand to look for sources of pain and to understand how it is affecting function.

Imaging — X-ray, MRI or Ultrasound

– X-rays are often the first-line imaging tool to look at bones and joints.
– Ultrasound can assess tendons, ligaments, and lumps or cysts.
– MRI provides more detailed views of the anatomy and may be helpful if simpler tests do not provide adequate information.

Nerve Conduction Studies

It is not routinely necessary to use NCTs to diagnose carpal tunnel syndrome  if the symptoms and findings point clearly to this diagnosis.  If the symtoms are less clear or if other types of nerve condition are suspected, NCTs may well be necessary arrive at a diagnosis.

Blood tests

Blood tests may occasionally be helpful if conditions like rheumatoid arthritis or gout are suspected.

Treatment of hand conditions.

Generally speaking there are a range of choices for the treatment of many hand conditions. Treatment is individualised to the severity and duration of conditions and also to the ongoing needs of patients in terms of daily activities, work and recreation.

Conservative Care

  • Rest and activity modification
  • Splints and supports
  • Anti-inflammatory medication — oral or topical
  • Ergonomic adjustments at work or home
  • Dietary optimisation

Hand Therapy

  • Targeted and individualised exercise regimens
  • Occupational therapy for adaptive strategies
  • Custom made splints and supports
  • Strategies to manage swelling and stiffness
  • Ultrasound therapy

Medical & Surgical

  • Corticosteroid injections
  • Carpal tunnel decompression
  • Trigger finger release
  • Trapeziectomy / Joint replacement (thumbs)
  • Joint replacement / Joint fusion (fingers)
  • Ganglion excision
  • Tennis elbow release
Oliver Harley

When to See Mr Harley

  • Pain that has persisted for more than a couple of weeks or keeps returning despite rest.
  • Persistent numbness, tingling, or burning sensations in the fingers.
  • Noticeable loss of grip strength or hand function affecting daily life.
  • Unexplained swelling, redness, or warmth in or around a joint.
  • Pain that consistently wakes you from sleep at night.
  • A lump, nodule, or deformity you would like assessed.

Do I need to consult with my GP first?

Whilst it may be preferable to consult your GP first, it is not essential and you can book in for a self-funded consultation directly.

If your care is to be funded via health insurance policy you will usually need to have a GP referral or contact your insurer prior to booking an appointment.

Mr Harley has NHS ‘choose and book’ clinics at Horder Centre and at North Downs Hospital – you will need to be referred by your GP to access these clinics.

Doctor inspecting patient for hand and wrist pain

Book Consultation

To book a consultation, either fill out the
form below or call 07908 073189