27 Causes of Finger Pain and How They Are Treated

Finger pain can be caused by many things, from arthritis and injuries to infections and autoimmune diseases. Sometimes it can be difficult to diagnose the cause without extensive testing, including blood tests, imaging studies, nerve conduction studies, and the extraction of fluid from a joint space (arthrocentesis).

A physical exam can often provide clues as to the underlying cause. Joint or finger swelling, redness or heat, or changes in skin color texture are just some of the signs healthcare providers will look for. When trying to pinpoint the cause of your finger pain, they will also want to know if the finger pain is acute (sudden and severe), chronic (persistent), or comes and goes in episodic flares.

Here are 27 possible causes of finger pain and the various ways they can be treated:

Arthritis

Osteoarthritis (OA) is one of the most common causes of finger pain, particularly in older adults. Also known as "wear-and-tear arthritis," OA is an aging-related condition in which joint cartilage gradually deteriorates, leading to joint pain, stiffness, and deformity. OA can affect any joint but is common in the smaller joints of the fingers and thumb.1

OA of the fingers is treated with finger exercises, ice packs, heat therapy, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), cortisone injections, and, in severe cases, joint replacement (arthroplasty).1

Autoimmune Diseases

Autoimmune diseases are those in which the body's immune system targets and attacks healthy tissues with inflammation. There are several that can directly or collaterally affect the joints of the fingers, including:2

• Rheumatoid arthritis
• Psoriatic arthritis
• Lupus
• Sarcoidosis
• Scleroderma

With the exception of scleroderma, one of the common features of all these diseases is dactylitis. This is when your fingers swell, giving them a round, puffed-up shape like sausages.2

The treatment of these autoimmune disorders can differ but may include many of the same supportive therapies as OA when the hands are involved. Immunosuppressant drugs are also commonly used to temper the inappropriate immune response.3

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a chronic condition caused by the compression of the median nerve at the wrist, causing pain, burning, numbness, and tingling in the hands and fingers. CTS is often the result of repetitive hand and wrist movements, such as from occupations that involve typing and manual labor.4

CTS may be treated with rest, ice, wrist splints, cortisone injections, and carpal tunnel surgery.4

Cysts

A cyst is a small pocket of tissue filled with fluid or pus that can develop as a result of an injury, infection, or other issues. There are two types that can affect the hands and fingers, causing pain either directly or indirectly:

• Synovial cysts develop in the fluid-filled space between joints, causing the compression of nerves, joint stiffness, and pain.5
• Ganglion cysts develop in the wrist or hand and cause radiating pain to the fingers.6

Some cysts may resolve on their own or be manageable with NSAIDS or cortisone injections. Others may require cyst aspiration (the removal of fluid with a needle) or surgical removal of the cyst.56

De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is the chronic inflammation of the tendons of the thumb. This can develop due to repetitive strain from activities like wringing out a washcloth, gripping a golf club, lifting a child, or hammering a nail. Symptoms include pain, tenderness, and swelling at the base of the thumb.7

De Quervain’s tenosynovitis is typically treated with rest, ice or heat therapy, hand exercises, NSAIDs, or a surgical procedure called a tenotomy (tendon release) in which the tightened sheath around the tendon is severed.7

Dupuytren's Contracture

Dupuytren's contracture is a condition of unknown origin in which one or more fingers become permanently bent in a flexed position. It is caused by the abnormal thickening of the skin which causes one or more fingers to contract (curl) toward the palm. As a result of the thickening, a nodule will develop which may or may not be painful.8

While cortisone injections and collagenase injections may provide relief in the early stages, surgery in the form of fasciotomy (in which thickened tissues are split) or fasciectomy (in which thickened tissues are removed) may be performed to improve hand function.8

Gout

Gout is an inflammatory arthritis that people mainly associate with the big toe but can also affect the wrist and finger joints, causing extreme pain, swelling, stiffness, and heat. Gout occurs when high uric acid levels in the blood cause the formation of crystals in joints. Gout attacks are episodic and can often occur after eating foods like shellfish that are high in purine.9

Gout can be managed by eating a low-purine diet. Attacks can be eased with NSAIDs, cortisone injections, or an anti-inflammatory drug called Colcrys (colchicine). Colcrys can also be prescribed to prevent gout in people with a history of frequent recurrence.9

Infections

Many different bacterial and viral infections can cause finger pain along with swelling, redness, heat, and stiffness. Some of the more common include:

• Felon infection: A painful infection that occurs when bacteria like Staphylococcus aureus (S. aureus) enter a penetrating wound on the pad of your finger10
• Paronychia: Caused when bacteria like S. aureus enter a break in the nail cuticle, resulting in pain and swelling under the nail and around the tip of the finger11
• Flexor sheath infection: A bacterial infection affecting the membrane covering the tendon of the fingers, most common due to a deeper cut or animal bite12
• Cellulitis: A potentially serious complication of a local bacterial infection like paronychia that spreads via the bloodstream into deeper tissue13
• Herpetic whitlow: A viral infection involving the herpes simplex virus that causes an outbreak of a blistering rash on the finger11

Minor infections may heal on their own, but severe bacterial infections may benefit from a short course of antibiotics while viral ones like herpetic whitlow can be treated with antiviral drugs like acyclovir.1011

Injuries

The fingers and hands are vulnerable to injury during work, sports, or a serious fall or impact. They can also occur due to repetitive motions that place cumulative stress on joints or connective tissues.

Some of the more common injuries include:

• Bone fractures: Caused by crush injury or excessive twisting or bending of a finger14
• Dislocation: In which a finger joint becomes displaced14
• Sprains: A partial tear of ligaments that attach bone to bone15
• Strains: A partial tear of tendons that attach bone to muscle15
• Bursitis: Inflammation of the cushioning sac between joints, called bursae, often due to an acute injury or infection16
• Tendinitis: Inflammation of tendons, often due to a repetitive stress injury (such as "trigger finger") as well as inflammatory diseases15
• Acute compartment syndrome: A potentially severe condition in which increased pressure builds within joints and other tissues following a crush injury or severe fracture17

Minor injuries may heal with rest, ice application, splinting, NSAIDs, and physical therapy. Severe cases may require surgery.

Peripheral Neuropathy

Peripheral neuropathy happens when the nerves that are located outside of the brain and spinal cord (called the peripheral nerves) are damaged. The damage may be due to the pinching of a nerve as it exits the spine or by disease or medications that damage the protective membrane surrounding nerve cells called the myelin sheath.18

The hands are commonly affected by peripheral neuropathy, causing sensory distortions called paresthesia in which there may be numbness, burning, tingling, pain, aching, tingling, or pins and needles sensations in the fingers.1

The causes of peripheral neuropathy are extensive ranging from alcohol abuse, autoimmune diseases, and HIV to chemotherapy, spinal injury, and diabetes.18

The treatment of peripheral neuropathy varies by the cause but may include medications like NSAIDs, antidepressants, and Neurontin (gabapentin).18

Raynaud's Syndrome

Raynaud’s syndrome is a condition in which the fingers, and sometimes the toes, become pale, painful, tingly, or swollen in response to cold temperatures and stress. The symptoms of Raynaud’s syndrome result from constriction of small blood vessels in the hands and feet.19

Raynaud's syndrome can occur on its own for no known reason (referred to as primary Raynaud's syndrome) or as a symptom of another disease (referred to as secondary Raynaud's syndrome).19

Secondary causes include carpal tunnel syndrome, connective tissue diseases, vascular diseases, and medications like beta-blockers, chemotherapy, some migraine drugs, and attention-deficit/hyperactivity disorder medicines.

When to See a Healthcare Provider

Contact your healthcare provider if your finger pain persists longer than a week, especially if you did not injure your hands or fingers. Many causes of finger pain and swelling are related to underlying conditions.

Some signs and symptoms suggest you should schedule a visit to see a healthcare provider, such as:

• Pain significantly impacts your ability to perform fine motor movements
• You cannot move your fingers without feeling pain
• Red, hot, or swollen fingers
• Loss of sensation in your finger
• Symptoms, such as fever, fatigue, or unexplained weight loss, accompany the pain
  

Summary

Many conditions can cause finger pain, including osteoarthritis, autoimmune diseases, infections, acute injuries, gout, cysts, carpal tunnel syndrome, Dupuytren's contracture, De Quervain’s tenosynovitis, peripheral neuropathy, and Raynaud's syndrome.

Many can be managed with rest, ice/heat application, OTC painkillers, cortisone injections, and splinting. Others may require surgery to repair injuries or correct structural deformities of the bones, joints, or connective tissues of the fingers.