Hand Injuries From High-Pressure Injection Tools

High-pressure tools, such as paint guns, are used in a wide number of industries and for home improvement projects. Some of these high-pressure tools have tips that spray paint, oil, or chemicals from a gun-like nozzle. While efficient and effective, these tools can cause serious injuries, and, at first, the injuries might not seem as severe as they really are.

A man spraying on paint with a paint gun
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High-Pressure Injection Injuries

Injuries can happen when using tools for construction work or DIY home improvement projects. They can also occur during cleaning or clearing a clogged tip from a spray gun. Almost all injuries affect the hand, typically at the tip of a finger.

Sometimes, an injury doesn’t look severe and can appear as just a tiny puncture wound. But hidden problems, like infections and chemical injuries, often develop.

These small injuries are often deceiving. Initially, the injury looks like a simple poke hole to the tip of a finger—but without proper treatment, they can worsen, even to the point that a finger amputation may be necessary.

Chemical Injuries

The pressure of these injection injuries can be up to 10,000 psi, and the fluid traveling out of the tip of the gun is often moving at 400 mph. This causes the fluid, which usually contains noxious chemicals, to be forcefully expelled into the hand and finger.

An injury to the tip of the finger can force paint, grease, or other chemicals all the way down into the palm of the hand.

Many different chemicals can be found in high-pressure injection guns, with the most common being paint, grease, hydraulic fluid, and paint thinner. The nature of the substance injected often determines the extent of the chemical injury. For example, oil paint injection injuries to the finger require amputation in over half of all reported cases, whereas latex-based paint injection injuries to the finger result in amputation less than 10% of the time.


High-pressure injection injuries are notoriously difficult to recognize, and they may be under-diagnosed. After the initial injury, you can see a small puncture, but you may have little or no pain. Like many people with these injuries, you can still have good mobility of your hand and fingers.

As time passes, and inflammation and chemical irritation increases, your symptoms can worsen. That’s why urgent treatment is recommended after a power tool injury. However, the average time that passes between the injury and diagnosis is nine hours—and sometimes it takes much longer.

Once a high-pressure injection injury has been diagnosed, the next step is often surgery, which can clean the chemical out of your hand or finger.

In some rare circumstances, such as high-pressure water or air gun injuries, surgery may be avoided (unless the finger has sustained damage that threatens the blood supply to the tissues).

When your operation is done, you may be surprised at how far away the chemicals can travel from the puncture site when they are injected under high pressure. The entire area of contamination is opened surgically and washed out. Often, the incisions are left open to allow for optimal healing of the wound.

Medications may be used to help limit potential complications. Steroids, a powerful anti-inflammatory medication, may be administered to help reduce swelling. Antibiotics are often administered to help prevent infection.

Prognosis After Injury

There are many factors that influence the outcome of an injury, including which type of material has been injected into the body. Prompt treatment and thorough surgical debridement are important. After healing, complications like stiffness and persistent pain are common. And despite prompt treatment, sometimes there is still a chance of amputation.

2 Sources
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  1. Rosenwasser MP, Wei DH. High-pressure injection injuries to the hand. J Am Acad Orthop Surg. 2014;22(1):38-45. doi:10.5435/JAAOS-22-01-38

  2. Yıldıran G, Sütçü M, Akdağ O, Tosun Z. High-pressure injection injuries to the upper extremity and the review of the literature. Ulus Travma Acil Cerrahi Derg. 2020;26(6):899-904. doi:10.14744/tjtes.2020.26751

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.