Causes of Nerve Pain in Hands and Treatment

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The nerves in your hands play many important roles. In addition to regulating muscle motion, they’re part of the network that relays pain, pressure, temperature, and tactile sensations back to the brain.

When these become injured—which can happen due to overuse, pressure, injury, or as the result of autoimmune disorders, diabetes, or other health conditions­—radiating pain, tingling, and numbness can occur. This significantly limits the motion and function of the hand, which can seriously disrupt daily life.

The anatomy of the hand is very complex. This part of the body is a conglomeration of bone, muscle, and ligaments, with three major nerves­—the radial, ulnar, and median nerves along with many branches—regulating both sensation and motion.

It’s because of this complexity that there’s a great deal of variation when it comes to nerve pain as well as several conditions that can lead to it. Specific treatment for nerve pain in the hands depends on the cause. However, everything from home management to surgery may be necessary to take it on. 

Woman with hand pain

Science Photo Library / Getty Images

Possible Causes

Generally speaking, nerve pain in the hands results from three types of conditions: injuries due to overuse, those due to muscular or skeletal issues, or damage as a result of other medical conditions.

Alongside injuries due to falls or car accidents, several conditions can be at fault. They can cause pain due to too much compression on the nerves, overstretching them, or damaging them.

Pinched Nerve

Impingement of the nerves in the hand can lead to pain, numbness, and tingling. A variety of conditions can cause a pinched nerve, including injury or arthritis, though it’s most often associated with carpal tunnel syndrome. It’s more common in those over 50, but it can affect people of any age.

Carpal Tunnel Syndrome

The most common compression-related nerve disorder, carpal tunnel syndrome is a progressive condition that affects about 5% of the population. Older people and women are more likely to develop this condition, caused by persistent inflammation of the nerves and leading to pain, tingling, and numbness in the hand.

This syndrome can arise due to overuse of the hand, during pregnancy, or result from chronic conditions such as diabetes.

Peripheral Neuropathy

Peripheral neuropathy refers to damaged nerves outside of the brain and spinal cord. In the hands, this condition can lead to muscle weakness, numbness, and loss of coordination, in addition to pain. Causes of peripheral neuropathy vary, including injury, autoimmune conditions like lupus and rheumatoid arthritis, and infection.

De Quervain’s Disease

Also known as de Quervain’s tenosynovitis or stenosing tenosynovitis, this is nerve damage due to the inflammation of tendons in the hand and thumb. Specifically, it occurs when the sheath of the tendon connecting the thumb and the wrist becomes inflamed, leading to pain, weakness, swelling, and a “grating” feeling in the wrist.

It can occur due to injury or repetitive hand motions that pressure the thumb, as in knitting, lifting heavy objects, or activities involving squeezing exertion.

Trigger Finger

Trigger finger and trigger thumb are forms of tendonitis that affect the index finger and thumb, respectively. This condition's primary symptom is catching or locking of the affected finger when it’s straightened or bent. It can occur due to endemic conditions, such as arthritis or diabetes, or overuse of the hand.

Dupuytren’s Disease

Sometimes referred to as Dupuytren's contracture, this is an abnormal thickening and hardening of tissue in the hand, which can lead to nerve pain and severely limit function. When the tendons in the hand and palm become affected (a condition called palmar fasciitis), this causes fingers to become bent and unable to be straightened.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is a compression of the ulnar nerve at the elbow, leading to tingling, numbness, and pain in the forearm and fingers, as well as the hand's inability to grip. Often mistaken for other conditions, it’s caused by bone spurs, arthritis, or previous fractures.

Ganglion Cysts

The development of these fluid-filled sacs on the hands and wrists can also cause nerve pain. The most common type of growth seen in this part of the body, ganglion cysts are noncancerous. They often go away on their own, though treatment may become necessary.

These emerge in the joints—often affecting the wrist, specifically—and can become problematic when they impact the nerves, affecting function and causing pain.

Osteoarthritis

The most common type of arthritis, osteoarthritis is the progressive breaking down of the cartilage surrounding joints due to aging and natural wear and tear. This causes inflammation, impacting the nerves of the hands and disrupting their function. This leads to stiffness and discomfort, which severely disrupts hand motion and function.

Rheumatoid Arthritis

An autoimmune disease that occurs when the body’s immune system erroneously attacks the joints, rheumatoid arthritis is another cause of nerve pain in the hands. It leads to pain, stiffness, and swelling, sometimes severely disfiguring fingers. When untreated, it can cause peripheral neuropathy and carpal tunnel syndrome.

Diabetes

Among the many effects of type 2 diabetes is nerve pain in the hands. Nerve damage occurs as a result of blood sugar levels being elevated for prolonged periods of time. The symptoms include pain, tingling, and numbness in the hands.

When to See a Healthcare Provider

It’s good to be proactive if you’re feeling nerve pain, tingling, or other symptoms in your hands. Seek medical help if you’re finding daily life and functioning affected by how you’re feeling, especially if you don’t know what’s causing the discomfort. In most cases, the sooner you’re managing or treating a condition, the better off you’ll be.

The signs that it is time to call your healthcare provider include:

  • Your symptoms disrupt daily living.
  • Pain is persistent, especially if it lasts for multiple days.
  • You’re unable to perform regular tasks with your hands.
  • Home management of symptoms is ineffective.
  • You have a loss of sensation and/or numbness.

Diagnosis

Given the wide range of conditions associated with nerve pain in the hand, diagnosis can be complex and multifaceted. It involves a thorough examination of medical history and physical examination. It may also require imaging approaches such as magnetic resonance imaging (MRI) or X-ray to assess results fully.

Labs and Tests

Evaluation for nerve hand pain always begins with physical and functional testing, alongside an assessment of overall health. The specific approach depends on the case, but it typically includes:

  • Assessment of symptoms: Your healthcare provider will get a sense of the scope and scale of your pain, tingling, numbness, or other symptoms.
  • Physical examination: The healthcare provider will palpate (squeeze) different parts of the hand and wrist to attempt to localize the source of the pain and look for signs of cyst formation or deformity due to arthritis.
  • Functional testing: Your ability to perform tasks with your hands, such as grasping, gripping, and supporting weight may also be tested.
  • Movement testing: In addition to functional performance, the ability of the hand and wrist to move will also be methodically assessed. Specialized approaches can isolate specific conditions, such as Finkelstein’s test, which helps healthcare providers diagnose de Quervain’s disease, and the Durkan test, which isolates cases of carpal tunnel syndrome.

In addition to physical examination, several other tests may be called for to assess nerve health:

  • Nerve conduction studies: If physical testing and other means aren’t enough for diagnosis, these tests assess how well and how rapidly electrical signals can travel through the nerves in your hand and arm.
  • Electromyography (EMG): This test assesses electrical nerve activity when your hand, wrist, and arm muscles are at work versus at rest.
  • Blood tests: Assessments of blood may be necessary if certain forms of arthritis, diabetes, or autoimmune diseases are suspected.

Imaging

While physical examination and testing are enough to diagnose some cases, other patients require imaging for confirmation or to aid in treatment. These methods include:

  • Ultrasound: This form of imaging relies on sound waves to provide a sense of the interior structures of the hand and fingers. Some healthcare providers' offices or hospitals offer this specialized service.
  • X-ray: A longstanding approach, beams of electromagnetic radiation are used to provide a picture of structures within the hand. It’s helpful to assess nerve damage due to compression from bones or fractures.
  • Magnetic resonance imaging (MRI): This type of imaging relies on magnetic waves to create real-time video and imagery of affected areas. MRI allows healthcare providers to see if tissue inflammation is impacting nerve function.

Differential Diagnosis

In addition to conditions causing direct damage to nerves in the hands, a couple of others may also cause these symptoms, including:

  • Heart attack
  • Lupus
  • Pregnancy
  • Gout
  • Chemotherapy
  • Shingles
  • Infection

Additional testing may be necessary if these are suspected, and, of course, a heart attack is a medical emergency.

Treatment

Treatment approaches for nerve pain in the hand vary a great deal based on the specific case and the underlying condition. In many cases, the first-line approach involves management at home. However, medications, complementary treatments, or even surgery may be needed to correct the problem.

Depending on the specific case, management of the condition may involve a combination of approaches.

Lifestyle Treatment Options

There are many approaches you can try at home to help with nerve pain. These include:

  • Splinting: Wearing a special splint for your thumb or affected finger can help in certain cases. Your healthcare provider may advise you wear one for a couple of weeks to see if symptoms improve.
  • Resting: Many nerve pain conditions resolve on their own. Allowing the affected area to rest for a sufficient time can help.
  • Heat and cold: Alternating heating and icing of the affected area promotes blood flow and can help manage inflammation and other symptoms. Heat tends to help with problems involving hand stiffness, while cooling helps with motion-related discomfort.
  • Exercises and stretches: If you work with a physical or occupational therapist, they may recommend certain exercises and stretches to help with hand or wrist pain.

Medications

As with many conditions involving pain, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin, can be helpful as both over-the-counter and prescribed alternatives. Prescribed pharmaceuticals may include:

  • Opioid painkillers, such as oxycontin, Percocet, and others, may be indicated, though these aren’t intended for chronic pain.
  • Lidocaine patches, a topical approach, may also help with peripheral neuropathy.
  • Anticonvulsant drugs like carbamazepine, Trileptal (oxcarbazepine), and Lamictal (lamotrigine), originally meant to take on seizures, have shown efficacy for nerve pain.
  • Tricyclic antidepressants like Elavil (amitriptyline), Sinequan (doxepin), and Pamelor (nortriptyline) are effective when prescribed at lower doses.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine) and Effexor (venlafaxine), may be effective; they may have fewer side effects than tricyclics.
  • Selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine) may be attempted, though evidence for efficacy isn’t as robust as other antidepressants.
  • Corticosteroid drugs, particularly prednisone, may be prescribed to reduce inflammation and pain.

Procedures and Therapy

If medication and at-home management don’t succeed in resolving nerve pain in the hand, there are other options that can be attempted prior to surgery:

  • Transcutaneous electrical nerve stimulation (TENS): This noninvasive medical approach involves transmitting electrical signals through the skin to affected areas. Though evidence for this approach is still somewhat lacking when applied to peripheral nerve problems, stimulating affected nerves in this way may help resolve pain problems.
  • Corticosteroid injection: Injections of corticosteroids in problematic areas can also help attenuate nerve pain in the hand. These provide longer-lasting relief—and completely resolve some cases—though typically the effect does wear off, calling for additional treatment.
  • Physical therapy: For chronic nerve pain in the hand, working with a physical therapist may be helpful as you learn exercises and stretches that can help ease discomfort.
  • Aspiration: In some cases of ganglion cyst, healthcare providers may call for draining the structure. This procedure, called aspiration, is performed using a specialized syringe while the surrounding area is numbed. Though this eases pressure on the nerves, if the root of the cyst remains, it can grow back.

Complementary and Alternative Treatments

Some studies have shown acupuncture to help with pain in the hand. A traditional Eastern medicine method, healthcare providers stimulate nerves by applying needles to specific areas in the hand, wrist, arms, and other parts of the body. Though research is ongoing, this approach is considered a complementary, alternative approach that may help.

Surgery

While they’re typically reserved for more challenging and advanced cases, several surgical approaches can also take on nerve pain in the hand as well as any underlying conditions. These primarily outpatient procedures, meaning you typically won’t need to spend the night in the hospital, include:

  • Carpal tunnel release surgery: Surgery aims to ease pressure on the affected nerve in your hand. Whether performed as an open procedure or using minimally invasive approaches, this is done by cutting the ligament around the carpal tunnel, the narrow passageway in your hand that allows the median nerve to pass through.
  • Decompression surgeries: Pinched nerves or nerve pain caused by other kinds of nerve compression, as with cubital tunnel syndrome, can be taken on by loosening up and altering structures surrounding the affected area. Older approaches involve severing problematic nerves, though this type of approach is falling out of favor.
  • Surgery for ganglion cysts: Taking on nerve pain caused by ganglion cysts may require surgery aimed at removing these, called “excision.” Via an outpatient procedure, the cyst and some of the surrounding ligament and structure are removed.
  • Reconstructive surgery: A surgery to take on nerve damage related to osteoarthritis and rheumatoid arthritis, this approach involves replacing arthritic bone with a reshaped tendon. It can be especially helpful in restoring thumb function and resolving problems with it. It’s highly successful in relieving pain, too.
  • Joint fusion: Another approach to arthritis-related pain involves stabilizing affected joints by fusing them with healthy ones. It can be helpful for cases like trigger finger or arthritis in the fingers, in particular. Though joint fusion successfully resolves pain and inflammation, it does leave the affected joint immobile.
  • Joint replacement: In some cases of hand nerve pain related to arthritis or degeneration of a joint, it can be replaced with a prosthetic. This helps relieve discomfort and restore hand function. However, the artificial replacement may eventually break down.

Prevention

As with many conditions involving damage to joints, there are some approaches you can take to help prevent nerve pain. These lifestyle modifications can go a long way and include:

  • Check ergonomics: Especially if you work on a computer, adjusting the position of your keyboard and the relative position of your wrists can ease strain on the hands. Wrist rests can help ensure that your forearms and hands are in a supported, neutral position that reduces tension there. It’s also a good idea to take regular stretching breaks from typing.
  • Maintain a healthy weight: Living with excess pounds is linked with nerve pain and can increase the risk of other conditions that lead to it, such as type 2 diabetes. As such, ensuring you’re eating a healthy diet, getting regular exercise, and taking other measures to manage your excess weight can help prevent nerve pain.
  • Skip alcohol: Quitting consumption of alcoholic drinks is another way to prevent damage to nerves and can also be a means of losing weight. It’s worth considering the benefits of forgoing the habit.
  • Warm up: Before beginning sports or repetitive motions, it’s helpful to perform stretches in the hands and wrists. By increasing blood flow to these parts of the body, this helps optimize function and can help reduce discomfort.

A Word From Verywell

Nerve pain in the hand can be daunting. It’s important to remember that it can be managed effectively. While it may take sustained effort and multiple methods, the tingling, numbness, loss of function, and pain associated with damage to nerves here can be treated.

In most cases, more extensive medical procedures like surgeries won’t be necessary. If you’re experiencing issues, be proactive about the management of the condition. Don’t delay seeking medical help. The sooner you spring into action, the better off your hands will be.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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