Causes of Hand and Foot Pain

Pain in the hands and feet can result from problems with the joints, tendons, ligaments, or nerves. The symptoms can range from deep aches and sharp pains, to joint stiffness or burning sensations.

There are a number of possible causes for these types of pain in the absence of trauma or sudden injury. Conditions including neuropathy, arthritis, fibromyalgia, and lupus are among them.

This article explains what each of these conditions mean and why they can lead to pain in your extremities (feet and hands). It lists many specific causes and the treatments that may offer relief.

Peripheral Neuropathy

Peripheral neuropathy is caused by damage to the peripheral nervous system. It is made up of the many nerves in the body, including those in the arms and legs. They send signals to and from the brain and spinal cord.

Peripheral nerves transmit sensory information, such as the feelings of pressure, pain, and temperature. They also send motor function messages to control the muscles. The hands and feet are most often affected by peripheral neuropathy.

The symptoms can vary based on the extent of damage to the nerves in the hands and feet. The most common symptom is nerve pain. Other symptoms include:

• Numbness
• Tingling
• Burning
• Muscle weakness
• Decreased sensation (ability to feel)
• High sensitivity to touch (allodynia)

There are many specific causes of peripheral neuropathy that may result in nerve damage and pain in the hands and feet. They include:

Nerve injury: There are many possible causes of nerve injury. They include falls and bone fractures, sports-related injuries, and auto accidents. Surgeries and other medical procedures can cause nerve injury too.

Diabetes: About 60% to 70% of people with diabetes will have diabetic peripheral neuropathy. They have symptoms of numbness, tingling, burning, and pain, most often in the feet.

Chemotherapy: Chemotherapy is used to treat various forms of cancer. It leads to symptoms in the hands and feet of 30% to 40% of patients. The numbness, tingling, and pain can last for several months after chemotherapy stops.

Carpal tunnel syndrome: Carpal tunnel syndrome is due to compression of the median nerve in the wrist, caused by finger flexor tendons that are tight and inflamed. Symptoms are most often found in the thumb and first three fingers of one or both hands.

Cubital tunnel syndrome: Cubital tunnel syndrome occurs when the ulnar nerve in your arm is compressed at the elbow. This causes pain, numbness, and tingling along the pinky finger, ring finger, and side of the hand. It is known as ulnar neuropathy.

Ulnar tunnel syndrome: This condition also can lead to ulnar neuropathy. The ulnar nerve is compressed at the wrist in an area known as Guyon’s canal, where the ulnar nerve passes through. You'll feel the same pattern of symptoms along the pinky finger, ring finger, and side of the hand. Repetitive motion is often the cause.

Guillain-Barre syndrome: Guillain-Barre syndrome is an autoimmune disorder. The body attacks its own nerves in an ascending pattern. This means it starts in the lower extremities and moves up to the rest of the body. For this reason, symptoms often begin in the feet.

Vascular damage: Damage to blood vessels has several causes. They include diabetes, smoking, high blood pressure, and atherosclerosis caused by plaque buildup in the arteries. Peripheral vascular disease (PVD) limits the oxygen carried to nerves in the hands and feet, which causes damage.

Infections: Many viral infections can attack nerve cells and cause neuropathy pain in the hands and feet. These infections include:

• Varicella-zoster (chicken pox and shingles)
• Herpes simplex (cold sores)
• Human immunodeficiency virus (HIV)
• Lyme disease
• West Nile virus
• Cytomegalovirus (primarily a risk to pregnant people)

Renal and liver failure: Chronic renal (kidney) failure also may lead to peripheral neuropathy. This type is known as uremic neuropathy and can occur no matter the cause of the kidney failure.

Research suggests that hyperkalemia (high potassium levels) may play a role in the development of this neuropathy. Peripheral neuropathy is also common in severe liver disease.

Vitamin deficiencies or toxins: Some toxins and nutritional deficiencies can damage the peripheral nervous system. Low levels of copper and vitamins B12, E, B6, and B1 have been linked to peripheral neuropathy.

How Peripheral Neuropathy Is Treated

Treatment for peripheral neuropathy depends on the underlying cause. In many cases, it is focused on relief for your symptoms. Options for managing peripheral neuropathy include:

• Over-the-counter pain medication
• Pain relief creams or lidocaine patches applied to the skin
• Prescription drugs to reduce pain, relieve inflammation, and decrease nerve signals
• Physical therapy to improve strength and range of motion
• Blood sugar control through diet, exercise, weight management, and medication
• A healthy diet to correct vitamin deficiencies
• Wearing protective footwear
• Hand splints used for carpal tunnel syndrome
• Surgery to relieve entrapped nerves
• Transcutaneous electrical nerve stimulation (TENS) for pain relief

Arthritis

Arthritis refers to a group of diseases that cause joint pain and swelling. There are more than 100 types of arthritis but the most common ones are osteoarthritis and rheumatoid arthritis (RA). The hands and fingers, including the thumb, are areas commonly affected by arthritis.

Osteoarthritis: This is a disorder that affects the cartilage of joints and wears them down over time. This cartilage is connective tissue, found on the end of each bone, that cushions and absorbs shock to the joints.

In osteoarthritis, the cartilage breaks down will cause pain and limited motion in the joints. In severe cases, the bone will eventually rub directly against bone. This causes increased pain, inflammation, and joint damage.

Rheumatoid arthritis: RA is an autoimmune disorder. It causes body-wide inflammation along with joint pain and swelling. The wrists, hands, and fingers are commonly affected. Unlike osteoarthritis, RA is usually symmetrical and affects the same joints on both sides of the body.

In RA, the synovium, or joint lining, is attacked by the immune system. It causes it to become thick and eventually destroys the cartilage and bone within the joint. If left untreated, RA can cause permanent and irreversible joint damage. It's found more often in women, with symptoms that include prolonged stiffness in the morning.

How Arthritis Is Treated

Osteoarthritis and rheumatoid arthritis can be managed with a variety of different treatment options. They include:

• Over-the-counter pain medication
• Pain relief creams applied to the skin
• Warm paraffin wax used on hands and fingers to relieve pain and stiffness
• Prescription drugs to reduce pain and inflammation, including disease-modifying antirheumatic drugs (DMARDs) for RA
• Cortisone injections into the finger and wrist joints to reduce inflammation
• Physical or occupational therapy to boost hand strength and range of motion
• Hand braces or splints to protect the joints
• Trapeziectomy, a wrist surgery for severe osteoarthritis of the thumb

Lupus

Lupus is a chronic autoimmune disease that causes pain and inflammation throughout the body. It most often affects skin, joints, and internal organs that include the heart and kidneys. The most common form of lupus is called systemic lupus erythematosus (SLE).

SLE can lead to a number of symptoms. The most common include:

• Extreme fatigue
• Headaches
• Low-grade fevers
• Joint pain and swelling
• A butterfly-shaped rash on the cheeks and nose

Lupus is like RA, in that it has symmetric effects on joints on both sides of the body. This is especially true of the wrists and hands. Symptoms are usually less severe than those of RA but include similar joint swelling, morning stiffness, and pain in the fingers, hands, and wrists.

About 5% to 10% of patients with lupus and arthritis-like symptoms go on to develop significant deformities in the finger joints. The most common of these features are:

• Swan neck deformity, with the middle joint of the finger bent back more than normal
• Ulnar drift, with the fingers angled toward the pinky finger instead of pointing straight.

Raynaud’s disease has also been associated with lupus. It causes fingers and toes to become numb, pale, and painful from decreased blood circulation, often made worse in cold weather.

How Lupus Is Treated

Unlike RA, the changes to the finger joints are caused by the tendons and ligaments relaxing rather than bone damage. This is often more easy to correct with finger braces or splints. Lupus is commonly managed with anti-inflammatory and immunosuppressive drugs.

Fibromyalgia 

Fibromyalgia is a chronic disease that causes pain in the hands, feet, and throughout the body. Other symptoms include:

• Fatigue
• Headaches
• Sleep disruption

The pain of fibromyalgia is usually felt in the muscles and soft tissues. It can cause tingling and numbness in the hands and feet, sometimes along with another form of arthritis such as RA.

Foot pain for people with fibromyalgia can be caused by plantar fasciitis. It is the irritation of a band of soft connective tissue that spans the sole of the foot.

Women are more likely to have fibromyalgia. So are those with other chronic inflammatory conditions like RA, lupus, and ankylosing spondylitis, which affects the spine.

Still, fibromyalgia is considered a nervous system disorder and not an inflammatory disease. Stress, traumatic injuries, and genetic history may play a role in people who develop fibromyalgia.

How Fibromyalgia Is Treated

Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, anticonvulsants, and muscle relaxers can be used to treat fibromyalgia. Other options include:

• Psychotherapy
• Physical therapy
• Exercise
• Healthy lifestyle changes

Summary

There are many causes of hand and foot pain due to peripheral nerve damage. Damage can arise for reasons that are as diverse as repetitive motion injury, infection, or the chemotherapy drugs used to treat cancer.

Some common conditions that lead to these types of hand and foot pain are related to arthritis or autoimmune disorders, such as lupus. Fibromyalgia, a nervous system disorder, can cause pain in the hands and feet. So can infections or other diseases, like diabetes or PVD.

Because there are so many possibilities, it's important to see your healthcare provider for an accurate diagnosis. Your treatment will depend on the reason for your pain and other symptoms.