Causes of Hand and Foot Pain

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Pain in the hands and feet can result from problems with the joints, tendons, ligaments, or nerves. Symptoms can vary from deep aches, sharp pains, joint stiffness, swelling, numbness, tingling, and burning sensations, and can result from several different conditions, including neuropathy, arthritis, and lupus.

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Peripheral Neuropathy

Peripheral neuropathy results from damage to the peripheral nervous system that is made up of the many nerves in the body, including those in the arms and legs, that send signals to and from the brain and spinal cord. Peripheral nerves transmit both sensory information, such as feelings of pressure, pain, and temperature, and motor function information to contract and relax muscles. The hands and feet are most commonly affected by peripheral neuropathy.

There are multiple causes of peripheral neuropathy that result in nerve pain in the hands and feet due to nerve damage, including:

  • Nerve injury: Injury to nerves can occur in a variety of ways, including motor vehicle accidents, falls, sports-related injuries, bone fractures, and medical procedures like surgeries. 
  • Diabetes: About 60% to 70% of people with diabetes suffer from diabetic peripheral neuropathy, numbness, tingling, burning, and pain most often in the feet.
  • Chemotherapy: Chemotherapy used to treat various forms of cancer can cause peripheral neuropathy in the hands and feet in 30% to 40% of patients, with symptoms of numbness, tingling, and pain lasting several months after stopping chemotherapy.
  • Carpal tunnel syndrome: Carpal tunnel syndrome results from compression of the median nerve in the wrist from tightness and inflammation of the finger flexor tendons. It often occurs in people who use a computer for extended periods of time or engage in repetitive hand motions as part of their job duties, such as construction and factory work. Symptoms include pain, numbness, tingling, and weakness in the thumb and first three fingers of one or both hands.
  • Cubital tunnel syndrome: Cubital tunnel syndrome occurs when the ulnar nerve is compressed at the elbow, causing pain, numbness, and tingling along the pinky finger, ring finger, and side of the hand, known as ulnar neuropathy
  • Ulnar tunnel syndrome: Ulnar neuropathy can also result from ulnar tunnel syndrome, where the ulnar nerve is compressed at the wrist in an area known as Guyon’s canal where the ulnar nerve passes through. Symptoms include pain, numbness, and tingling along the pinky finger, ring finger, and side of the hand, often caused by repetitive motions or sustained pressure on the wrist with activities like hammering, weightlifting, golfing, and bicycling.
  • Guillain-Barre syndrome: Guillain-Barre syndrome is an autoimmune polyneuropathy where the body attacks its own nerves in an ascending pattern starting from the lower extremities that can progress to the rest of the body. Pain, tingling, and weakness often begin in the feet.
  • Vascular damage: Damage to blood vessels from diabetes, smoking, high blood pressure, atherosclerosis, and peripheral vascular disease decreases the delivery of oxygen to peripheral nerves, resulting in damage.
  • Infections: Viral infections, such as varicella-zoster (chicken pox and shingles), herpes simplex (cold sores), human immunodeficiency virus (HIV), Lyme disease, West Nile virus, and cytomegalovirus can attack nerve cells, causing damage and resulting in neuropathic pain that can affect the hands and feet.
  • Renal and liver failure: Chronic renal failure is associated with peripheral neuropathy. This type of peripheral neuropathy is known as uremic neuropathy. It occurs regardless of the cause of renal failure, and research suggests that hyperkalemia (higher than normal levels of potassium) may play a role in the development of this neuropathy. Peripheral neuropathy is also common in severe liver disease.
  • Vitamin deficiencies or toxins: Certain toxins and nutritional deficiencies can damage the peripheral nervous system. Deficiencies of vitamins B12, E, B6, and B1 and copper have been linked to peripheral neuropathy. Exposure to several metals like lead, thallium, and mercury has been shown to cause this condition. Alcoholism has also been commonly reported in people with peripheral neuropathy.

Symptoms of peripheral neuropathy can vary based on the extent of damage to the nerves in the hands and feet. The most common symptom is nerve pain in the hands and feet.

Other symptoms of peripheral neuropathy include:

  • Numbness
  • Tingling
  • Burning
  • Muscle weakness
  • Decreased sensation
  • Hypersensitivity to touch (allodynia)

How Peripheral Neuropathy Is Treated

Treatment for peripheral neuropathy depends on the underlying cause. It often focuses on managing symptoms.

Options for managing peripheral neuropathy include:

  • Over-the-counter pain medication
  • Topical pain-relieving creams or lidocaine patches
  • Prescription medication to reduce pain, relieve inflammation, and decrease nerve signals 
  • Physical therapy to improve strength and range of motion
  • Controlling blood sugar via diet, exercise, weight management, and medication
  • Eating a healthy diet and correcting vitamin deficiencies 
  • Wearing protective footwear
  • Hand splinting for carpal tunnel syndrome 
  • Surgical release to remove nerve entrapment
  • Transcutaneous electrical nerve stimulation (TENS) for pain relief

Arthritis

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

Osteoarthritis, also called degenerative joint disease or wear-and-tear arthritis, is a condition affecting the cartilage of joints. Cartilage is a connective tissue that covers the end of each bone in the body and provides cushioning and shock absorption to the joints. In osteoarthritis, the cartilage breaks down over time, causing pain and increased difficulty moving the joints. In severe cases, the cartilage wears down so much that bone rubs directly against bone, causing increased pain, inflammation, and joint damage.

Rheumatoid arthritis is an autoimmune condition that causes systemic inflammation throughout the body along with joint pain and swelling. The wrists, hands, and fingers are commonly affected. Unlike osteoarthritis, rheumatoid arthritis 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, which causes thickening. This thickened synovium eventually destroys the cartilage and bone within the joint. If left untreated, rheumatoid arthritis can cause permanent and irreversible joint damage. Rheumatoid arthritis also causes prolonged morning stiffness and occurs more commonly in women.

How Arthritis Is Treated

Osteoarthritis and rheumatoid arthritis can be managed with a variety of different treatment options, including:

  • Over-the-counter pain medication
  • Topical pain-relieving creams
  • Warm paraffin wax application to the hands and fingers to decrease pain and stiffness
  • Prescription medication to reduce pain and inflammation, including disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis 
  • Cortisone injections into the finger and wrist joints to reduce inflammation
  • Physical or occupational therapy to improve hand strength and range of motion
  • Hand bracing or splinting for joint protection
  • Trapeziectomy for severe osteoarthritis of the thumb

Lupus

Lupus is a chronic autoimmune disease that causes widespread pain and inflammation throughout the body, most commonly affecting the skin, joints, and internal organs, including the heart and kidneys. The most common form of lupus is systemic lupus erythematosus (SLE), which can produce a wide variety of symptoms like extreme fatigue, headaches, low fevers, pain and swelling in the joints, and a butterfly-shaped rash on the cheeks and nose.

Similar to rheumatoid arthritis, lupus affects many joints symmetrically on both sides of the body, with an increased likelihood of affecting the wrists and hands. Symptoms are usually less severe than those of rheumatoid arthritis but present similarly, causing joint swelling, periods of morning stiffness, and joint pain in the fingers, hands, and wrists.

About 5% to 10% of patients with lupus and arthritis-like symptoms develop significant deformities in the finger joints. The most common misalignments of the fingers that result from lupus are a swan neck deformity, where the middle joint of the finger is bent back more than normal, and excessive ulnar deviation (also called ulnar drift), where the fingers become angled toward the pinky finger instead of pointing straight. Raynaud’s disease has also been associated with lupus, where the fingers and toes can become numb, pale, and painful from decreased circulation.

How Lupus Is Treated

Unlike rheumatoid arthritis, these changes to the joints of the fingers result from ligament and tendon laxity rather than bone damage and are often easier to correct with bracing or splinting of the fingers. Lupus is commonly managed with anti-inflammatory and immunosuppressive medications.

Fibromyalgia 

Fibromyalgia is a chronic disease that causes widespread pain throughout the body, including the hands and feet, fatigue, headaches, and sleep disturbances. Fibromyalgia pain is usually felt in the muscles and soft tissues. Fibromyalgia can also cause tingling and numbness in the hands and feet. It can occur together with another form of arthritis such as rheumatoid arthritis or osteoarthritis. Foot pain in this condition can also be caused by plantar fasciitis, which is the irritation of a band of soft connective tissue that spans the sole of the foot.

Women are more likely to be diagnosed with fibromyalgia, so are those with other chronic inflammatory conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis. Fibromyalgia is a non-inflammatory condition, however, and is thought to be a nervous system disease. Stress, traumatic injuries, and genetic history are thought to play a contributing role in the development of fibromyalgia.

How Fibromyalgia Is Treated

Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, anticonvulsants, and muscle relaxers, psychotherapy, physical therapy, exercise, and healthy lifestyle changes are most commonly used to treat symptoms of fibromyalgia. 

A Word From Verywell 

Foot and hand pain can result from a variety of different causes and conditions. It is important to see your doctor if you have been suffering from ongoing pain in your feet or hands to discuss your symptoms and medical history. Your doctor will then determine if further examination and tests like x-rays or blood work are needed to determine a possible diagnosis in order to effectively manage your pain and prevent worsening of symptoms.

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