A burning sensation in the hands, often described as tingling, fiery discomfort, or pins and needles, is a common experience. This symptom indicates that the sensory nerves in your hands are irritated or damaged, causing them to send abnormal signals to the brain. While a temporary sensation might be harmless, a persistent or worsening feeling suggests an underlying medical condition. The source of this discomfort varies, originating from localized nerve issues, widespread chronic diseases, or problems with the skin and blood flow.
Nerve Compression in the Wrist and Arm
One of the most frequent causes of a fiery feeling in the hands involves a mechanical problem where a nerve is physically squeezed or compressed along its path. This localized pressure causes the nerve to become inflamed and transmit faulty sensory signals, which the brain interprets as burning or pain. The median nerve, which travels through the narrow carpal tunnel in the wrist, is a common site of this compression.
When the tendons in the carpal tunnel swell due to repetitive motions or certain wrist positions, they press against the median nerve, leading to Carpal Tunnel Syndrome. This condition typically causes a burning sensation and numbness in the thumb, index, middle, and half of the ring finger. Symptoms often worsen at night when the wrist is naturally flexed during sleep. The pressure reduces blood flow to the nerve, causing it to become dysfunctional.
Another site of compression occurs at the elbow, affecting the ulnar nerve in a condition known as Cubital Tunnel Syndrome. The ulnar nerve provides sensation to the little finger and the other half of the ring finger. When compressed, a burning or tingling sensation may be felt along the inner side of the forearm and into these two fingers. Both carpal and cubital tunnel syndromes are examples of mononeuropathy, meaning a single nerve is damaged, and symptoms are confined to the areas that nerve supplies.
Systemic Neuropathy and Underlying Conditions
A more complex set of causes for chronic hand burning involves systemic conditions that result in widespread nerve damage, known as peripheral neuropathy. Unlike localized compression, this type of nerve damage affects peripheral nerves throughout the body. Symptoms often start in the farthest points, such as the hands and feet. This nerve dysfunction causes sensory nerve fibers to become irritable, firing pain signals even without an external stimulus.
Diabetes Mellitus is the most common cause of peripheral neuropathy. Chronically high blood sugar levels physically damage the small blood vessels supplying oxygen and nutrients to the nerves. This process, known as diabetic neuropathy, causes nerve fibers to deteriorate over time, resulting in a persistent burning, tingling, or numbing sensation. Managing blood glucose levels is the primary way to slow the progression of this nerve damage.
Nutritional deficiencies can also directly impact nerve health, particularly a lack of Vitamin B12, which is essential for maintaining the protective myelin sheath surrounding nerve fibers. Inadequate intake or poor absorption of B12 can lead to anemia and subsequent neuropathy, causing a burning or pins-and-needles feeling in the hands and feet. Other systemic issues, including hypothyroidism or chronic kidney disease, can disrupt the body’s metabolic balance, damaging the peripheral nerves.
Autoimmune diseases also represent a category of systemic causes, as the immune system mistakenly attacks healthy nerve tissues. Conditions such as Lupus, Rheumatoid Arthritis, or Sjögren’s Syndrome can cause inflammation and nerve damage, leading to painful burning sensations. This form of neuropathy is often accompanied by other symptoms of the underlying disease, such as joint pain or fatigue.
Skin Irritation and Circulatory Issues
Not all causes of burning hands originate from the nervous system; sometimes, the problem is localized to the skin or the circulatory system. Direct contact with certain substances can trigger an inflammatory response on the skin’s surface, known as Contact Dermatitis. Exposure to harsh cleaning chemicals, metals like nickel, or ingredients in soaps and lotions can cause the skin to become red, inflamed, and feel intensely hot or burning.
Environmental factors can also cause a burning sensation through direct tissue damage or extreme temperature changes. Severe sunburn or chemical burns can damage the upper layers of the skin, leading to pain and a sensation of heat. Conversely, exposure to intense cold can cause blood vessels to constrict sharply. This reaction, seen in Raynaud’s phenomenon, causes the hands to turn pale and cold, and the subsequent rush of blood during rewarming produces a painful, fiery sensation.
A rare but distinct cause related to blood flow is Erythromelalgia. This vascular pain disorder causes episodes of severe burning pain, redness, and increased skin temperature, typically in the hands and feet. The condition involves abnormal blood vessel regulation, resulting in excessive blood flow to the extremities, which triggers the intense sensation of heat and burning. Flare-ups are often provoked by heat, exercise, or simple warming.
When to Seek Professional Diagnosis
While a temporary, fleeting sensation of burning may not be a concern, certain signs indicate that a medical evaluation is necessary. If the burning sensation is persistent (meaning it does not resolve quickly) or if it begins to interfere with sleep or daily activities, you should consult a healthcare provider. A sudden onset of severe burning, especially if accompanied by muscle weakness or a rapid spread of symptoms up the arm, warrants prompt medical attention.
A physician will typically begin the diagnostic process with a thorough physical examination and a detailed review of your medical history and lifestyle. They may order blood tests to check for systemic causes, such as elevated blood glucose levels to screen for diabetes or low Vitamin B12 levels. To investigate potential nerve damage, specialized tests like nerve conduction studies or electromyography might be used. These tests measure how well your nerves transmit electrical signals. Identifying the precise cause is the first step toward finding an appropriate treatment plan.