When your hands feel intensely hot, as if exposed to flames, the sensation is medically described as dysesthesia—a painful, abnormal sense of touch. This feeling is the body’s way of signaling a problem within the communication network of the nervous system. It typically manifests from an underlying condition affecting the peripheral nerves that extend from the spine into your hands.
Understanding the Burning Sensation
The intense burning results from a miscommunication within the peripheral nervous system. Sensory neurons, which are specialized nerve fibers, transmit information about temperature, touch, and pain from the skin to the brain. When these nerves become irritated, damaged, or diseased—a condition known as neuropathy—they fire signals spontaneously or send incorrect messages.
The brain interprets these distorted signals as pain or extreme heat, even though no thermal stimulus is present. This phenomenon is similar to the “pins and needles” feeling when a limb “falls asleep.” Neuropathy can be acute (sudden onset) or chronic (slowly progressing). The specific type of nerve damage determines if the sensation is a painless tingling or a painful, fiery burn.
Systemic Conditions That Cause Burning Hands
Symmetrical burning in both hands often indicates a systemic condition impacting the body’s entire peripheral nervous system, known as polyneuropathy.
Metabolic and Nutritional Causes
Diabetes Mellitus is the most common cause of nerve damage worldwide (diabetic polyneuropathy). High blood sugar levels (hyperglycemia) damage the tiny blood vessels supplying nerves, leading to nerve fiber deterioration. Deficiencies in certain vitamins, particularly B12 and B1 (thiamin), can also impair nerve function. Chronic kidney disease can also result in uremic neuropathy due to the buildup of toxins harmful to nerve tissue.
Other Systemic Factors
Excessive, long-term alcohol consumption can directly damage nerve fibers due to toxic effects and nutritional deficiencies, causing alcoholic neuropathy. Autoimmune disorders, such as Sjögren’s syndrome, lupus, and rheumatoid arthritis, cause nerve damage when the immune system mistakenly attacks its own tissues. Systemic diseases often affect the longest nerves first, which is why symptoms frequently begin in the feet before progressing to the hands in a “stocking-and-glove” distribution.
Localized Nerve Compression and External Triggers
Not all burning sensations stem from body-wide disease; many result from localized pressure or environmental factors affecting a single nerve.
Nerve Compression
Carpal Tunnel Syndrome (CTS) is the most prevalent example, involving compression of the median nerve in the wrist. This compression can cause pain, numbness, and a burning or tingling sensation specifically in the thumb, index, middle, and half of the ring finger. The pressure on the nerve often increases at night or during repetitive movements.
Pain Syndromes
Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that usually develops after an injury, such as a fracture or surgery, often in the hand or arm. CRPS is characterized by continuous, intense burning pain disproportionate to the original injury. It also presents with changes in skin temperature, color, and texture, typically affecting only the injured limb.
External Triggers
External triggers can produce a true, localized burning sensation. Direct exposure to caustic chemicals causes immediate damage to skin and nerve endings. Acute thermal injuries, such as severe sunburn or the recovery phase of frostbite, also cause significant, temporary burning due to sensory nerve damage. These localized causes are typically asymmetrical, affecting only one hand or a specific part of a hand.
When Immediate Medical Care Is Necessary
While many causes of burning hands are manageable with lifestyle changes and treatment, certain red flag symptoms require immediate medical attention to rule out acute or severe conditions. Seek emergency care if the burning sensation suddenly appears alongside:
- Acute muscle weakness or difficulty moving fingers.
- Paralysis in the hand or arm.
- Rapid spreading of the sensation up the arm.
- Systemic symptoms like confusion, severe headache, or loss of consciousness.
These symptoms may signal a rapid-onset neurological event or severe nerve compression. Immediate evaluation is also necessary for any burning that follows known exposure to a toxic substance, electrical source, or a deep, severe burn. Prompt diagnosis is important for preventing permanent nerve damage and managing the underlying cause.