The hand’s intricate structure, with 27 bones, numerous joints, ligaments, and tendons, allows for remarkable motion and dexterity. This complexity also makes it susceptible to various sources of discomfort. What people describe as “bone pain” in their hands often originates from these interconnected tissues, rather than exclusively from the bones themselves.
Arthritis and Inflammatory Conditions
Arthritis is a common cause of persistent hand pain, encompassing several types that involve inflammation and joint degradation. Osteoarthritis, or “wear and tear” arthritis, develops as protective cartilage cushioning bone ends erodes. This erosion causes bones to rub, leading to pain, stiffness, and sometimes bone spurs. In the hands, osteoarthritis commonly affects the joint at the base of the thumb, the middle finger joint (PIP), and the fingertip joint (DIP).
Rheumatoid arthritis is an autoimmune disorder where the immune system attacks the joint lining (synovium). This causes inflammation, leading to pain, swelling, warmth, and stiffness, especially in the mornings or after rest. RA often affects the small joints of both hands symmetrically, including the MCP and PIP joints, typically sparing the DIP joints. Chronic inflammation can eventually cause bone erosion and joint deformity.
Psoriatic arthritis, an inflammatory arthritis linked to psoriasis, can also affect the hands. A distinctive symptom is dactylitis, where entire fingers or toes become swollen, tender, and warm, often described as “sausage digits.” Psoriatic arthritis can occur asymmetrically, affecting one side of the body more than the other.
Gout is an inflammatory condition from uric acid crystal accumulation in joints, causing sudden, severe episodes of pain, redness, and swelling. While most common in the big toe, it can affect hand, wrist, and finger joints. Untreated gout can lead to visible white bumps called tophi and cause joint damage.
Injuries and Overuse
Physical trauma or repetitive actions can cause hand pain, sometimes perceived as bone pain. Fractures commonly occur in the hand due to direct impact, falls, or crush injuries. Common hand bones susceptible to fracture include the scaphoid bone in the wrist, metacarpals, and phalanges. A scaphoid fracture, often from a fall onto an outstretched hand, typically causes pain and swelling on the thumb side of the wrist.
Metacarpal fractures are prevalent, resulting from direct trauma or forceful punching, sometimes called a “boxer’s fracture” when affecting the fifth metacarpal. Symptoms include immediate pain, swelling, bruising, and difficulty moving the hand or fingers. Phalangeal fractures present with localized swelling, tenderness, and potentially a visible deformity. Even minor fractures can significantly impact hand function if not properly addressed.
Repetitive strain injuries (RSIs), such as tendinitis, involve inflammation of tendons or their sheaths from overuse. While tendinitis affects soft tissues, the pain can be mistaken for bone pain. De Quervain’s tenosynovitis is a specific RSI affecting wrist tendons on the thumb side, causing pain, swelling, and difficulty with grasping or pinching. Repetitive hand or wrist movements, like typing, can exacerbate these conditions.
Other Conditions Affecting Hand Bones
Hand pain can also stem from less common conditions or referred pain. Cysts and tumors, often benign, can cause localized pain by pressing on surrounding bones, nerves, or soft tissues. Ganglion cysts, fluid-filled sacs near hand or wrist joints, can cause discomfort, tingling, or muscle weakness if they press on nerves.
Infections can also affect hand bones, a condition called osteomyelitis. This serious bone tissue infection, typically caused by bacteria or fungi, leads to severe pain, swelling, redness, and fever. Though less frequent in the hand, it requires prompt medical attention to prevent complications. It can occur if an open fracture allows bacteria to enter the bone.
Nerve compression syndromes can also produce symptoms perceived as bone pain. Carpal tunnel syndrome, a common condition, involves median nerve compression in the wrist’s carpal tunnel. This compression leads to pain, numbness, tingling, and weakness in the thumb, index, middle, and part of the ring finger. The sensation is due to nerve irritation, not direct bone involvement.
When to Consult a Healthcare Professional
Recognizing when to seek medical advice for hand pain is important for proper diagnosis and management. Consult a healthcare professional if you experience severe pain, especially if it appears suddenly after an injury like a fall or impact. Significant swelling, visible deformity, or inability to move your hand or fingers normally are strong indicators for immediate medical evaluation.
Pain that persists or worsens despite rest and home care, or interferes with daily activities, warrants professional assessment. Additional signs like numbness, tingling, or symptoms suggestive of infection, such as redness, warmth, or fever, should prompt a doctor’s visit.