Pain on the inside of your hand, the palm side, is most often caused by overuse, nerve compression, or inflammation in the tendons that control your fingers. The specific location of the pain, whether it’s near your thumb, in the center of your palm, or at the base of a finger, narrows down the likely cause considerably. Here’s what could be going on and how to tell the difference.
Pain at the Base of Your Thumb
The fleshy mound at the base of your thumb (called the thenar eminence) is one of the most common spots for palm pain. This area works hard every time you grip, pinch, or text, and repetitive thumb movements are the leading cause of pain here. Frequent texting with your thumbs is one of the most common and easily avoidable triggers.
Sports injuries can also cause pain in this spot, particularly in baseball when catching a fast-moving ball barehanded or falling on an outstretched hand. Arthritis at the base of the thumb is another possibility, especially if you’re over 50 and notice grinding or weakness when you try to open jars or turn doorknobs. Osteoarthritis tends to develop at the base of the thumb, at the end joint closest to the fingertip, or at the middle joint of a finger.
Numbness, Tingling, or Burning
If your palm pain comes with tingling, numbness, or a burning sensation in your thumb, index finger, or middle finger, carpal tunnel syndrome is the most likely explanation. This happens when the main nerve running through your wrist gets squeezed inside a narrow passageway. Symptoms usually start slowly and often feel worse at night. Your fingers may feel swollen, even when they don’t look it, and you might notice your hand feels cold.
Left untreated, carpal tunnel progresses. In long-term cases, the fingers can feel numb all the time, and the muscles at the base of your thumb can weaken to the point where buttoning a shirt or working a zipper becomes genuinely difficult. Carpal tunnel affects roughly 1 to 5 percent of the general population, making it one of the most common nerve conditions in the body. Overuse in the thumb muscles can actually contribute to carpal tunnel by increasing swelling inside the wrist, so these two problems often feed into each other.
A Finger That Catches or Locks
If the pain is concentrated at the base of one finger, right where it meets the palm, and you notice that finger catching, clicking, or locking when you try to straighten it, you likely have trigger finger. This happens when the tunnel that guides your flexor tendon becomes inflamed and thickened, making it hard for the tendon to glide smoothly. The finger may snap straight suddenly after getting stuck, which is where the name comes from.
Trigger finger is surprisingly common, with a prevalence of about 2 to 10 percent in the general population. It’s more frequent in people with diabetes and in those who do repetitive gripping. The pain is often worst in the morning and improves as you move the hand throughout the day.
A Firm Lump in the Palm
If you feel a firm lump or nodule under the skin of your palm, two conditions are worth knowing about. Ganglion cysts are soft, fluid-filled bumps that can appear on either side of the hand for no obvious reason. They’re the most common benign soft-tissue tumor of the hand and wrist, and they’re harmless, though they can press on nearby structures and cause discomfort.
Dupuytren contracture is different. It begins as a firm lump in the palm that may or may not be painful. Over time, this lump can extend into a hard cord under the skin that runs up into a finger, gradually pulling that finger toward the palm. The ring finger and pinky are most often affected. This condition tends to progress slowly over years, but once a finger starts curling inward, it won’t straighten on its own.
Pain That Spreads From the Wrist or Forearm
Not all palm pain originates in the palm itself. Tendon inflammation in the wrist or forearm can send pain radiating into the hand. De Quervain’s tenosynovitis causes pain and swelling on the thumb side of the wrist that can extend into the palm when you grip or twist. Golfer’s elbow, despite the name, produces pain that runs from the inner elbow down through the forearm and into the palm side of the wrist and hand.
General tendonitis can affect any tendon in the hand or wrist, but the wrist and fingers are the most commonly involved areas. If your pain gets worse with specific movements and eases with rest, inflamed tendons are a strong possibility.
Ergonomic Changes That Help
If your palm pain is tied to computer work or repetitive tasks, small equipment changes can make a real difference. The most natural resting position for your hand is nearly vertical, about 80 to 90 degrees perpendicular to the surface, with your fingers gently curled. A standard flat mouse forces your hand into a fully pronated (palm-down) position, which strains the wrist and forearm muscles.
Switching to a vertical or slanted mouse reduces wrist rotation and lowers muscle activity in the forearm extensors. Research on ergonomic mouse design has found that even a partial tilt of 50 degrees or more helps move the hand closer to that neutral position. A wrist rest or support pad also helps by preventing your wrist from bending backward or angling to one side. If you use a mouse for hours each day, using one with thumb support and keeping your arm supported on the desk rather than floating can reduce strain significantly.
Signs That Need Prompt Attention
Most palm pain improves with rest, ice, and avoiding the activity that triggered it. But certain symptoms point to something that needs medical evaluation sooner rather than later:
- Severe pain that makes you feel faint or dizzy
- Fever or feeling generally unwell alongside hand pain, which can signal infection
- A snapping, grinding, or popping sound at the time of injury
- Inability to move your thumb or hold objects
- A finger or thumb that has changed shape or color
- Loss of feeling in part or all of your hand
In rare cases, progressive thickening across the entire palm combined with joint stiffness in multiple fingers can be a sign of a systemic condition called palmar fasciitis. This is uncommon but worth mentioning because it has been linked to underlying cancers of the ovary, lung, pancreas, and other organs. The pattern is distinctive: bilateral hand involvement, morning stiffness that improves during the day, and difficulty flexing and extending all fingers. If palm pain develops rapidly in both hands along with joint swelling and you can’t identify an obvious cause, that warrants a thorough medical workup.