Pain on the outside of the hand, or dorsal hand pain, is a common experience. The hand is a complex structure of bones, tendons, nerves, and ligaments. This article explores the anatomy of the dorsal hand, common causes of pain, when medical attention is advised, and initial self-care steps.
Exploring the Outside of Your Hand
The dorsal side of the hand and wrist contains several structures that can contribute to pain. Eight small carpal bones form the wrist, connecting the forearm to the hand. Beyond the wrist, five metacarpal bones form the framework for the fingers.
Overlying these bones are extensor tendons, responsible for straightening the fingers and wrist. Ligaments connect bones, providing stability to the hand and wrist joints. Nerves like the superficial radial nerve provide sensation to the back of the hand.
Common Causes of Dorsal Hand Pain
Injuries are a frequent cause of dorsal hand pain. Sprains involve ligament stretching or tearing, often from a direct blow or fall, causing pain, stiffness, swelling, and bruising. Fractures, or broken bones, can also occur, such as a Boxer’s fracture affecting the fifth metacarpal bone, or a scaphoid fracture causing pain and swelling near the thumb side of the wrist. Contusions, or bruises, result from direct impact, causing pain, swelling, and discoloration.
Overuse and repetitive strain can lead to inflammatory conditions affecting tendons. Extensor tendinitis involves inflammation of the extensor tendons on the back of the hand, causing pain, stiffness, swelling, and warmth that worsens with hand use. De Quervain’s tenosynovitis affects tendons on the thumb side of the wrist, with pain radiating to the back of the hand, particularly with grasping or pinching motions.
Arthritis can also cause dorsal hand pain. Osteoarthritis, a degenerative condition involving cartilage breakdown, commonly affects the carpometacarpal joint at the base of the thumb, causing pain, stiffness, and sometimes bony lumps. Rheumatoid arthritis, an autoimmune inflammatory disease, often affects small joints of the wrists, hands, and fingers, typically on both sides of the body. Symptoms include pain, swelling, stiffness, and warmth, often worse in the morning.
Nerve compression or irritation can lead to pain and altered sensation. Radial nerve entrapment can cause pain, numbness, or tingling that extends to the back of the hand.
Cysts and lumps are another potential source of discomfort. Ganglion cysts are fluid-filled sacs that commonly appear on the back of the wrist or hand. While often painless, they can cause pain, tingling, or muscle weakness if they press on nearby nerves or structures. A carpal boss is a bony lump or overgrowth on the back of the wrist, often at the base of the index or middle finger. While often painless, it can become tender or painful with wrist movement.
Inflammatory conditions like gout can also cause severe hand pain. Gout results from uric acid crystal buildup in a joint, leading to sudden, intense pain, swelling, redness, and warmth. While most commonly affecting the big toe, gout can also occur in the wrist and finger joints.
When to Seek Medical Attention
Seek medical attention if dorsal hand pain is severe, persistent, or worsens over time. Immediate evaluation is recommended if pain follows a significant injury, especially with visible deformity, an inability to move the hand or fingers, or if a popping or snapping sound was heard at the time of injury. Numbness, tingling, or weakness in the hand or fingers also warrants a doctor’s visit, as these can indicate nerve involvement.
Other warning signs include significant swelling, redness, or warmth around the affected area, which could suggest infection or severe inflammation. If self-care measures do not alleviate the pain within a few days, or if symptoms recur frequently, a medical professional can provide an accurate diagnosis and appropriate treatment plan.
Initial Self-Care and Prevention Strategies
For mild dorsal hand pain, several self-care strategies can help manage symptoms and prevent recurrence. The R.I.C.E. method is recommended: Rest the affected hand by avoiding activities that aggravate the pain. Apply Ice packs to the painful area for 10-20 minutes at a time, several times a day, to reduce swelling and pain. Compression with a bandage can help minimize swelling. Elevate the hand above heart level when resting to further reduce swelling.
Over-the-counter pain relievers, such as NSAIDs like ibuprofen or naproxen, can help reduce pain and inflammation. Gentle stretching exercises can maintain flexibility, but avoid any movements that increase pain. Ergonomic adjustments in daily tasks, such as modifying workstation setup, can reduce strain on the hand. Consistently avoiding activities that trigger or worsen the pain is also an important preventive measure.