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What Is Hand Pain?
Jump to Finger Pain
Jump to Wrist Pain
Jump to Elbow Pain
Fingers
Nearly everyone has injured a finger at sometime during their life. After an injury, the finger can remain a bit crooked or stiff. However, your hand can still work quite well with minor deformities.
Fingers do not need to open or close completely to be functional.
Numbness or tingling in the fingers may be a sign of a problem with nerves or blood flow.
Wrist
One of the most common reasons for wrist pain is Carpal tunnel syndrome (CTS). It is a disorder marked by weakness and pain in the hand and wrist. CTS occurs in the nerves of the hands -- not the
muscles, as some people believe. The symptoms of CTS can be incapacitating.
To understand how carpal tunnel syndrome arises, it is important to know the parts of the hand and wrist that are involved.
The Carpal Tunnel. The carpal tunnel is a passageway that forms beneath the strong, broad transverse ligament. This ligament is a bridge that extends across the lower palm and connects the bones
of the wrist (carpals), which form an arch below the tunnel.
The Median Nerve and Flexor Tendons. The median nerve and nine flexor tendons pass under the ligament bridge and through the carpal tunnel (similar to a river). They extend from the forearm and
up into the hand:
• The flexor tendons are fibrous cords that connect to muscles of the fingers (two to each finger) and one to the thumb. They allow flexing of the fingers and clenching of the fist.
• The median nerve plays two important roles. It supplies sensation to the thumb, index, middle, and ring fingers, and to the flexor tendons. It provides function for the muscles at the base of
the thumb (the thenar muscle).
It is not completely known how the process leading to carpal tunnel syndrome actually evolves, and how nerve conduction (the passing of the nerve signal) through the wrist becomes changed. In general,
carpal tunnel syndrome develops when the tissues around the median nerve swell and press on the nerve. Early in the disorder, the process is reversible. Over time, however, the insulation on the
nerves may wear away, and permanent nerve damage may develop.
The following events have been observed in the hands of people with carpal tunnel syndrome:
• The protective lining of tendons (called the tenosynovium) swells within the carpal tunnel. Some research suggests that this swelling is caused by build-up of fluid (called synovial fluid) under
the lining. Synovial fluid lubricates and protects the tendons.
• The transverse ligament, the band of fibrous tissue that forms the roof over the median nerve, becomes thicker and broader.
• The swollen tendons and thickened ligament compress the median nerve fibers, just as stepping on a hose slows the flow of water through it. The effect is to reduce blood flow and oxygen supply
to the nerve, slowing the transmission of nerve signals through the carpal tunnel. Some cases of carpal tunnel syndrome may be due to enlargement of the median nerve rather than compression by
surrounding tissues.
The result is pain, numbness, and tingling in the wrist, hand, and fingers. Only the little finger is unaffected by the median nerve.
For more on Carpal tunnel syndrome (CTS), view our In-Depth CTS report.
Elbow
There are a number of injury-related and non-injury related causes of elbow pain.
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.
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