Anatomy

There are 29 bones in the human hand and wrist if the radius and ulna are included. The hand has many bones, muscles, and ligaments that allow for a large amount of movement and agility.

There are three types of major bones in the hand:

• Phalanges: There are 14 bones that are found in the fingers of each hand and also in the toes of each foot. Each finger has 3 phalanges (distal, middle, and proximal); the thumb only has two.
• Metacarpal bones: There are 5 bones that create the middle part of the hand.
• Carpal bones: There are 8 bones that make up the wrist. There are 2 rows of carpal bones are connected to 2 bones of the arm (ulna bone and radius bone).

Many muscles, ligaments, tendons, and sheaths are found within the hand. The muscles function in the hand is to contract allowing for the bones to move. The ligaments are fibrous tissues that help mesh the joints in the hand together. The sheaths are tube-like structures that surround the fingers. The tendons are connective muscles in the arm or hand that are connected to the bone and allow for there to be movement. In addition, there are arteries, veins, and nerves within the hand that allow for blood to flow to the hands and fingers.

Common Causes of Pain

Hand pain can have many causes, but there are a few conditions that are essentially responsible for most hand pain. Some hand pain is mild and can be resolved with self-care and other hand pain requires medical treatment.

The most common causes of pain are:

• Arthritis
• Tendonitis/trigger finger
• Ligament injury
• Carpal tunnel syndrome
• Injuries
• Ganglion cysts
• Raynaud’s phenomenon
• Scleroderma

Arthritis

Hands are a common part of the body to develop arthritis and specifically osteoarthritis. This happens due to aging and involves a lot of lost cartilage in your joints. The majority of people over the age of 60 have common signs of osteoarthritis in their hands, but that doesn’t mean people can’t develop hand arthritis at an earlier age. Symptoms that can be severe are: joint pain and inflammation, joint stiffness or lack of motion, cracking, grinding, or popping in the joints, and misaligned joints.

Osteoarthritis is a common type of joint disease that affects the hand. Other diseases can include rheumatoid arthritis which is an autoimmune disease that attacks the lining of the joints.

Tendonitis

Tendonitis is inflammation in the tendon. It causes pain in the hands and fingers when they move and pain and swelling at the sight of inflammation. Tendonitis is caused by injuries or repetitive movement. These injuries are caused by sharp or sudden movements.

Tendons sometimes develop lumps called nodules that you can feel through your skin. They can stick to other structures in the hand causing your finger to be stuck when you try to move it. When the tendon releases, it causes a snapping sensation known as “trigger finger”.

Ligament Injury

The hand has 27 bones that are connected by ligaments that allow for movement in the joints. Any kind of trauma to your hands can injure one or more ligaments which causes problems with simple activities such as bending your fingers, gripping, or pinching.

Ligament injuries can take months to heal and it is not uncommon for people to notice swelling and stiffness for a long time afterward.

Carpal Tunnel Syndrome

Several major nerves provide sensation to the hand and when one of them is injured or compressed because of inflammation it can cause a lot of pain and reduce function. The most common hand condition is carpal tunnel syndrome. Carpal tunnel syndrome causes hand pain that can be painful. Sometimes it causes tingling or numbness in the fingers and thumb. Rubbing inside of your wrist may cause electrical nerve sensations causing pain to radiate up your arm. You will notice weakness or clumsiness with this syndrome.

Heredity and other conditions play a role in contributing to this condition.

Injuries

The hand is susceptible to many kinds of injuries including bone fractures and muscle strains. Potential causes of hand injuries are endless and with a several small bones, joints, and muscles in a small space where of breaks or strains that come with their own specific symptoms and functional limitations.

Ganglion Cysts

The body has joints and tendons that contain fluid. A ganglion cyst is formed when the fluid accumulates into a pouch which shows up in the form of a bump. These cysts develop in the wrist most of the time.

Ganglion cysts cause pain when normal movements in the joints and tendons are made. The two common reasons the cysts develop is because the hand has a multitude of joints and tendon sheaths where cysts can form. Another is that they are easy to see, whereas if they are elsewhere they can go unnoticed.

Ganglion cysts are common in adults under 40. People who put a lot of strain on their wrists are especially prone.

Raynaud’s Phenomenon

Raynaud’s phenomenon is when your fingers and other extremities have an abnormally strong reaction to cold temperatures. They can turn blue or white when chilled and then bright red when they warm up. Some people experience painful throbbing, tingling, or swelling. Raynaud’s occurs because of over-responsive blood vessels in your extremities.

Scleroderma

Scleroderma is a disease that hardens the skin and other organs, and it especially affects the hands and face. The first symptoms of this condition are often swollen, painful muscles and joints in the hands. Scleroderma involves abnormalities in the immune system, connective tissues, and small blood vessels.