Understanding Chronic Hand Pain: Causes and Common Conditions

Whether you have carpal tunnel syndrome, osteoarthritis, rheumatoid arthritis, or a similar condition, you are well aware of the one pervasive symptom they all share: chronic hand pain. 

As Dr. Iyer, a board-certified orthopedic surgeon with HUES, shares, “From small things like holding a pen to larger tasks like carrying a bag of groceries, living with chronic hand pain can undoubtedly make activities of daily living (ADLs) challenging.”

Fortunately, surgical and non-surgical treatment options can help alleviate and manage hand and wrist joint pain. However, like with any condition, first understanding the root cause is crucial for taking proactive steps for relief. 

Causes of Chronic Hand Pain

The human hand is a complex structure, consisting of 27 bones, ligaments for stability and movement, muscles for motor control and grip strength, tendons, nerves, blood vessels, and connective tissue.

Chronic hand pain can become a problematic symptom when these delicate structures within our hands become affected, as with various medical conditions. Some of the most common medical causes of this include:

• Carpal tunnel syndrome
• Complex regional pain syndrome (CRPS)
• Fibromyalgia
• Ganglion cysts
• Gout
• Osteoarthritis
• Peripheral neuropathy
• Psoriatic arthritis
• Rheumatoid arthritis
• Tendinitis

These conditions can lead to chronic pain through various mechanisms, such as inflammation, nerve compression, or joint degeneration. Because of this, the specific symptoms and treatment options a doctor recommends will vary based on the mechanism of pain and underlying cause.

Continuous Hand Pain: Explained

You may have received a diagnosis to explain your chronic hand pain, but how well do you know what is going on? Here is a deeper explanation of the top causes to understand your continuous hand pain better.

Arthritis

Arthritis is inflammation in the joints that causes pain, stiffness, and reduced mobility. It encompasses over 100 conditions, with osteoarthritis and rheumatoid arthritis being the most common. Osteoarthritis results from joint wear and tear, while rheumatoid arthritis is an autoimmune disorder. 

Common causes of arthritis include aging, genetics, injuries, repetitive motions, obesity, and certain infections. While the exact causes of autoimmune arthritis aren't fully understood, environmental and lifestyle factors may contribute.

Carpal Tunnel 

Carpal tunnel syndrome occurs when the median nerve is compressed in the wrist's carpal tunnel, causing numbness, tingling, and weakness in the hand. It is commonly caused by repetitive hand and wrist movements. Other risk factors include obesity, pregnancy, diabetes, thyroid issues, and rheumatoid arthritis. 

Peripheral Neuropathy

Peripheral neuropathy is damage to nerves outside the brain and spinal cord, causing symptoms like numbness, tingling, pain, and weakness, typically starting in the hands and feet. The most common cause is diabetes, but it can also result from autoimmune diseases, infections, certain medications, alcohol abuse, vitamin deficiencies, injuries, toxin exposure, and inherited disorders. Sometimes, the cause is unknown. 

Symptoms can develop suddenly or gradually. Diabetes-related neuropathy is the most prevalent form in developed countries, and treatment generally focuses on managing the underlying condition and preventing further nerve damage.

Tendonitis 

Tendonitis is inflammation of a tendon causing pain and tenderness near joints often worsened by movement. It commonly affects shoulders, elbows, wrists, knees, and heels. The main causes include repetitive motions from work or sports, sudden injuries, poor posture, and lack of proper conditioning. 

Underlying conditions, like rheumatoid arthritis, can also contribute to developing tendonitis. Treatment typically involves rest, physical therapy, and anti-inflammatory medications, but severe or chronic cases might need more intensive interventions.

When to See a Doctor for Chronic Hand Pain Management

If you begin noticing any unusual signs or symptoms, it is important to seek medical attention immediately. Early diagnosis and treatment can not only lead to a better outcome but also help prevent more complicated issues down the line. 

Here are some signs that a person should see a doctor for chronic hand pain:

• Clicking, popping, or grinding sensations when moving fingers
• Numbness, tingling, or burning sensations
• Pain that does not respond to over-the-counter medications
• Pain that interferes with daily activities or sleep
• Persistent pain lasting several weeks or months
• Stiffness or limited range of motion in fingers or wrist
• Visible swelling, redness, or deformity of the hand or fingers
• Weakness or difficulty gripping objects

Surgical Procedures for Chronic Hand Pain Relief

“Depending on the severity of your chronic hand pain, options for managing pain naturally and non-surgically, such as with medication and physical therapy, may be fairly effective when implemented in the right way,” explains Dr. Iyer.

In cases when non-surgical procedures have failed, however, surgery can prove instrumental in restoring mobility and comfort.

Here are some standard effective surgical treatment options for chronic hand pain:

Tendon Repair

Tendon repair involves reattaching or reconstructing damaged tendons. It is commonly used for conditions like severe tendonitis or ruptures. Tendon repair can restore function and reduce pain in cases where conservative treatments have failed.

Nerve Repair

Nerve repair procedures address issues with compressed or damaged nerves. Procedures include:

• Carpal tunnel release: Relieves pressure on the median nerve.
• Cubital tunnel release: Decompresses the ulnar nerve at the elbow.
• Nerve grafting: Replaces severely damaged nerve segments.

Fasciotomy

A fasciotomy releases tight fascia (connective tissue) to relieve pressure and is commonly performed in treating conditions like Dupuytren's contracture, where it helps restore finger mobility.

Joint Replacement

This surgical procedure replaces damaged joint surfaces with tissue from another area of the body or other synthetic material. These options typically include:

• Finger joint arthroplasty: Replaces joints in fingers, often for severe arthritis.
• Thumb basal joint arthroplasty: Addresses arthritis at the base of the thumb.

The choice of procedure depends on the specific condition, severity, and individual patient factors. Post-operative rehabilitation is often crucial for optimal outcomes.

Start Your Journey Toward Chronic Hand Pain Relief Today

“Living with chronic hand pain can be challenging and disheartening. But, there is hope. I have helped many patients finally find chronic hand pain relief through both surgical and non-surgical solutions.”

If you or someone you know has been living with one of these conditions and is battling continuous hand pain, we invite you to book an appointment with one of our world-renowned upper-extremity physicians.  

At The Center for Hand & Upper Extremity Surgery, we treat chronic pain in hands, hand, wrist, arm, and shoulder arthritis, nerve injuries, and other common causes of chronic hand pain. 

If you are ready to explore surgical options for arthritis, contact Dr. Iyer and the care team at The Center for Hand & Upper Extremity Surgery, part of The Institute for Advanced Reconstruction, for a consultation today.