Hand Pain: Causes by Where It Hurts

Written by Shamaine Soh, Principal Hand Occupational Therapist at Phoenix Rehab, AHPC A1302343D.Clinically reviewed by Nigel Chua, Principal Hand Occupational Therapist & Director, AHPC A1300362Z.Last reviewed 3 November 2026.

Hand pain usually comes from a nerve, a tendon, a joint or a recent injury, and where it hurts narrows down which. Palm pain with numb fingers points to the carpal tunnel. A catch at the base of a finger points to trigger finger. After surgery or a fall, the questions change, so start with those.

Key takeaways

Where it hurts narrows it down: the palm, the back of the hand, the base of the thumb, the finger joints or the whole hand each point to different problems.
After carpal tunnel release, soreness on either side of the scar is called pillar pain, and most cases settle by about six months.
A palm or finger that is red, hot and swollen, or a finger held bent that hurts to straighten, needs the emergency department now.
Pain in the arm or hand with chest pain, breathlessness or sweating is a 995 call.
Numb fingers, a growing lump, or hand pain that is no better after two weeks is worth having checked.

After hand surgery or an injection

After hand surgery, some soreness, swelling and stiffness is expected, and your surgeon’s protocol sets the limits. What differs is where the pain sits and how long it usually lasts. This table gives the usual pattern by operation, and the page that covers each one in detail.

Operation	Pain that is common afterward	Read next
Carpal tunnel release	Soreness on either side of the scar at the heel of the hand, worse leaning on the palm. Most pillar pain settles by about six months.²	Carpal tunnel syndrome
Trigger finger release	A tender scar at the base of the finger, and a finger that is stiff to close in the early weeks	Trigger finger
Dupuytren’s surgery	Scar tightness, swelling, and fingers that are stiff to bend and to straighten	Dupuytren’s Contracture Recovery Program
A hand or finger bone fixed with wires, a plate or screws	Swelling, stiff knuckles, and an ache on gripping	Finger and Metacarpal Fracture Recovery Program
Wrist fracture, in a cast or with a plate	Stiff, swollen fingers, and a sore hand as the wrist starts moving	Wrist Fracture Recovery Program
Thumb base surgery	A deep ache at the base of the thumb, and a weak pinch	Thumb joint pain

Had an injection for hand pain?

A steroid injection for trigger finger, carpal tunnel or a thumb joint may be part of your story. Whether to have one, or another, is between you and your doctor. Pain easing afterward does not tell you how strong your grip is or how far the finger moves, because those are measured separately. Therapy after an injection covers what that looks like.

Where does your hand hurt?

Start from the spot. Each row is the usual pattern, not a diagnosis, and more than one can be going on at once.

Where	What usually goes with it	What it often is
Palm and thumb, index and middle fingers	Numbness or tingling, worse at night, eased by shaking the hand	Carpal tunnel syndrome
Palm, at the base of one finger	A tender bump, and a catch or click, often worse in the morning	Trigger finger
Palm, below the little finger	Started with a club, bat or racquet, or a fall, and hurts to press	Hook of hamate fracture, a doctor the same day
Palm, firm lump or cord	Usually painless, runs toward the ring or little finger, and the finger slowly stops straightening	Dupuytren’s contracture
Base of the thumb	Deep ache on pinching, turning a key or opening a jar	Thumb joint pain
Thumb side of the wrist	Worse lifting a baby or wringing a cloth	De Quervain’s tenosynovitis
Back of the hand	Sharp on bending the wrist or spreading the fingers, sometimes a bump	An irritated tendon or a ganglion
Finger joints	Stiffness, swelling, knobbly end joints	Finger pain
Ring and little fingers	Tingling, worse with the elbow bent	Cubital tunnel, at the elbow
Whole hand, one side	Comes with neck pain, or changes when you turn your head	A pinched nerve in the neck
Both hands, knuckles and wrists	Swollen, with morning stiffness that lasts more than 30 minutes	Rheumatoid arthritis, a doctor soon

Pain in the palm of the hand

Pain in the palm usually comes from the nerve in the carpal tunnel, a flexor tendon at the base of a finger, a bruise, or a firm cord of tissue under the skin. Where in the palm it sits is the first clue. Whether the fingers also go numb is the second.

At the heel of the hand, thumb side. With a numb thumb, index or middle finger that wakes you up, this is the usual place for carpal tunnel pain. Pain alone, with no numbness at all, makes it less likely.
Just below a finger. Press the crease where the finger meets the palm. A tender pea-sized bump and a finger that clicks on the way back up is the pattern for trigger finger.
At the heel of the hand, little-finger side. After a fat shot in golf or a mishit with a bat, this can be a broken hook of the hamate, which a first X-ray can miss. Long bike rides on the handlebars can press the ulnar nerve in the same spot, and the little and ring fingers tingle.
A firm lump or cord. It usually does not hurt much. Dupuytren’s matters for the finger it can slowly pull down, so see a doctor soon.
Red, hot, swollen and throbbing. After a cut, a splinter or a fish spine, treat this as an infection until a doctor says otherwise. It is on the emergency list below.

Sharp pain on top of the hand

Sharp pain on the back of the hand is usually an irritated tendon, a ganglion, or, after a punch or a fall, a broken metacarpal. Tendon pain follows a line and hurts when you lift the fingers against resistance. Bone pain sits on one spot and hurts to press. After an injury, that needs a doctor the same day, and the doctor decides on an X-ray.

A burning patch on the back of the hand near the thumb is a different problem. A tight watch strap or a bracelet can press the skin nerve there, which is covered in Wartenberg’s syndrome.

Hand pain from writing, typing or overuse

Pain that builds over days of writing, typing, phone use or gripping tools often sits under the label repetitive strain injury. Some people have a clear tendon or nerve problem, and others have a regional ache with no single structure to point at. Both patterns are common.¹ Tests that come back clear do not mean the pain is imagined.

Three things are worth changing first. Use a thicker pen and a lighter grip, because force matters as well as repetition.¹ Break up the work every 30 minutes, even for one minute. Move the phone off the thumb for a week by using voice typing or the other hand, and see what the pain does.

What to do first at home

Take rings off as soon as a hand starts to swell. They are much harder to remove later.
After a knock, use a wrapped ice pack for 10 to 15 minutes at a time and keep the hand above your heart when you can.
For stiffness without swelling, warm water and slow opening and closing of the hand usually help more than keeping it still.
Keep moving what you are allowed to move. Fingers that are not injured stiffen quickly when held still, more so if you have had surgery. Your surgeon’s limits come first.
Do not stretch into numbness. If a stretch brings on tingling, stop that stretch.
Ask a pharmacist which painkiller suits you, especially if you take other medication.

Is this normal?

Usually expected: a bruise-like ache after a knock that eases each day. Sore hands for a day or two after moving house or a long gardening weekend. After surgery, a tender scar, some swelling, a grip weaker than the other hand, and a small numb patch beside the scar that shrinks.

Worth getting checked: pain that is no better after two weeks. Numbness that comes back night after night. A finger that catches. A grip that stays weaker than the other hand from one month to the next. A scar that is still too sore to lean on at six months.

When to see a doctor first

Call 995 for pain in the arm or hand with chest pain or pressure, breathlessness or sweating. For sudden weakness or numbness in one hand with a drooping face, slurred speech or confusion. For a wound bleeding heavily that firm pressure does not slow.
Go to the emergency department now if a finger or the hand looks bent or out of place, or bone shows. If the hand or a finger turns cold, pale or blue and stays that way. If a palm or finger is red, hot and swollen, especially with fever, or a finger is held bent and hurts to straighten: an infection along the tendon spreads quickly and is treated urgently.³ After any bite, including a cut over a knuckle from a punch. After a paint, grease or water jet under pressure enters the skin, even if the hole looks small. If a cut has left a fingertip numb or a finger that will not bend or straighten. If pain is severe and far out of proportion after a crush injury or under a tight cast.
See a doctor the same day after a fall, punch or blow if you cannot grip or one spot of bone hurts to press. For palm pain below the little finger after one swing. For a fingertip that suddenly will not bend or a fingertip that droops. For new numbness or weakness. For fingers that turn white, blue or cold and then recover. After surgery, contact your surgeon the same day if the wound is red, leaking or more painful, or you have a fever.
See a doctor soon for numbness that wakes you at night, or a fleshy pad at the base of the thumb that looks thinner than the other side. For both hands swollen and stiff in the morning. For a lump that is growing, or a firm cord in the palm. For hand pain with night sweats or weight loss, or pain no better after two weeks.

Where are you with this right now?

1. It was a heavy week, and it is settling

You moved house, or the deadline moved, or you knocked it on a door frame. It is less sore each day, the grip is coming back, and nothing is numb. That is a hand behaving as most do. You do not need us for this, and we would rather say so.

2. It has stopped improving

It started around the week of the deadline. Eight weeks on, the kettle goes to the other hand. Someone else opens the jar. The laptop bag has changed shoulders, the car key hurts to turn, and on the MRT you have stopped holding the pole with that hand without ever deciding to.

You rested it. You rubbed in the cream and wore the strap from the pharmacy. It eased, and then you lifted the kettle. Rest takes the load away, and it does not show which nerve, tendon or joint is carrying the pain.

The X-ray may have been clear. Has anyone measured your grip against the other hand, or tested the feeling in each finger?

Finding the real problem is half the battle. Treating it is the other half. One Assessment & Treatment with a hand therapist who works only on the finger, hand, wrist, forearm and elbow measures grip and pinch on both hands, the bend at each joint in degrees, and swelling as finger circumference. It tests the feeling in each fingertip, checks each tendon on its own, and presses over the nerves at the wrist and elbow. If the pattern needs a doctor, a scan or a nerve test, we say so and write to your doctor. If it does not, treatment starts in the same appointment, and you leave knowing your stage, what limits you and what Stage 4 requires. If this has gone on for months, the Stalled Recovery Review is three visits over three weeks with the same therapist.

3. You have had surgery, or you have a date

The surgeon deals with the structure. The weeks after decide how the scar, the swelling and the stiff knuckles behave, within the limits your surgeon sets. Hand therapy after surgery lists the procedures, and the recovery programs cover them stage by stage. All of it runs on the four stages of The Phoenix Recovery Protocol.

Questions people ask

What causes hand pain?

Hand pain most often comes from a pinched nerve such as carpal tunnel syndrome, an irritated tendon such as trigger finger or De Quervain’s, arthritis in a joint, repeated strain, or an injury. Where it hurts, and whether fingers go numb, narrows it down. A hand therapist or doctor can confirm which.

What does pain in the palm of your hand mean?

Palm pain usually points to carpal tunnel syndrome if the thumb and first fingers go numb, trigger finger if there is a tender bump below one finger, or a bruise after a knock. A palm that is red, hot and swollen may be infected and needs the emergency department now.

What causes sharp pain on top of the hand?

Sharp pain on the back of the hand is usually an irritated tendon, a ganglion, or a broken metacarpal after a punch or a fall. Tendon pain follows a line and hurts when you lift the fingers. Pain on one bony spot after an injury needs a doctor the same day, and the doctor decides on an X-ray.

Why is my hand burning all of a sudden?

A burning hand usually comes from an irritated nerve at the wrist, elbow or neck. It can also follow a tight strap or a long ride. Burning with sudden weakness, a drooping face or slurred speech is a 995 call. New numbness or weakness without those signs needs a doctor the same day.

Is pain in the left hand a sign of a heart attack?

Left hand pain on its own is usually from a nerve, tendon or joint, and it often changes when you move the hand. Pain spreading into the arm with chest pain or pressure, breathlessness, sweating or nausea can be a heart attack. Call 995 and do not wait to see if it passes.

How long does a soft tissue injury in the hand take to heal?

A mild sprain or bruise usually eases over one to three weeks. A torn ligament or tendon injury usually takes six weeks or more, and strength comes back later than comfort does. Ranges vary with the structure and your work. A hand no better after two weeks is worth having checked.

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Find out which stage you are in

Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment & Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting your hand, treats it in the same appointment, and you leave with your current stage and a written plan.

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