Finger pain: described as any pain from your knuckles to the tip of your fingers. For the purpose of this article we will be discussing the index, middle, ring and little fingers. To establish where exactly your finger pain is coming from it can be very helpful identifying what structure is causing your pain. This is our field of specialty, we are the experts.
Any pain or problem in your finger will have a ripple effect on your hand, wrist and elbow. So if you are uncertain what the cause may be, rather let us have a look at it before you cause even more problems. Causes of finger pain include any of the muscles, joints, tendons or nerves in your finger, so let’s look at each of these structures:
Click here if you have pain in your thumb, the thumb will be discussed separately.
There are only two groups of muscles that extend into the fingers from the hand. One group bends the knuckles forward (lumbricals) and the other spreads the fingers apart as wells as bring them back together (interosseous).
Both groups of muscles attach onto the first bone in the fingers (closest to the palm). The lumbricals are on the palm side of the hand and the interosseous muscles are more towards back side of your hand.
Injury to these muscles can occur due to forcefully splitting the fingers apart or from trauma such as a cut to the side of the fingers.
Trauma to the muscle in the finger will cause swelling and pain due to an inflammatory process that the body naturally implements. The swelling will restrict the movement of the finger.
On the palm side of the finger there are two groups of rope-like tendons that run from the forearm to your fingertips. The Flexor Digitorum Superficialis, and Flexor Digitorum Profundus, that gives you the ability to close your fingers into a fist.
The back of the finger has the Extensor Digitorum Communis that allows you to straighten your fingers. Injuring these tendons will leave you unable to straighten your fingers.
Unfortunately the Flexor group on the palm side of the hand is more prone to injury. You can cut these tendons by either glass or a knife. Defending yourself against an incoming knife by shielding yourself with an open hand may lead to severing your flexor tendon group. Another scenario may be washing dishes and the glass breaks in your hand, or even trying to catch a falling sharp object.
Trigger finger is a common phenomenon that involves the tendon running in the finger. This leaves the finger stuck in a bent position.
A Mallet finger is when the tendon (EDC) that anchors onto the tip of the finger, rips out a piece of bone (avulsion fracture) that leaves the last joint of the finger to stay bent.
There are three branches of nerves that supply the power and feeling to your fingers. The Median nerve supplies the palm side of the Thumb, Index and middle finger. Similarly the Ulnar nerve supplies the palm side of the Ring and Little fingers. On the other side the radial nerve gives feeling to the back of your Thumb and fingers.
In most cases nerves are compressed, irritated or injured closer to the wrist, but the dominant pain, burning, shocks, cramps, tingling, pins & needles or any other nerve pain is felt at your fingertips.
A web of nerves that spreads out over your finger to give your skin feeling is present in the finger. These digital nerves are always involved when a tendon is severed, which cuts off the sensation to the skin after the laceration.
The first joint of your finger is where the finger and the hand meet, commonly known as your knuckles but medically known as the Metacarpal phalangeal joint (MCPJ for short). After that the finger can bend at two points the first, known as the Proximal Interphalangeal Joint (PIPJ). Second is the Distal Interphalangeal Joint (DIPJ).
Enlarged or swollen finger joints (mostly the DIPJ’s or PIPJ’s) is one of the clear signs of osteoarthritis. Heberden’s node’s are nodules that form on the DIPJ or PIPJ, associated with osteoarthritis, which is distinctively different from rheumatoid nodules.
When the MCPJ’s deviate from a straight position, drifting towards the outside this may be a sign of Rheumatoid arthritis.
Any swelling in a joint will lead to pain and difficulty moving the finger.
Volar Plate is a ligament that prevents your finger from hyperextending. Trying to catch a ball but the ball overextends your fingers, may rupture these sensitive yet vital ligaments.
Ulnar Collateral ligaments are ligaments on the side of the pinky that prevents your fingers dislocating towards your Thumb’s side. Radial Collateral ligaments are on the Thumb’s side of your fingers that prevent the fingers deviating towards the pinky finger. These ligaments are at every joint MCP, PIP and DIP joints.
The finger joints are more vulnerable to dislocate. Any overload and force to any of the fingers may dislocate the finger in any direction. During a dislocation it is important to note that torn ligaments are common. Ligaments are responsible to keep the MCPJ, PIPJ and DIPJ stable, if these ligaments sustain an injury, the risk of you dislocating your finger again is high. A dislocation and/or torn ligaments are associated with swelling and bruising in the finger and joints.
The bones in your fingers are called phalanges. Each finger has three phalanges. Starting at the tips the bones in your fingers are the Distal Phalanx, then the Middle Phalanx, and your Proximal phalanx that connect to your knuckles.
A fracture of the finger involves the crack or splinter of any of the three bones that makes up your finger. You may not always be sure if your finger is broken. If it’s broken and you try to bend it, it will be painful, but you’ll still be able to move it. Don’t be fooled if you can still move the finger, this does not mean the finger in not broken.
When an egg is in an upright position it is able to hold a much greater weight than when it’s turned onto its side. In the same way, when a force is applied to the finger bones at the wrong angle, it can be very fragile to break.
Types of finger pain & structures they may relate to:
Nerve pain in finger
Pins & Needles
Sharp stabbing, shooting pain
Electrical shock pain
Unable to control movement
Dead feeling over skin
Muscle pain in finger
Pain gets worse during activity
Burning or cramp like pain
Stiffness and tightness
Dull pain when stretched
Pain only at the end of range
No loss of muscle strength
Able to move your finger through the full range of movement
Joint pain in finger
Sharp sudden pain
Worse when moving as compared to static positions
Pain when doing a specific moment
Muscle tightness surrounding sharp pain
Deep pulling feeling when stretched/ moved
With or without swelling
Pinching feeling at end of range
Unable to pinpoint it to one specific spot
Dull ache over a large area
Unable to find a pain-free position
Although there are many reasons why a finger might get stuck, the most common is a trigger finger. Decreased movement can originate from the joint, tendon or ligamnets. A trigger finger is a tendon that does not glide and slide through the tendon sheeth as it should. This leaves you with a bent finger that can only go streight when pulled.
Numbness in the fingers usually relate to a nerve compression/entrapment or irritation. The feeling of numbness, pins and needles or tingling in your finger tips are signs and symptoms of nerve compression. If you are having these symptoms in your thumb, index finger and middle finger you most likely have a median nerve compression. Your ring finger and little finger (pinkie) will have these sensations with compression of the ulnar nerve.
Swelling of a finger or joint indicates an inflammatory process. The body’s natural way of healing is by a process of inflammation. Reasons for the inflammatory process can be in the joint, muscle, ligament or tendon. Trauma, arthritis or repetitive strain are all associated with swelling. In most cases swelling leads to pain and discomfort in the finger and joints.
In most cases exercising a stiff finger will improve the range of motion. However it is important to understand what is causing the stiffness and the underlying problem. This will ensure that the exercises are treating the cause and not just the symptom.
Tendon problems, inflammation in the joints or injury to the ligaments that keep the joint stable can cause joint pain in your fingers. It is best to determine the structure involved in causing the pain or swelling. Identifying the cause will assist you in the best treatment for the pain.