Finger, Hand, and Wrist Injuries

Topic Overview

Bones of the elbow At one time or another, everyone has had a minor injury to a finger, hand, or wrist that caused pain or swelling. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or an injury.

Finger, hand, or wrist injuries most commonly occur during:

  • Sports or recreational activities.
  • Work-related tasks.
  • Work or projects around the home, especially if using machinery such as lawn mowers, snow blowers, or hand tools.
  • Accidental falls.
  • Fistfights.

The risk of finger, hand, or wrist injury is higher in contact sports, such as wrestling, football, or soccer, and in high-speed sports, such as biking, in-line skating, skiing, snowboarding, and skateboarding. Sports that require weight-bearing on the hands and arms, such as gymnastics, can increase the risk for injury. Sports that use hand equipment such as ski poles, hockey or lacrosse sticks, or racquets also increase the risk of injury.

In children, most finger, hand, or wrist injuries occur during sports or play or from accidental falls. Any injury occurring at the end of a long bone near a joint may injure the growth plate (physis) and needs to be evaluated.

Older adults are at higher risk for injuries and fractures because they lose muscle mass and bone strength (osteopenia) as they age. They also have more problems with vision and balance, which increases their risk of accidental injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve symptoms and promote healing.

Sudden (acute) injury

An acute injury may occur from a direct blow, a penetrating injury, or a fall, or from twisting, jerking, jamming, or bending a limb abnormally. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries include:

Overuse injuries

Overuse injuries occur when too much stress is placed on a joint or other tissue, often by "overdoing" an activity or repeating the same activity. Overuse injuries include the following:

  • Carpal tunnel syndrome is caused by pressure on a nerve (median nerve) in the wrist. The symptoms include tingling, numbness, weakness, or pain of the fingers and hand.
  • Tendon pain is actually a symptom of tendinosis, a series of very small tears (microtears) in the tissue in or around the tendon. In addition to pain and tenderness, common symptoms of tendon injury include decreased strength and movement in the affected area.
  • De Quervain's disease can occur in the hand and wrist when tendons and the tendon covering (sheath) on the thumb side of the wrist swell and become inflamed.

Treatment

Treatment for a finger, hand, or wrist injury may include first aid measures; medicine; "buddy-taping" for support; application of a brace, splint, or cast; physical therapy; and in some cases, surgery. Treatment depends on:

  • The location, type, and severity of the injury.
  • How long ago the injury occurred.
  • Your age, health condition, and activities (such as work, sports, or hobbies).

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a finger, hand, or wrist injury?
Yes
Finger, hand, or wrist injury
No
Finger, hand, or wrist injury
How old are you?
Less than 5 years
Less than 5 years
5 years or older
5 years or older
Are you male or female?
Male
Male
Female
Female
Has it been more than a month since the finger, hand, or wrist injury?
Yes
Finger, hand, or wrist injury over a month ago
No
Finger, hand, or wrist injury over a month ago
Have you had finger, hand, or wrist surgery in the past month?
If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.
Yes
Fingers, hand, or wrist surgery in the past month
No
Fingers, hand, or wrist surgery in the past month
Do you think that any of your fingers might have frostbite?
Yes
Cold temperature exposure
No
Cold temperature exposure
Have you had a major trauma in the past 2 to 3 hours?
Yes
Major trauma in past 2 to 3 hours
No
Major trauma in past 2 to 3 hours
Do you have severe bleeding that has not slowed down with direct pressure?
Yes
Severe bleeding
No
Severe bleeding
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Are you having trouble moving your fingers or hand normally?
Pain or swelling can limit movement.
Yes
Difficulty moving fingers or hand
No
Difficulty moving fingers or hand
Can you move the fingers, hand, and wrist at all?
Yes
Able to move the fingers, hand, and wrist
No
Unable to move the fingers, hand, and wrist
Have you had trouble moving the fingers, hand, or wrist for more than 2 days?
Yes
Difficulty moving hand for more than 2 days
No
Difficulty moving hand for more than 2 days
Is there any pain in the fingers, hand, or wrist?
Yes
Pain in fingers, hand, or wrist
No
Pain in fingers, hand, or wrist
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
5 to 10: Moderate to severe pain
Moderate to severe pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is increasing
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is improving
Do you have any pain in your fingers, hand, or wrist?
Yes
Finger, hand, or wrist pain
No
Finger, hand, or wrist pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is getting worse
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is getting better
Has the pain lasted for more than 2 days?
Yes
Pain for more than 2 days
No
Pain for more than 2 days
Is your hand blue, very pale, or cold and different from the other hand?
If the hand or arm is in a cast, splint, or brace, follow the instructions you got about how to loosen it.
Yes
Hand is blue, very pale, or cold and different from other hand
No
Hand is blue, very pale, or cold and different from other hand
Is any part of a finger partially or completely cut off?
Yes
Part of finger cut off
No
Part of finger cut off
Is it more than the tip of the finger or more than half the size of a dime, or can you see the bone?
Gently wash off any dirt, put the cut-off part and some ice in a clean, dry bag (like a plastic freezer bag), and bring it to the hospital.
Yes
More than tip of finger severed
No
More than tip of finger severed
Was the finger or wrist twisted or bent out of its normal position, even if it is back in its normal position now?
Yes
Finger or wrist is or was dislocated
No
Finger or wrist is or was dislocated
Is the finger or hand trapped in something, like a jar or a toy?
Yes
Trapped finger or hand
No
Trapped finger or hand
Is there an object stuck in your finger or hand, and you can't get it out?
This could be something like a nail, a needle, or a large piece of wood, metal, or plastic.
Yes
Embedded object in finger or hand
No
Embedded object in finger or hand
Has your hand or finger been injected with something under high pressure, like oil or paint from a sprayer?
Yes
Hand or finger injected with something under high pressure
No
Hand or finger injected with something under high pressure
Is there any swelling or bruising?
Yes
Swelling or bruising
No
Swelling or bruising
Did you have swelling or bruising within 30 minutes of the injury?
Yes
Swelling or bruising within 30 minutes of injury
No
Swelling or bruising within 30 minutes of injury
Has swelling lasted for more than 2 days?
Yes
Swelling for more than 2 days
No
Swelling for more than 2 days
Do you have weakness, numbness, or tingling in your arm or hand that has lasted more than an hour?
Weakness is being unable to use the arm or hand normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness.
Yes
Numbness, weakness, or tingling for more than 1 hour
No
Numbness, weakness, or tingling for more than 1 hour
Do you think that the injury may have been caused by abuse?
Yes
Injury may have been caused by abuse
No
Injury may have been caused by abuse
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Do you think the problem may be causing a fever?
Some bone and joint problems can cause a fever.
Yes
Possible fever
No
Possible fever
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Do you think you may need a tetanus shot?
Yes
May need tetanus shot
No
May need tetanus shot
Have you had symptoms for more than a week?
Yes
Symptoms for more than a week
No
Symptoms for more than a week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Finger, Hand, and Wrist Problems, Noninjury

With severe bleeding, any of these may be true:

  • Blood is pumping from the wound.
  • The bleeding does not stop or slow down with pressure.
  • Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

  • The bleeding slows or stops with pressure but starts again if you remove the pressure.
  • The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

  • The bleeding stops on its own or with pressure.
  • The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

  • Passing out.
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children 3 years and older

  • Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
  • Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

Major trauma is any event that can cause very serious injury, such as:

  • A fall from more than 10 ft (3.1 m) [more than 5 ft (1.5 m) for children under 2 years and adults over 65].
  • A car crash in which any vehicle involved was going more than 20 miles (32 km) per hour.
  • Any event that causes severe bleeding that you cannot control.
  • Any event forceful enough to badly break a bone.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Symptoms of shock in a child may include:

  • Passing out.
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.
Postoperative Problems
Cold Temperature Exposure

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

  • For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
    • You haven't had a tetanus shot in the past 5 years.
    • You don't know when your last shot was.
  • For a clean wound, you may need a shot if:
    • You have not had a tetanus shot in the past 10 years.
    • You don't know when your last shot was.

Home Treatment

First aid for a suspected broken bone

  • If a bone is sticking out of the skin, do not try to push it back into the skin. Cover the area with a clean bandage.
  • Control bleeding.
  • Remove all rings or bracelets. It may be hard to remove the jewelry once swelling occurs, which in turn can cause other serious problems, such as nerve compression or restricted blood flow.
  • Free a trapped finger or hand from an object, such as a pipe, toy, or jar.
  • Splint the injured area without trying to straighten the injured limb. Loosen the wrap around the splint if signs develop that indicate the wrap is too tight, such as numbness, tingling, increased pain, swelling, or cool skin below the wrap. A problem called compartment syndrome can develop.

Home treatment for a sore or sprained finger

  • Use rest, ice, compression, and elevation (RICE) for pain and swelling.
  • If you do not have diabetes or peripheral arterial disease, a sore or sprained finger can be "buddy-taped" to the uninjured finger next to it. Protect the skin by putting some soft padding, such as felt or foam, between your fingers before you tape them together. The injured finger may need to be buddy-taped for 2 to 4 weeks to heal. If your injured finger hurts more after you have buddy-taped it, remove the tape. Then check your symptoms again. Caution: Never splint a finger in a completely straight position, such as on a Popsicle stick. For proper healing, the finger should be slightly bent and in a relaxed position.
  • Stop, change, or take a break from activities that cause your symptoms.

Home treatment for a minor hand or wrist injury

Home treatment may help relieve pain, swelling, and stiffness.

  • Remove all rings, bracelets, or any other jewelry that goes around a finger or wrist. It will be harder to remove the jewelry later if swelling increases.
  • Use rest, ice, compression, and elevation (RICE) for pain and swelling.
  • Do not use your injured hand or wrist for the first 24 hours after an injury, if possible. An elastic bandage can help decrease swelling. The wrap will also remind you to rest the injured hand or wrist. A wrist splint can help support an injured wrist. Talk to your doctor if you think you need to use a splint or bandage for more than 48 to 72 hours.
  • Gently massage or rub the area to relieve pain and encourage blood flow. Do not massage the injured area if it causes pain.
  • For the first 48 hours after an injury, avoid things that might increase swelling, such as hot showers, hot tubs, hot packs, or alcoholic beverages.
  • After 48 to 72 hours, if swelling is gone, apply heat and begin gentle exercise with the aid of moist heat to help restore and maintain flexibility. Some experts recommend alternating between heat and cold treatments.
  • Treat blisters.

Cast and splint care

If a cast or splint is applied, be sure to keep it dry and to try to move your extremity as normally as possible to help maintain muscle strength and tone. Your doctor will give you instructions on how to care for your cast or splint.

Do not smoke or use other tobacco products. Smoking slows healing, because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Smoking.

Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Pain or swelling develops.
  • Signs of infection develop.
  • Numbness; tingling; or cool, pale skin develops.
  • Symptoms do not improve with home treatment.
  • Symptoms become more severe or frequent.

Prevention

The following tips may prevent finger, hand, and wrist injuries.

  • Do exercises that strengthen your hand and arm muscles.
  • Learn safe hand and wrist movements to avoid an injury.
  • Reduce the speed and force of repetitive movements in activities such as hammering, typing, knitting, quilting, sweeping, raking, playing racquet sports, or rowing.
  • Change positions when you hold objects, such as a book or playing cards, for any length of time.
  • Use your whole hand to grasp an object. Gripping with only your thumb and index finger can stress your wrist.
  • Consider wearing gloves that support the wrist and have vibration-absorbing padding when working with tools that vibrate.
  • Use safety measures, such as gloves, and follow instructions for the proper use of hand and power tools.
  • Use caution when using knives in preparing food or craft activities. Supervise a child using knives or sharp scissors in craft activities.
  • Wear protective gear, such as wrist guards, in sports activities. Be sure to learn what you can do to help prevent injuries for your child too.
  • Review your work posture and body mechanics.
    • Organize your work so that you can change your position occasionally while maintaining a comfortable posture.
    • Position your work so you do not have to turn excessively to either side.
    • Keep your shoulders relaxed when your arms are hanging by your sides.
    • When using a keyboard, keep your forearms parallel to the floor or slightly lowered, and keep your fingers lower than your wrists. Allow your arms and hands to move freely. Take frequent breaks to stretch your fingers, hands, wrist, shoulders, and neck. If you use a wrist pad during breaks from typing, it's best to rest your palm or the heel of your hand on the support, rather than your wrist.

Reduce falls

General prevention tips

  • Wear your seat belt in a motor vehicle.
  • Don't carry objects that are too heavy.
  • Use a step stool. Do not stand on chairs or other unsteady objects.
  • Wear protective gear during sports or recreational activities, such as roller-skating or soccer. Supportive splints, such as wrist guards, may reduce your risk for injury.
  • Warm up well and stretch before any activity. Stretch after exercise to keep hot muscles from shortening and cramping.
  • Use the correct techniques (movements) or positions during activities so that you do not strain your muscles.
  • Avoid overusing your hand and wrist doing repeated movements that can injure your bursa or tendon. In daily routines or hobbies, examine activities in which you make repeated arm movements.
  • Consider taking lessons to learn the proper techniques for sports. Have a trainer or person who is familiar with sports equipment check your equipment to see if it is well-suited for your level of ability, body size, and body strength.
  • If you feel that certain activities at your workplace are causing pain or soreness from overuse, talk to your human resources department for information on other ways of doing your job or to discuss equipment modifications or other job assignments.

Keep your bones strong

  • Eat a nutritious diet with enough calcium and vitamin D, which helps your body absorb calcium. Calcium is found in dairy products, such as milk, cheese, and yogurt; dark green, leafy vegetables, such as broccoli; and other foods.
  • Exercise and stay active. It is best to do weight-bearing exercise, such as walking, jogging, stair climbing, dancing, or lifting weights, for 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. In addition to weight-bearing exercise, experts recommend that you do resistance exercises at least 2 days a week. Talk to your doctor about an exercise program that is right for you. Begin slowly, especially if you have not been active. For more information, see the topic Fitness.
  • Don't drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman. People who drink more than this may be at higher risk for weakening bones (osteoporosis). Alcohol use also increases your risk of falling and breaking a bone.
  • Don't smoke or use other tobacco products. Smoking puts you at a much higher risk of developing osteoporosis. It also interferes with blood supply and healing. For more information, see the topic Quitting Smoking.

Possible abuse

Injuries such as bruises, burns, fractures, cuts, or punctures may be a sign of abuse. Suspect possible abuse when an injury cannot be explained or does not match the explanation, repeated injuries occur, or the explanations for the cause of the injury change. You may be able to prevent further abuse by reporting it and seeking help.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What are your main symptoms?
  • How long have you had your symptoms?
  • How and when did an injury occur? How was it treated?
  • Have you had any injuries in the past to the same area?
    • Was your injury evaluated by a doctor? What was the diagnosis?
    • How was your injury treated?
    • Do you have any continuing problems because of the previous injury?
  • What activities, related to sports, work, or your lifestyle, make your symptoms better or worse?
  • Do you think that activities related to your job or hobbies caused your symptoms?
  • What home treatment measures have you tried? Did they help?
  • What nonprescription medicines have you tried? Did they help?
  • Do you have any health risks?

Credits

By Healthwise Staff
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
David Messenger, MD
Last Revised October 11, 2012

Last Revised: October 11, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

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