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Finger, Hand, and Wrist Injuries
Topic Overview
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:
- Bruises. After a wrist or hand injury, bruising may extend to the fingers from the effects of gravity.
- Injuries to ligaments, such as a skier's thumb injury.
- Injuries to tendons, such as mallet finger.
- Injuries to joints (sprains).
- Pulled muscles (strains).
- Broken bones (fractures), such as a wrist fracture.
- Dislocations.
- Crushing injury, which can lead to compartment syndrome.
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
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.
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.
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.
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 large bone (like an arm bone or leg bone).
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.
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.
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.
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.
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 quickly occur after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
- Passing out (losing consciousness).
- 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.
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 (losing consciousness).
- 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.
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.
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.
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.
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.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
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.
Call 911 or other emergency services now.
Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.
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.
Try a nonprescription medicine to help treat your pain: |
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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. |
Be sure to follow these safety tips when you use a nonprescription medicine: |
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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
- Take steps to prevent falls and injuries in adults, such as removing any obstacles from your walking path.
- Take steps to prevent falls and injuries in babies and toddlers, such as not leaving your baby unattended in any infant seat or "sitting" toy.
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
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?
Related Information
Credits
ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Kathleen Romito, MD - Family Medicine
Adam Husney, MD - Family Medicine
Current as ofNovember 20, 2017
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Current as of: November 20, 2017