Hand Pain

hand pain

Hand pain can include the following conditions…


Carpal Tunnel Syndrome (CTS)

What is it?

The carpal tunnel is a canal formed between the small bones of the wrist called carpal bones and a ligament that lies across the front of the wrist.  The median nerve passes through this canal.

In Carpal Tunnel Syndrome the nerve becomes compressed within the canal.

A number of factors are linked to an increased chance of suffering with CTS:

  • Pregnancy
  • Repetitive or strenuous activities of the wrist
  • A family history of CTS
  • Diabetes

Symptoms include pins and needles, pain and/or numbness in the index and middle fingers and weakness of some muscles in the fingers and/or thumb which may cause poor grip.

Carpal tunnel syndrome is most often diagnosed by your clinician, using the history of the onset and a range of simple tests which can be carried out in the clinic. However, if there remains some doubt as to the diagnosis a nerve conduction study may be requested, which involves sending micro-currents along the median nerve to see if and where there is a disruption to the signal.

Dealing with Carpal Tunnel Syndrome

In many cases CTS will resolve with some simple self-management measures, focussing on altering your aggravating activities. In some cases measures such as wrist splints and/or steroid injects may be recommended to manage the symptoms. If triggered by pregnancy, symptoms often resolve within a few months of the baby being born, although they still may require treatment in this time.

If the measures described above do not achieve the desired effect, and symptoms become severe or there is deemed to be a chance of permanent nerve damage, surgery may be required. It is usually a straightforward procedure, and sometimes relieves symptoms entirely, although in some cases the aim will be simply to stop further progression of the condition.

De Quervain's

What is it?

De Quervain's tenosynovotis is inflammation of the sheath which surrounds the tendons at the base of the thumb. These tendons generally work to move the thumb away from the palm.

It is often caused by repetitive wrist and thumb movements.

How to deal with it?

The primary consideration is to reduce the aggravating activity, before gradually building up the use and strength of the thumb and hand. Although exercises can be useful, it is important that they are comfortable to carry out, particularly in the early stages.

This will often be enough for symptoms to resolve after a period of a few weeks to months, although in some cases the use of cold to the area, anti-inflammatories such as ibuprofen, and a thumb splint may be advised by your health care professional.


Osteoarthritis in the thumb

What is it?

Osteoarthritis in the thumb is the most common form of arthritis that affects the hands. It usually affects the joint at the base of the thumb near the wrist.

How to deal with it?

Medication and heat or cold to help control the pain can be useful. Avoidance or alteration of activities which worsen the pain can be particularly important during flare-ups. A thumb splint can be useful for some people if used in moderation.



Trigger finger or thumb

What is it?

Trigger finger or thumb is a common disorder characterised by the inability to straighten a finger or thumb fully. It can also present as catching or locking of the finger, and people often need to use their other hand to help straighten it out.

More than one finger at a time can be affected, and there can be swelling associated with the condition.

How to deal with it?

Applying heat (e.g. warm water) several times throughout the day may help. A steroid injection is often recommended if symptoms become problematic, and in a small number of cases surgery is required.

Additional Resources

Self refer into our service

It is important that you apply the advice and guidance provided above for around 8 weeks by which time we would expect you to notice improvement and in some cases complete recovery. If not, we have a team of trained physios who can help.

Self-refer into our service today

Think you need more urgent or emergency treatment? Follow the below guidance to see if you need to see someone quicker. 

Physiotherapy Triage

Physiotherapy Triage Red flag re-direction of patients to A&E/GP consultation

IMPORTANT 'Cauda Equina Syndrome’ although rare, can cause a permanent change to your bladder and/or bowel function, or foot strength.

IF you are suffering with low back pain and if you have any changes regarding the following since your pain started;

  • Bladder or bowel function (i.e., Increasing difficulty when you try to urinate, increasing difficulty when you try to stop or control your flow of urine, loss of sensation when you pass urine, leaking urine or recent need to use pads, inabilityof knowing when your bladder is either full or empty, inability to stop bowel movement or leaking, loss of sensation when you pass a bowel motion)
  • Loss of sensation/tingling around genitals, back passage, buttocks or inner thighs • Erectile or ejaculation problems or loss of sensation in genitals during sexual intercourse
  • Loss of sensation/ tingling or numbness in both legs
  • Weakness in foot (i.e. floppy foot or inability to lift front of foot when walking)

If YES call NHS 111 or go to A&E IMMEDIATELY

If you are suffering with low back pain and if you have any of the following;

  • History of cancer
  • Unexplained weight loss
  • Feeling generally unwell/fever/lack of appetite

Please contact with your GP as soon as possible to discuss if other investigations are required rather than self-referring to physiotherapy.

You can also visit your GP for more information and advice on;

  • Women's and men's health including pelvic floor and incontinence
  • If you have had a series of falls and want to learn more to help avoid them
  • If you have reduced mobility and require a stick or frame
  • If you require neurological support for example if you have had a stroke or Parkinson's
  • If you are housebound
  • If you are under 16 years old