Hand Pain – Causes of Back of Hand and Palm Surface Pains

We do not realize just how versatile and highly functional our hands are yet it is one of the most hard working parts of the body. It is only when a problem arises like pain, stiffness or weakness. Hand pain is a common problem that most of us will experience from time to time. In many instances it is a temporary symptom that is due to strain and will quickly resolve. However, there are instances where hand pain is due to a chronic and sometimes serious medical condition.

Hand pain can be caused by injury, inflammation, infection, overuse and degeneration of any of the structures of the hand. Hand pain may either be localized to a particular region or be felt across the entire hand area. The pain may be mild or severe. The nature of the pain differs based on the cause: the pain may be described as throbbing, aching, piercing, or burning sensations. In some cases, the pain may not be restricted only to the hand region. Wrists, forearms and arms may also be painful.

Parts of the Hand

It is important to understand the different parts of the hand to further understand the reasons for pain and where it may be originating. Our hands are complicated structures formed by the integration of various components: bones, ligaments, muscles, tendons, nerves, blood vessels, nails and skin.

The structure of our hand is divided into two distinct surfaces: the palmar surface and the dorsal surface. The palmar surface of the hand refers to the front part of the hand (the palms). The fingers of the hand fold in the direction of the palmar surface. The dorsal surface of the hand refers to the back of the hand. The knuckles of the fingers are present on this surface. The palmar surface is lighter in complexion compared to the dorsal surface of the hand.

Our hands and fingers are capable of multiple types of movements. These are made possible through the presence of numerous joints between the bones of the hands. The following are the main joints of the hands:

  • Wrist joint: The wrist joint connects the hand to the forearm. It is formed by eight small bones known as carpal bones.
  • Carpometacarpal joint: The bones of the palm (the long metacarpal bones) articulate with some of the carpal bones of the wrist at the carpometacarpal joints.
  • Metacarpophalangeal joint: These joints are articulation points of the metacarpal bones of the palms and the phalanges (finger bones).
  • Interphalangeal joint: The bones that constitute the fingers articulate with each other at the interphalangeal joints within the fingers.

All the joints described above are held together through strong ligaments. These ligaments determine the range of motion that is available at each joint. For example, the collateral ligaments present at the sides of the fingers prevent lateral bending at the interphalangeal joints. The movement of bones is coordinated by various muscles in the hand and in the forearms. The muscles are connected to the bones of the hands through rope-like structures known as tendons. The hand is also supplied by three main nerves: radial, ulnar, and median nerves.

Other Symptoms

Hand pain is a symptom which may or may not occur alone. Other signs and symptoms that may accompany hand pain are as follows:

  • A feeling of tingling and numbness may be felt in the hands.
  • Bruises may be seen on the hand region where pain is localized.
  • Burns, lacerations and other injuries may be evident.
  • The skin of the hands may be pale or discolored.
  • Abnormal hot or cold sensations may be felt in the affected hand.
  • Redness and swelling may be seen in the region of the pain.
  • Hand movements may become restricted to various degrees.
  • Hand strength may be affected, resulting in weak gripping power.
  • Joints of the hand and the wrist may be stiff.
  • Painful hands may have a deformity.
  • Fever, sore-throat and other flu-like symptoms may also occur.
  • There may be signs of muscle wasting.

Also read on hand weakness.

Causes of Hand Pain

The common causes of hand pain have been discussed below. However, hand pain may occur as a symptoms of many diseases, sometimes even without any damage or inflammation of the tissues in the hand.


Injury to hands is one of the most common causes of hand pain. The trauma may involve any of the structures of the hand: tendons, ligaments, bones, muscles, nerves and blood vessels. The signs of injury may or may not be obvious.

Apart from injury caused by blunt or sharp trauma, fractures, and presence of foreign bodies, hand pain may also result from overuse of hands in certain activities. This usually happens when a person is doing tasks that require repetitive hand motions over a long period of time (for example, typing, writing, catching a ball, and sewing).

Strain and inflammation of tendons (called tendonitis) also cause hand pain. Sometimes, injury and pain in the hand may be a result of surgery. Both pain may be post-operative pain or a result of accidental damage to the structures of hand during surgery.

Nerve problems

Compression or damage to nerves of the hand also result in hand pain. A common example is carpal tunnel syndrome, caused by compression of the median nerve within the carpal tunnel of the wrist. The usual cause of carpal tunnel syndrome is repetitive hand motions (such as in typing or keyboarding). However, it can also occur in conditions such as obesity, diabetes, rheumatoid arthritis, hypothyroidism, and pregnancy. Other nerve problems that may result in hand pain include cervical spondylosis and peripheral neuropathy.

Joint problems

Hand movements depend on the proper functioning of the numerous joints in the hand. Joint problems caused by conditions such as rheumatoid arthritis, osteoarthritis, and septic arthritis may reduce joint mobility and cause pain in the joints of the hands.

Circulatory problems

Any disruption of blood flow through the arm can result in pain. It is usually due to a blood clot that may block an artery resulting in acute limb ischemia. Sometimes this clot may arise after a medical procedure like with the insertion and removal of an IV drip. Another circulatory problem is Raynaud phenomenon where the blood vessels in the hand suddenly narrow thereby reducing blood flow to the hand. This is due to temporary spasm of the blood vessel muscles.


Various infections may also cause hand pain. Examples include cellulitis (affects subcutaneous tissue), paronychia (affects region around the fingernails), infections via animal bite wounds, and felon (infection of pulp space of the fingertips).

Skin diseases

Several skin diseases may present with pain in addition to common skin symptoms like itching and a rash. Contact dermatitis is a common skin condition that may present with pain particularly when the hand has been exposed to harsh substances, including abrasives and strong acids or alkalis.

Also read on dishpan hands.

Other causes

There are various other causes that can cause hand pain. Examples include ganglion cyst, tumors, Dupuytren’s contracture, myocardial infarction  (heart attack) and Buerger’s disease.

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