Finger, Hand, and Wrist Injuries
Finger, Hand, and Wrist InjuriesSkip to the navigationTopic 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) injuryAn 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 injuriesOveruse 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.
TreatmentTreatment 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 SymptomsDo 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 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 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 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, wrap the cut-off part in a clean cloth, put the wrapped part in a plastic bag, place the bag on ice to keep the digit cool 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 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? 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 Do you think the problem may be causing a fever? Some bone and joint problems can cause a fever. Are there red streaks leading away from the area or pus draining from it? 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 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.
Try Home TreatmentYou 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 TodayBased 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 NowBased 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 NowBased on your answers, you need
emergency care. Call911or 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 NowBased 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. Finger, Hand, and Wrist Problems, Noninjury Postoperative Problems Cold Temperature Exposure Home TreatmentFirst 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 injuryHome
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 careIf 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: |
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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. | 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 treatmentCall 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.
PreventionThe 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 fallsGeneral 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 abuseInjuries 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 AppointmentTo 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?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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