Hand Pain, Numbness, or Stiffness? Understanding Common Hand and Wrist Conditions

Hand pain and numbness can affect nearly every part of daily life. Whether you are experiencing tingling, weakness, stiffness, or ongoing discomfort, understanding the cause is the first step toward finding the right treatment for your hand pain and numbness.

These symptoms can make it difficult to type, drive, work, sleep, open a jar, hold a coffee cup, or participate in the activities you enjoy. The challenge is that similar symptoms can come from very different conditions.

Tingling in the thumb may point to one problem, while numbness in the little finger may indicate another. Pain near the base of the thumb could be caused by arthritis, tendon inflammation, or an injury.

Matthew L. Jones, MD, is a board-certified orthopaedic surgeon at Columbia Orthopaedic Group who specializes in conditions affecting the hand, wrist, elbow, and upper extremity. Dr. Jones has cared for patients at Columbia Orthopaedic Group since 2013.

"Your hands are how you interact with the world," Dr. Jones explains. "They are an extension of your brain."

Although many people associate hand specialists primarily with carpal tunnel syndrome, Dr. Jones treats a much wider range of conditions involving bones, joints, ligaments, tendons, nerves, and soft tissue.

Below are several of the most common causes of hand pain, numbness, stiffness, and weakness.

Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve becomes compressed as it travels through a narrow passageway in the wrist called the carpal tunnel.

The tendons that move the fingers also pass through this space. Inflammation or swelling inside the tunnel can increase pressure on the nerve.

Symptoms most often affect the thumb, index finger, middle finger, and part of the ring finger. Patients may experience:

• Numbness
• Tingling
• Burning
• Electric-shock sensations
• Weakness when gripping
• Difficulty holding or picking up objects

"Patients tend to notice the symptoms more at night," says Dr. Jones. "They may also notice them while driving, holding a phone, using a blow dryer, gripping, or working with vibrating tools."

Severe or longstanding carpal tunnel syndrome can cause weakness or muscle loss near the base of the thumb. Some people begin dropping objects or struggling with fine motor tasks.

Treatment usually begins conservatively. A wrist brace worn at night can keep the wrist in a neutral position and reduce pressure on the nerve.

Anti-inflammatory medications may help when medically appropriate, and a corticosteroid injection may reduce swelling inside the tunnel.

If symptoms continue or nerve compression becomes severe, carpal tunnel release surgery may be recommended. During this procedure, the ligament forming the roof of the tunnel is released to create more room for the nerve.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is another nerve compression condition, but it involves the ulnar nerve at the inside of the elbow. This is the nerve commonly known as the "funny bone" nerve.

Unlike carpal tunnel syndrome, cubital tunnel syndrome typically causes numbness and tingling in the little finger and the adjacent side of the ring finger.

Symptoms may become worse when the elbow remains bent for extended periods, such as while:

• Sleeping
• Driving
• Holding a phone
• Working at a desk
• Resting the elbow on an armrest

"When the elbow is straight, the nerve is relatively loose," Dr. Jones explains. "When the elbow is bent, the nerve becomes tight. Prolonged elbow flexion can stretch and irritate it."

Advanced cases can weaken the small muscles within the hand. This may cause reduced grip strength, difficulty buttoning clothing, clumsiness, or problems with other fine motor tasks.

Initial treatment may include changes in activity, an elbow pad, or nighttime positioning to prevent the elbow from bending completely.

When nerve compression is severe or persistent, surgery may be needed to release pressure on the nerve.

Trigger Finger

Despite its name, trigger finger is not a nerve condition. It is a form of tendon inflammation.

The tendons that bend the fingers travel through small loops of tissue called pulleys. If a tendon becomes swollen or develops a nodule, it may have trouble gliding smoothly through the pulley.

The finger may initially feel sore or stiff. It may then begin to click, catch, or lock in a bent position.

In more advanced cases, the finger may become difficult or impossible to straighten without using the other hand.

"Trigger finger can start as pain without any catching," says Dr. Jones. "It may progress to clicking or locking, although patients do not always move through those stages in order."

A corticosteroid injection can be highly effective for many patients.

Dr. Jones estimates that, in his experience, approximately 80% of patients may receive lasting relief from the first injection. Patients with diabetes may be less likely to respond fully and may develop trigger finger in multiple fingers.

If an injection does not provide adequate relief, a short procedure can release the tight pulley, allowing the tendon to move freely again.

De Quervain's Tenosynovitis

De Quervain's tenosynovitis is inflammation of the tendons along the thumb side of the wrist.

The pain is usually localized and may worsen with lifting, gripping, pinching, or moving the thumb.

Unlike carpal tunnel syndrome, which often causes tingling or more generalized wrist discomfort, De Quervain's is typically tender when pressure is applied directly over the affected tendons.

"It is common for someone with De Quervain's to be able to point directly to the painful area," Dr. Jones says.

The condition is more common in women and may develop in parents, grandparents, or other caregivers who frequently lift infants.
Treatment may include:

• Anti-inflammatory medication
• Activity modification
• A brace that supports the wrist and thumb
• A corticosteroid injection

Surgery may be considered when conservative treatments do not provide relief.

Thumb CMC Arthritis

Thumb carpometacarpal, or CMC, arthritis affects the joint at the base of the thumb.

This joint allows the thumb to move across the palm and perform essential pinching and gripping motions.

Patients commonly notice pain when:

• Opening jars
• Turning keys
• Opening doors
• Shaking hands
• Squeezing objects
• Pinching or gripping

Advanced arthritis may cause pain even when the hand is resting.

"Thumb CMC arthritis is a degenerative condition," Dr. Jones explains. "The cartilage wears down, and the joint can eventually become bone on bone."

Treatment often begins with anti-inflammatory medications, splinting, activity modifications, and corticosteroid injections.

Injections do not reverse the arthritis, but they may provide several months of meaningful relief.

When pain becomes severe and conservative care is no longer effective, CMC arthroplasty may be considered. The procedure removes the damaged trapezium bone and reconstructs the base of the thumb.

"The advantage of this procedure is that we can address the pain while preserving motion," says Dr. Jones. "Patients do not necessarily have to sacrifice movement to get relief."

When to Seek Hand Pain and Numbness Treatment

Not every sore hand or stiff wrist requires surgery or immediate medical treatment. However, worsening symptoms should not be ignored.

Dr. Jones recommends scheduling an evaluation when pain, numbness, weakness, or stiffness:

• Continues to get worse
• Interferes with sleep
• Makes work or daily activities difficult
• Causes a noticeable loss of motion
• Leads to weakness or dropping objects
• Does not improve with rest or activity changes

"If a hand problem is getting worse with time, it is better to have it evaluated," he says. "That helps make sure it is not something we need to catch earlier rather than later."

A proper examination can help determine whether symptoms are coming from a nerve, tendon, joint, ligament, or bone.

Depending on the problem, an evaluation may also include X-rays, nerve conduction testing, or other diagnostic imaging.

Do All Hand and Wrist Conditions Require Surgery?

No. Many hand and wrist conditions can initially be treated without surgery.

Depending on the diagnosis and severity of the symptoms, treatment may include:

• Rest
• Activity modification
• Bracing or splinting
• Hand therapy
• Anti-inflammatory medication
• Corticosteroid injections
• Home exercises

Surgery may be considered when symptoms persist despite conservative treatment, nerve function is at risk, or the condition significantly affects a patient's quality of life.

The goal is to understand the cause of the symptoms and choose the most appropriate treatment, rather than assuming surgery is always necessary.

Hand Pain and Numbness Treatment in Columbia, MO

Patients looking for hand pain and numbness treatment in Columbia, MO can meet with Dr. Matthew Jones and the hand and upper extremity team at Columbia Orthopaedic Group.

The team provides evaluation and treatment for conditions affecting the:

• Fingers
• Hand
• Wrist
• Forearm
• Elbow
• Upper extremity

Treatment may include bracing, therapy, injections, medication, activity modifications, or surgery when necessary.

Get Answers About Your Hand or Wrist Symptoms

You do not have to keep guessing about what is causing your hand pain, numbness, tingling, stiffness, or weakness.

Dr. Matthew Jones and the hand and upper extremity team at Columbia Orthopaedic Group can help identify the source of your symptoms and explain your treatment options.

Schedule an evaluation today and get clear answers about your hand or wrist symptoms.

Call or text Columbia Orthopaedic Group at 573-443-2402 to schedule an appointment with Dr. Jones's team.

For an injury or another orthopaedic problem that should not wait, the Orthopaedic Urgent Care Hub offers walk-in access, on-site imaging, and a direct path to specialized orthopaedic care when needed.