Differential Diagnosis for Extreme Hand Pain

• Single most likely diagnosis
  • Carpal Tunnel Syndrome: This condition is characterized by numbness, tingling, and pain in the hand, particularly in the thumb, index, and middle fingers, due to compression of the median nerve. It is a common condition that can cause extreme hand pain, especially at night or after activities that involve repetitive wrist movements.
• Other Likely diagnoses
  • Tendinitis: Inflammation of the tendons in the hand can cause significant pain, especially with movement or use of the hand. This is common in individuals who perform repetitive tasks or have poor ergonomics.
  • Arthritis (Osteoarthritis or Rheumatoid Arthritis): Both forms of arthritis can cause hand pain, stiffness, and swelling. Osteoarthritis is more common and tends to affect the joints at the base of the thumb and the fingers, while rheumatoid arthritis can cause more widespread hand pain and deformity.
  • Ganglion Cyst: A lump or mass that forms on the wrist or hand, which can cause pain, especially if it presses on a nerve.
• Do Not Miss diagnoses
  • Compartment Syndrome: A serious condition that occurs when pressure within the muscles builds to dangerous levels, cutting off blood flow and preventing nourishment and oxygen from reaching nerve and muscle cells. It requires immediate medical attention to prevent permanent damage.
  • Infection (Cellulitis or Abscess): Bacterial infections of the skin and soft tissues of the hand can cause severe pain, redness, swelling, and warmth. Prompt antibiotic treatment is necessary to prevent serious complications.
  • Nerve Injury: Trauma to the hand can result in nerve damage, leading to pain, numbness, and weakness. Early diagnosis and treatment are crucial for optimal recovery.
• Rare diagnoses
  • Raynaud’s Phenomenon: A condition that affects blood flow to the fingers and toes, and sometimes the ears, nose, and lips, causing them to turn blue or white in response to cold or stress. It can cause significant pain during episodes.
  • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can be extremely painful and is often relieved by cooling the affected area.
  • Complex Regional Pain Syndrome (CRPS): A chronic pain condition that most often affects one of the arms, legs, hands, or feet after an injury or trauma. It is characterized by intense burning or aching pain in the affected limb.