From the Guidelines
Nerve pain in hands is commonly caused by conditions that compress, irritate, or damage nerves, with carpal tunnel syndrome being the most frequent cause, and treatment depends on the cause but may include rest, splinting, anti-inflammatory medications, nerve pain medications such as gabapentin, physical therapy, and in severe cases, corticosteroid injections or surgery. The causes of nerve pain in hands can be varied, including:
- Carpal tunnel syndrome, which occurs when the median nerve is compressed at the wrist, typically causing pain and tingling in the thumb, index, middle, and half of the ring finger 1
- Cubital tunnel syndrome, which affects the ulnar nerve at the elbow, causing pain in the pinky and ring fingers
- Cervical radiculopathy, which happens when nerve roots in the neck are compressed, often from herniated discs or bone spurs, sending pain down the arm to the hand
- Peripheral neuropathy, often related to diabetes, vitamin deficiencies, or certain medications, which can cause symmetrical hand pain
- Repetitive strain injuries from overuse, arthritis causing joint inflammation near nerves, and direct trauma to nerves can also trigger hand pain
Proper diagnosis is essential for effective treatment, as addressing the underlying cause rather than just managing symptoms leads to better outcomes. Treatment options may include:
- Rest and splinting to reduce pressure on the affected nerve
- Anti-inflammatory medications like ibuprofen (400-800mg three times daily) to reduce pain and inflammation
- Nerve pain medications such as gabapentin (starting at 300mg daily and increasing as needed) to manage neuropathic pain
- Physical therapy to improve range of motion and strength
- In severe cases, corticosteroid injections or surgery may be necessary to relieve compression on the nerve. According to a recent study, gabapentinoids, serotonin-norepinephrine reuptake inhibitors (SNRIs), sodium channel blockers, tricyclic antidepressants (TCAs), and SNRI/opioid dual-mechanism agents could all be considered in the treatment of pain in diabetic peripheral neuropathy 1.
From the Research
Causes of Nerve Pain in Hands
- Nerve pain in hands can be caused by various factors, including:
- Trauma
- Iatrogenic damage
- Local peripheral nerve compression
- Nerve tumors
- Systemic diseases, such as diabetes mellitus 2
- Diabetic peripheral neuropathy is a common complication of diabetes mellitus, affecting up to 50% of patients, and can cause nerve pain in hands and feet 3, 4
- Other potential causes of nerve pain in hands include:
- Poor glycemic control
- Vitamin B12 deficiency
- Elevated blood pressure
- Obesity 3
Risk Factors
- Patients with diabetes mellitus are at higher risk of developing nerve pain in hands due to diabetic peripheral neuropathy 3, 4
- Other risk factors include:
- Poor glycemic control
- Vitamin B12 deficiency
- Elevated blood pressure
- Obesity 3
Diagnosis and Treatment
- A precise diagnosis is essential for adequate therapy and satisfactory functional results 2
- Treatment options for nerve pain in hands include: