Back of hand pain: what is the cause?

March 23, 2023 6:43 PM

When I move my arm/hand in certain ways, I experience a shooting pain across the back of my hand. This depends largely on the position of my arm, and only happens during palmar flexion or ulnar deviation/adduction (both together is worst). Is this familiar to you?

I am currently between doctors (mine just retired and finding new doctors where I live is turning out to be difficult).

The most reliable way to cause this pain is: arms up straight (rotation of the shoulder doesn't seem to matter); thumbs up (but why???); tip towards the pinky side of the hand.
Another way: arms dangling straight down; thumb position doesn't matter; flex fingers (make a loose or tight fist); flex wrist

The arm position is crucial - I can do all of these movements painlessly with a bent elbow. I am also using 'flex' to mean the opposite of 'extend'

Things that help a bit: bent elbow; hard pressure where the bicep attaches to the forearm; pressure on the extensor digitorum (or one of those extensors on the forearm such as the rad. brevis)

This is currently a minor irritation, but I would like to figure it out soonish. I don't care what it is so much as how I can fix it. I assume stretches and exercise, but... which?

My job is sedentary. I have chronic back/neck/shoulder pain (and weak muscles there). I have no (excessive) weakness in any of my fingers (extension/flexion), wrists, etc.

My best guess is a pectoralis minor/major problem but that is more due to imagination than anything concrete (I'm just trying to picture what's going on, but my intuitive sense here is not very good).

posted by Acari to Health & Fitness (7 answers total)

Best answer: Back of hand pain for me was caused by leaning my elbow on a hard surface, like a desk or a plastic chair arm. Is that something you do a lot? The pressure on the nerve can cause problems up in the hand.
posted by brook horse at 7:10 PM on March 23, 2023 [1 favorite]

Best answer: I have worked as an LMT but IANYLMT. If you were going to be getting on my massage table, I’d ask you about overall shoulder ROM, if this pain is affecting your daily activities, how long this has been going on, what kind of pain it is.

Along with seeing a doctor, you should be practicing regular self-care: stretching, strength building, regular massage, and maybe a yoga practice.
posted by computech_apolloniajames at 8:12 PM on March 23, 2023

Best answer: Does your sedentary job involve spending long hours in front of a screen? If so, is your workstation set up so that the screen is centred in your field of view and positioned so that the top edge of its display area is at your eye height? Also, do you use a wrist rest with your mouse?

Seconding everything computech_appoloniajames said.
posted by flabdablet at 2:19 AM on March 24, 2023

Best answer: I am currently between doctors (mine just retired and finding new doctors where I live is turning out to be difficult).

A physical therapist might be easier to find and possibly more helpful. (As far as doctors go you might want to look specifically for an orthopedist, or possibly an osteopath.)

Seconding that depending on the problem, massage might also help.

As far as stretches for this kind of thing go, the advice I've always gotten is to do it as gently as possible: move slowly until the point where you feel a bit of stretch, rest there until you feel the muscle relax, and then stretch forward just a bit more, instead of pushing forward as far as possible the way people normally tend to do when stretching.
posted by trig at 3:20 AM on March 24, 2023

Best answer: For stretching, ABSOLUTELY stop before the point of pain. If it hurts before you "feel a stretch," then don't feel a stretch -- stop before it hurts. (And if you find you can do less and less before it hurts, see a doctor asap.)

You can also do mobility exercises, like drawing circles with your wrists, raising and lowering your shoulders, or closing and opening your hands quickly. These shouldn't feel like a stretch at all, just they're just to keep your joints and tiny muscles active. You can find lots of them online. Sometimes it's helpful to do ones that aren't even near your painful body part: moving your back and shoulders around can start a chain reaction that gets your hands feeling better.
posted by nebulawindphone at 7:10 AM on March 25, 2023 [1 favorite]

Response by poster: After two weeks of not sitting with my arm resting on the armrest of my chair, I'd say that was probably the biggest issue.

Absolutely all of the comments here were helpful.
posted by Acari at 3:55 PM on April 15, 2023

It really is amazing just how much damage can be done by furniture whose entire reason for existence is to provide comfort, when used to do exactly that. It's a bit of a trap. Glad you sussed it.
posted by flabdablet at 12:04 AM on April 16, 2023