Causes and treatments for stiff fingers

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A person may notice that the stiffness in their fingers is worse in the morning. The sections below outline some conditions that cause stiff fingers in the morning.

Osteoarthritis

Osteoarthritis is a form of arthritis that results in inflammation around the joints. It affects over 32.5 million adults in the United States.

This condition is a result of the joint cartilage between bones breaking down or sustaining damage. The prolonged lack of movement during sleep can cause the joints to tighten up.

Other symptoms that a person with osteoarthritis may experience include:

• joint pain that ranges from mild to severe
• swelling
• tenderness
• stiffness after getting out of bed
• decreased range of motion
• decreased flexibility

According to the American Society for Surgery of the Hand, osteoarthritis of the hands commonly affects:

• the base of the thumb joint
• the joints closest to the fingertips
• the middle joint of the fingers

Along with the fingers, a person may notice that osteoarthritis affects the lower back, the neck, and joints such as the knees, hips, and feet.

Rheumatoid arthritis

Rheumatoid arthritis is another form of arthritis. It is an autoimmune and inflammatory condition, which means that the immune cells within the body attack healthy cells and cause inflammation in certain parts of the body.

A person may experience stiff fingers and general stiffness in the morning that can last for several hours. The condition commonly affects the wrist and finger joints. A unique symptom of rheumatoid arthritis is the fingers drifting away from the thumb.

The fingers may also change shape, such as the middle finger being overextended and bent. A doctor may refer to this as a Boutonniere deformity or a swan-neck deformity. A person with rheumatoid arthritis may also have difficulty bending their fingers.

Some other signs and symptoms of rheumatoid arthritis include:

• pain and stiffness in more than one joint
• tenderness and swelling in more than one joint
• fever
• fatigue
• weakness
• weight loss
• the same symptoms on both sides of the body

Trigger finger

Trigger finger, or tenosynovitis, occurs when the fluid within the protective sheath around the tendons in the affected finger experiences inflammation. Trigger finger commonly affects the ring finger and thumb, but it can affect any of the other fingers.

This condition may lead to difficulty moving the affected joint as well as:

• pain when bending or straightening the finger
• flushing
• swelling
• the affected finger becoming stuck in a bent position
• a tender lump at the base of the finger on the palm side of the hand
• a catching, popping, or locking sensation with finger movement

Some potential causes of trigger finger include:

• autoimmune conditions such as rheumatoid arthritis and diabetes
• overuse of the affected joint, or repetitive strain injury
• infectious organisms, such as methicillin resistant Staphylococcus aureus or Staph infections

There may also be no established cause of trigger finger.

According to the American Academy of Orthopaedic Surgeons, the stiffness and locking of the affected finger are often worse after long periods of inactivity, such as in the morning after waking up.

Dupuytren contracture

Dupuytren contracture is a condition that affects the fascia of the hands, which is the connective tissue that surrounds the bones. The condition most commonly affects the ring and pinky fingers, and it is most common in the morning.

The type of collagen normally present in the hand is type 1 collagen. However, in Dupuytren contracture, this is replaced by type 3 collagen. This results in changes in hand mobility and grip strength.

Nodules form along the lines of the tendons, which eventually produce cords that result in contracture deformities.

A person with Dupuytren contracture may feel the nodules on the palm side. The cords thicken and shorten, resulting in a loss of range of motion in the hands. The affected fingers may contract, and it may be difficult to straighten them.

Alternatively, a person may experience stiff fingers at night. The following sections look at some conditions that cause stiff fingers at night.

Carpal tunnel syndrome

Carpal tunnel syndrome occurs when the nerve that runs from the forearm into the palm, called the median nerve, experiences pressure or constriction at the wrist.

A person with carpal tunnel syndrome may experience frequent numbness or a tingling sensation in the fingers, especially in the thumb, index finger, and middle finger.

Symptoms often present at night when lying down and normally get better during the day. However, as the condition progresses, a person with carpal tunnel syndrome may also experience symptoms during the day — especially during repetitive actions.

Hand tendonitis

Tendonitis occurs when there is inflammation and swelling of the tendons. It occurs as a result of repetitive activities such as playing sports and engaging in manual labor.

A person with hand tendonitis may experience pain just outside of the joint, especially when moving the joint. They may also experience swelling in the affected area.

A person may develop carpal tunnel syndrome during pregnancy. Pregnancy-related carpal tunnel syndrome occurs as a result of hormones retaining fluid. The fluid softens the ligament in the tunnel of the wrist, which can compress the median nerve.

This condition causes symptoms such as:

• a tingling sensation in the fingers
• numbness
• stiffness
• weakness
• a burning sensation in the fingers
• sharp shooting pains from the wrist
• a pain that radiates into the arm and shoulder
• pain that is worse at night

Stiff fingers can also occur due to causes that are not specific to a time of day. For example, a person may experience stiff fingers as a result of a hand injury, such as:

• a fracture
• a sprain
• a bad strain
• an injury to a tendon or muscle
• dislocation

Symptoms that may accompany a hand injury include:

• pain
• swelling
• flushing
• a sensation of warmth in the affected area
• bruising

When diagnosing the cause of finger stiffness, the doctor will likely ask about the person’s activity levels and symptoms. They may also ask about any injuries that occurred in the days leading up to the appointment.

They will also perform a physical examination to check the range of motion and assess the symptoms.

Imaging tests such as X-rays are a regular part of the process. Looking at the underlying structures in the hand can help the doctor identify anything irregular, such as damage.

In some cases, a doctor may use a CT or MRI scan to get a closer look at the structures in the hand.

The treatment options that will be available to a person with stiff fingers will depend on the cause of the stiffness.

Almost all causes of stiff fingers will benefit from anti-inflammatory medications, such as ibuprofen.

A doctor will likely recommend a range of self-care methods and home remedies before considering alternative treatments, such as steroids or surgery.

Hand stretches are an important part of treatment, and they may help prevent or ease stiffness.

Various stretches can help promote full hand function and a full range of motion. For example, a 2017 study found that participants with rheumatoid arthritis had improved hand function after practicing hand exercises. Although long-term adherence to stretching exercises can be difficult, it is crucial for improving hand function.

Hand and finger stretches are not a replacement for treatment, but, in many cases, they can be complementary.

Depending on the cause of stiffness, the doctor may recommend specific exercises. A person should follow the guidance of a doctor or physical therapist.

The sections below list some example stretches for stiff fingers.

Gentle fist

Practicing making a soft fist can help promote motion in the hand. To perform this:

1. Open the hand, spreading the fingers as far as possible.
2. Make a gentle fist with the thumb over the rest of the fingers.
3. Do not clench too tightly.
4. Hold the position for 45 seconds.
5. Repeat the process five times each day.

This should not cause pain and should help the hand feel more open and mobile.

Finger flexing

This helps promote a range of motion in the tendons and muscles. To perform this:

1. Place the arm and hand flat on a table, with the palm facing up.
2. Keeping the wrist straight, bring the fingers slowly toward the palm.
3. Slowly release the fingers until they lie flat on the table again.
4. Repeat the process 10 times.

Finger touches

Finger touches promote a range of motion in the thumb. To perform these:

1. With the palm facing up, bring the fingers straight up.
2. Bend the thumb across the palm to touch the base of the pinky finger, holding this position for 5 seconds.
3. Move the thumb back to its normal position.
4. Do this again, touching the thumb to the bases of the other fingers.
5. Repeat this set five times.

Finger stretch

This stretches all of the fingers at once and may help improve the range of motion. To perform this:

1. Start with the hand flat on a table, with the palm facing down.
2. Apply slight pressure so that the fingers lie as straight and as flat against the table as possible without forcing the joints or causing pain.
3. Hold this for up to 60 seconds, then release the position.
4. Repeat this five times each day.

Fingertip stretch

This stretch promotes a range of motion in the tips of the fingers. To perform this:

1. Hold the hand vertically, with the palm facing toward the body.
2. Bring the fingertips down so that they touch the top of the palm.
3. Hold this position for 30 seconds, then release it.
4. Repeat this five times daily on each hand.

Grip and pinch strengtheners

Doctors may also recommend exercises with grip and pinch strengtheners. These soft, springy balls or putty provide some resistance when the person squeezes or pinches them.

Here are some tips on how to use them:

• Squeeze a grip strengthener as hard as possible without causing pain.
• Hold the position for a few seconds at a time, then relax.
• Try to do the exercise 10–15 times per day.
• It may be a good idea to alternate hands on different days to allow each hand to rest.
• When using a softer pinch strengthener, pinch it between all five fingers as hard as possible without causing pain. Hold the pinch for up to 30 seconds, then release it, and try to repeat the exercise 15 times per day.

Exercising with these tools is important to increase strength in the muscles of the hands and fingers.

There are certain things that a person with stiff fingers can do at home to improve their symptoms. These include:

• applying heat or ice packs to the affected fingers
• taking nonsteroidal anti-inflammatory drugs, such as aspirin
• doing hand exercises to regain mobility
• applying capsaicin creams or gels to the affected fingers
• resting the affected fingers in cases of acute injury or trauma
• limiting the use of the affected fingers

Splints or casts

Using splints, such as ring splints, may support the alignment of stiff fingers, improve their function, and prevent deformities from progressing. Splints stabilize the finger and can help restore a normal range of motion. This may encourage stretching of the contracted tissue.

Splinting can be effective for trigger finger and result in a 60% cure rate if a person uses a splint for 6–9 weeks.

If the cause of the stiff fingers is more recurrent and if the home remedies or stretches do not ease the symptoms, a doctor will likely consider the following methods to treat the pain.

Corticosteroids

A doctor may inject a corticosteroid at the affected site to provide relief. This may be an option for a person with a trigger finger, rheumatoid arthritis, or osteoarthritis. Corticosteroids are anti-inflammatory and can reduce inflammation in these conditions.

Side effects of steroid injections may include:

• pain
• bleeding
• a flare reaction
• infection
• an increase in blood glucose levels in people with diabetes

A person who receives a corticosteroid injection for stiff fingers should avoid using the affected fingers for at least 3 days and avoid tight grips or grasping for 3 weeks.

Enzymes

Enzymes are proteins that speed up reactions within the body. Collagenase is an enzyme that breaks down collagen.

If a collagenase injection is appropriate for a person, a doctor will inject the enzyme into the cords present in Dupuytren contracture. The enzyme will disrupt the cords, and the doctor will manually rupture them.

Some research suggests that 96.6% of people experience at least one mild-to-moderate complication with enzyme injections, including:

• pain at the injection site
• bruising
• tenderness
• itchiness
• flushing
• blisters
• upper limb pain

Surgery

If the cause of stiff fingers is more severe or if the condition has not responded well to other treatment options, the person may require surgery. The sections below outline some surgical options.

Limited fasciectomy

This involves surgically removing the cords to improve the mobility of stiff fingers. This is the most popular surgical technique.

A person with Dupuytren contracture may require this type of surgery if their condition has not responded well to enzyme injections or if it is severe.

Tenolysis

When the cause of the stiff fingers is an issue with the tendons, a person may require tenolysis. This involves the surgical release or freeing of a tendon to restore range of movement. In severe cases, a person may require reconstruction of the tendon.

Synovectomy

A person with arthritis may require joint surgery, such as a synovectomy. This involves the surgical removal of the damaged synovium or the lining of the joints. This may temporarily reduce pain and improve hand function.

Carpal tunnel release

A person with carpal tunnel syndrome may require a surgical process known as carpal tunnel release. This involves surgically cutting a ligament around the wrist. This reduces the pressure on the median nerve and may improve symptoms of stiff fingers.

Stiff fingers can be cumbersome, and arthritis or minor injuries are common causes. In some cases, health issues involving the bones, connective tissues, or muscles in the hand are responsible.

A doctor can diagnose the cause and recommend the best course of treatment. Treatment options include taking pain medications, applying splints to the fingers, receiving enzyme and corticosteroid injections, and undergoing surgery.

Stretching the hands and fingers can help prevent stiffness, and exercises often complement treatment.