Throbbing, aching, or shooting pain in the knuckles can result from an injury or an underlying medical condition.
This article discusses four common causes of knuckle pain and their symptoms and treatments.
A knuckle is a finger joint. The knuckles are where the two phalanges, or finger bones, meet each other and where they meet the metacarpals, or hand bones.
Most people have 14 knuckles in each hand, three on each finger, and two on each thumb.
Complex networks of nerves, muscles, tendons, and ligaments allow the knuckles to move, giving rise to precise finger movements, such as typing, holding utensils, and scratching the head.
Typically, four main issues cause knuckle pain.
Injury
Injuring any of the structures that make up the knuckles can lead to knuckle pain. Types of knuckle injuries include:
- Strains: including stretched or torn muscles and tendons
- Sprains: stretched or torn ligaments
- Fractured or broken knuckles: can occur when a person punches something or falls on their hand
- Dislocated knuckle: when a phalanx, or finger bone, moves out of its original position
Learn about the differences between a strain and a sprain here.
Symptoms of a knuckle injury
The symptoms of a knuckle injury vary depending on the type and severity of the damage.
People may feel mild to severe pain in the injured knuckle or knuckles. This can feel like a dull ache or a sharp, stabbing sensation.
The pain may worsen with movement.
Symptoms of a strain or sprain near a knuckle include:
- pain
- swelling
- limited flexibility
- stiffness or reduced range of motion
Symptoms of a fractured or broken knuckle include:
- bruising
- limited or no range of motion
- numbness or tingling in the affected finger
- visible changes, such as swelling and discoloration
- finger appears bent at an abnormal or extreme angle
Treatments for knuckle injuries
People can treat sprains, strains, and other mild knuckle injuries with RICE therapy:
- Rest: Avoid moving or using the injured knuckle while it heals. Consider immobilizing the knuckle in a splint or brace.
- Ice: Apply an ice pack or cold compress on the injured knuckle. This will help reduce swelling and relieve pain.
- Compression: If the knuckle appears swollen, consider wrapping it with a bandage or buddy tape.
- Elevation: Keep the injured finger raised above the heart. This may help reduce swelling.
A healthcare provider can diagnose a fractured, broken, or dislocated knuckle.
They will reset broken bones or maneuver a dislocated phalanx back into place. They may recommend wearing a brace or splint while the knuckle heals.
Over-the-counter (OTC) pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can reduce swelling and pain.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is an autoimmune disease that leads to inflammation in the joints. The Arthritis Foundation state that RA typically affects the joints in the hands, wrists, and knees.
According to an overview article in
Symptoms of RA in the knuckles include:
- tenderness or pain in the knuckles of one or both hands
- knuckles feel stiff, especially in the morning
- pain and stiffness occur in other joints, such as the wrists, knees, or hips
RA can lead to widespread symptoms, such as fatigue and weight loss.
The goals of RA treatment include:
- relieving inflammation
- managing other symptoms, such as pain and fatigue
- improving joint function and mobility
- preventing
long-term complications , such as heart disease, obesity, and reduced quality of life
A healthcare provider may recommend one or more of the following treatments for knuckle pain related to RA:
- NSAIDs, immunosuppressants, or corticosteroids to reduce inflammation and pain
- topical pain relievers
- physical therapy to improve joint mobility
- heat therapy to relax the finger muscles and promote joint lubrication
- cold therapy to reduce inflammation and pain
Osteoarthritis
Osteoarthritis (OA) is the most common type of arthritis, affecting more than
It is an age-related degenerative disease that involves cartilage loss and bone changes. OA can affect any joint in the body, including the knuckles.
OA most often affects the joints at the tip and middle of the fingers. OA can also cause swelling at the base of the thumb.
Symptoms of OA include:
- swelling in multiple knuckles
- deep, aching pain in the affected knuckles
- joint stiffness, especially in the morning
- reduced flexibility and limited range of motion in the affected knuckles
- muscle weakness near the knuckles
- a clicking or popping sound when bending the knuckles
There is no cure for OA. However, combining medication, physical therapy, and lifestyle changes, such as exercise and weight control, can help relieve OA symptoms and prevent long-term complications.
Medications for OA include:
- OTC pain relievers, such as acetaminophen and ibuprofen
- topical creams or gels that contain lidocaine, menthol, or capsaicin
- oral or injectable corticosteroids
- platelet-rich plasma (PRP) injections
Non-drug therapies for OA include:
- physical therapy exercises to strengthen the joints and reduce stiffness
- surgery to remove damaged cartilage, for example
Ganglion cyst
A ganglion cyst is a round, fluid-filled growth that usually develops on the back of the wrist and the base of the fingers. Ganglion cysts can also appear on the knuckle closest to the tip of the finger.
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A ganglion cyst may feel painful or tender to the touch. The pain only affects the knuckle where the cyst developed.
A ganglion cyst may resolve suddenly without medical treatment. A healthcare provider may also use a needle to drain a ganglion cyst.
A doctor may need to surgically remove a ganglion cyst if it returns or does not respond to other treatments.
Other causes of knuckle pain
Other possible causes of knuckle pain include:
- soft tissue growths, such as boils or nodules
- swollen tendons, also known as tendinitis
- gout
- infections
- bone cancer
- multiple sclerosis (MS)
- Raynaud’s phenomenon
- scleroderma
- lupus
- polymyositis
A doctor or other healthcare provider can diagnose the underlying cause of knuckle pain.
They usually start the diagnosis process by examining the knuckle for signs of inflammation. They may be able to diagnose a broken or dislocated knuckle from a visual inspection alone.
A doctor can confirm a diagnosis or rule out other possible causes of knuckle pain with one or more of the following tests:
Joint aspiration is a procedure where a healthcare provider inserts a needle in the space between a joint. They use the needle to collect joint fluid, which they send to a laboratory for analysis.
Joint aspiration tests can help diagnose RA and gout.
People can treat knuckle pain at home by:
- applying hot and cold compresses to the inflamed or injured knuckle
- resting the fingers by avoiding typing, writing, and other activities that involve the hands
- taking OTC pain relief medication
- gently stretching the fingers
- reducing stress with meditation and deep breathing exercises
The following tips may help a person prevent knuckle pain:
- Wear gloves and other protective hand gear.
- Take frequent breaks from repetitive tasks that place strain on the knuckles.
- Maintain a moderate weight.
- Control blood sugar levels.
- Quit smoking.
Some causes of knuckle pain resolve with rest and at-home treatments.
However, a person may want to consider seeing a doctor if they have persistent knuckle pain that does not improve despite at-home treatments.
People should also seek medical attention if they experience:
- a potential fractured, broken, or dislocated knuckle
- new or worsening knuckle pain with no apparent cause
- pain or stiffness in other joints
- numbness or tingling in the affected finger that spreads to the hand, wrist, or arm
- visible changes to their knuckle, such as swelling or discoloration
- a painful or tender bump on a knuckle
Knuckle pain due to a minor injury will often heal without medical intervention.
Rest, ice therapy, compression, and elevation are useful methods for treating most mild injuries. A doctor can set and bind a fractured, broken, or dislocated knuckle.
Knuckle pain that persists despite at-home treatments may indicate an underlying condition, such as RA, OA, or a swollen tendon.
In these cases, knuckle pain should resolve after treating the underlying condition.
People can prevent knuckle pain by protecting their fingers and hands during recreational activities.
To help prevent overuse injuries, a person can take frequent breaks from tasks that involve repetitive finger movements, such as typing or writing.