Knuckle Pain

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What is knuckle pain?

Pain in your knuckle can arise from a number of different causes. Knuckle pain may develop as a result of conditions affecting any of the structures in the knuckle, including skin, nerves, muscles, joints, tendons, bones, ligaments, blood vessels, and connective tissue. Injury from trauma and osteoarthritis are common causes of knuckle pain.

You might describe your knuckle pain as sharp, stabbing, dull or throbbing. Your knuckle pain may be mild to severe in intensity and occur only at certain times of day or when you perform certain activities. Moving your knuckle or joints near it may either worsen or relieve the pain. With severe pain related to traumatic injuries, it may be impossible to move the affected knuckle at all.

In some cases, knuckle pain due to injury is localized to only one knuckle. In many cases, several knuckles may be affected. Inflammation within the knuckle causes swelling and pain. Further, rheumatoid arthritis, a chronic autoimmune disease characterized by joint inflammation, and other arthritis-related conditions are associated with knuckle pain, again due to inflammation and swelling.

Knuckle pain may be recent in origin (acute) or may develop over time (chronic). In some situations, knuckle pain can occur as a result of chronic medical conditions you may have that affects your entire body, such as arthritis, vascular disease, or diabetes).

Although life-threatening complications of knuckle pain are rare, seek immediate medical care (call 911) if you have injuries that involve profuse bleeding or tissue damage. In rare cases, infections of the bone (osteomyelitis) or skin and soft tissues (cellulitis) of the knuckle can spread throughout the body, resulting in shock and organ failure. Another rare but potentially life-threatening cause of knuckle pain is cancer of the bones or soft tissues.

If your knuckle injury or condition is persistent, recurrent, or causes you concern, seek prompt medical care.

What other symptoms might occur with knuckle pain?

Knuckle pain may be accompanied by other symptoms, depending on its cause and any underlying diseases or conditions. Some conditions that may affect the hands, such as diabetic neuropathy (nerve damage due to high blood sugar levels associated with diabetes), can cause symptoms in other body systems.

Knuckle symptoms that may occur along with knuckle pain

Pain in a knuckle may accompany other symptoms including:

Other symptoms that may occur along with knuckle pain

Knuckle pain may accompany symptoms related to other body systems including:

  • Back pain

  • General stiffness that lasts more than one hour after rising in the morning

  • Leg pain

  • Muscle spasms or cramps

  • Redness, warmth or swelling of the joints

Serious symptoms that might indicate a life-threatening condition

In some cases, knuckle pain may occur with other symptoms that might indicate a serious or life-threatening condition that should be evaluated immediately in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

What causes knuckle pain?

Injury or damage to any of the structures in the knuckle can cause knuckle pain. Diseases that affect the entire body, such as diabetes, arthritis, or vascular disease, are more complex processes that can lead to knuckle pain.

Traumatic causes of knuckle pain

A number of common injuries can cause knuckle pain including:

Inflammatory causes of knuckle pain

Inflammation can cause knuckle pain that is restricted to one knuckle or even to a specific location on one knuckle. Other inflammatory conditions can cause knuckle pain that involves several fingers or all fingers. Examples of inflammatory causes of knuckle pain include:

Infectious causes of knuckle pain

Infectious processes can also cause knuckle pain including:

  • Abscess

  • Cellulitis (skin and soft tissue infection)

  • Osteomyelitis (bone infection)

  • Papilloma virus infection (warts)

Other causes of knuckle pain

Knuckle pain can also be caused by problems that affect multiple body systems including:

  • Alcohol abuse

  • Benign or malignant tumors

  • Blood clots

  • Bone spurs

  • Buerger’s disease (acute inflammation and clotting of arteries and veins)

  • Congenital deformities

  • Diabetes (chronic disease that affects your body’s ability to use sugar for energy)

  • Obesity

  • Peripheral artery disease (PAD, also called peripheral vascular disease, or PVD, which is a narrowing of arteries due to a buildup of fat and cholesterol on the artery walls, which limits blood flow to the extremities)

  • Raynaud’s disease or phenomenon (spasms of small blood vessels of the fingers and toes, reducing blood circulation). Raynaud’s disease is when the cause is not known. Raynaud's phenomenon is secondary to another condition, including many autoimmune disorders such as lupus.

Serious or life-threatening causes of knuckle pain

Although life-threatening causes of knuckle pain are rare, all serious injuries, including hand and foot injuries, should be evaluated immediately in an emergency setting.

Questions for diagnosing the cause of knuckle pain

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your knuckle pain including:

  • How long have you had knuckle pain?

  • Is your pain constant, or does it come and go?

  • What other symptoms are you experiencing?

  • When do your symptoms occur?

  • Are your symptoms worsened or relieved by movement or specific activities?

What are the potential complications of knuckle pain?

Managing the underlying causes of knuckle pain can, in many cases, prevent the development of serious complications, such as joint deformity, widespread infection, gangrene, or even amputation. Left untreated, long-term complications, such as infection throughout the body or gangrene of the feet, can be life threatening. Possible complications of untreated knuckle pain include:

  • Joint deformity and destruction

  • Necrosis (death) of tissues and gangrene, which may require removal of the dead tissues or amputation

  • Sepsis (life-threatening bacterial blood infection)

  • Serious infections and gangrene

  • Spread of cancer

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 19
  1. Hand injuries and disorders. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/handinjuriesanddisorders.html
  2. Osteoarthritis. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001460/
  3. Rheumatoid arthritis. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001467/
  4. What Is Raynaud’s? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/raynaud/
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