The five metacarpal bones (Metacarpal bone) are located between the eight bones of the wrist and the three finger bones of the respective fingers (the thumb consists of only two finger bones). They can in turn be divided into three sections, a so-called base (which is in connection with the carpal bones), a bone body (Corpus) and a little head (Caput), which is furthest away from the body. The bone heads are visible as knuckles on the back of the hand.
Painful sensations can occur in the metacarpal bones for various reasons. Depending on the cause, this pain can be burning, stabbing, dull, pressing, or tingling, among other things. In addition, a distinction can be made between permanent (chronic) and acute pain.
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also read: Pain in the back of the hand
Pain in this area can be due to bony causes, such as a broken or sprained metacarpal bone. In rare cases, there can also be a space-occupying process in this bone, i.e. a bone cyst, a bone tumor or a bone metastasis. But muscles or tendons in the metacarpal area can also be the starting point for pain. This can also simply be an expression of acute overstrain or improper strain on the hand. A nerve pulling along there can be irritated, inflamed or pinched and thus also cause pain. Joints adjacent to the metacarpal bones can also cause rheumatism, gout or general signs of wear and tear (arthrosis) pain.
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The metacarpal bones can also break as a result of trauma to the hand. This usually happens in the context of a fall, during sports or due to a punch. A distinction is made between shifted (dislocated) and bone ends that are still correctly positioned. This break can also be open, i.e. visible in the wound, or closed. Such a fracture is either immobilized in a plaster cast for a few weeks or, in the case of more complicated fractures, straightened in an operation and, for example, treated with a plate or a nail.
$config[ads_text2] not foundRead more on the subject: Metacarpal fracture
The sheath of a tendon can become inflamed, especially in the hand area (Tendovaginitis). This can happen with chronic, one-sided exposure, such as desk work, in connection with rheumatism or rarely be caused by bacteria or other pathogens. The pain then occurs when the hand is moved, swelling of the affected area can occur, as well as palpable crunching or rubbing symptoms, which are caused by nodular changes in the affected tendon sheath.
First of all, it is important to protect the affected hand, and cortisone can also be injected into the tendon sheath to combat the inflammation. If the symptoms cannot be combated in this way, an operation may be necessary. The tendon sheath is split lengthways to relieve the tendon.
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This phenomenon is also known as the "fingering finger", the technical term is "Tendovaginitis stenosans". This form of inflammation is also caused by overloading, which leads to minor tendon injuries and swelling, which in the long term turn into nodular changes in the tendon. These knots have to pass through the ring ligaments that also regularly surround the tendons. Often this happens in the area of the first (body-hugging) ring ligament of a finger, so that this resistance must first be overcome with more effort. Once a certain degree of strength has been reached, the tendon suddenly slides through and the finger "snaps" into the flexion, for example. Overall, this makes stretching and bending the finger increasingly painful.
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$config[ads_text3] not foundRead more on the topic: Flicking finger
The metacarpal bones, as well as the carpal and wrist as a whole, are often affected by injuries from falls and blows. The forearm fracture is the most common fracture in humans as an injury near the wrist, but the metacarpal bones can also be affected by sprains, bruises, fractures and joint damage. Typical accidents are prop trauma or punches.
Depending on the angle of the injury and the impact of violence, contusions, simple fractures or comminuted fractures can occur. Typical triggers are still ball sports such as basketball or volleyball, in which hits on the metacarpal bones are common.
In the acute phase after the injury, the hand must be cooled, stored high, protected and stabilized with a pressure bandage. This will reduce bruises and swellings and splint the potentially injured bone. The diagnosis of a fracture of the metacarpal bones can be made on the basis of an X-ray from the doctor. A bruised metacarpal bone only needs to be spared, whereas a broken bone often has to be surgically screwed in so that the hand remains stable against stress in the long term.
Read more on the subject here: Metacarpal fracture
Metacarpal pain can occur in different areas.
All of the above-mentioned causes can also be underlying pain in the area of the metacarpal bone of the middle finger. The middle and index fingers can also be affected by carpal tunnel syndrome, among other things. The median arm nerve (Median nerve) chronically trapped in an excessively narrow carpal canal, a connective tissue structure on the border between hand and forearm on the inside of the hand, which can lead to sensory disorders such as tingling and sometimes burning pain, especially in the thumb, index finger and middle finger area. Shaking or massaging the hands often improves symptoms. The constricting ligament can be split in an operation, so that the pain and discomfort disappear.
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In the case of the ring finger, too, all the reasons described under causes come into question, for example a break in this very bone. More details must then be clarified through further examinations and possibly an X-ray.
Read more on the topic: Rheumatoid arthritis, ring finger pain
As already described for “middle finger”, a carpal tunnel syndrome is an alternative to consider in addition to the other causes and should be clarified in a survey, examination and test.
The fifth metacarpal bone, which is close to the body of the little finger, is often affected by fractures, particularly near the metacarpophalangeal joint of the little finger. This break will too "Boxerbruch" called because it often occurs in the context of punching objects or the bones of other people (for example their skull). This fracture is treated like fractures of the other metacarpal bones.
In addition to pain in the metacarpal bones, swelling may occur, usually as part of inflammation or acute injury. Other abnormal sensations, such as a tingling or electrifying sensation, can also occur. This speaks for a nerve involvement. A sensory disorder in certain areas of the hand must also be clarified - here there seem to be problems with the transmission of information via the nerves. Redness of the hand is often of an inflammatory nature. A lack of functionality and overheating also speak for it.
Mobility can also be changed. There may be stiffness in the adjacent joints or in the fingers, which can be caused, for example, by joint wear (arthrosis) may be the case, or the metacarpal area is abnormally mobile. There is a suspicion of a break, which must be further clarified immediately. In the context of rheumatic diseases or tendinitis, palpable hardening can be found.
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First there is a thorough survey (anamnese), which should clarify:
In order to be able to estimate the strain on the hand, the handedness of the patient, the occupation and typical everyday activities are also important. You should also ask about trauma or injury if the pain is acute. Then the hand must be examined carefully and compared with the healthy hand. In doing so, attention must be paid to swelling, the specific pain point, discoloration or other change, skin temperature, mobility and, in the case of possible fractures, malpositions or abnormal mobility in the metacarpal bones.
$config[ads_text1] not foundOften, an X-ray of the hand is also necessary, possibly also a magnetic resonance tomography image (MRI). If an inflammatory disease is suspected, blood tests are due. Sometimes an ultrasound scan can also help. Nerve damage can be detected by measuring nerve conduction speeds, among other things. If the finding remains unclear, an (operative) jointoscopy (Arthroscopy), Create clarity. Sometimes this can be combined with a therapeutic intervention.
Read more on the topic: Pain in hand
Therapy is based on the results of the diagnosis and thus on the diagnosis. Sometimes the pain goes away on its own after a short time if the cause is an overload of the hand. In general, pain relievers such as aspirin, ibuprofen or diclofenac can help in the short term. However, this is more to be viewed as symptomatic, that is, the actual problem is not eliminated. Often, either a (short-term) protection of the hand, the use of bandages or other aids or targeted exercise as part of physiotherapy help. Depending on the cause, cold or heat therapy can help. In general, if there is an inflammatory phenomenon, it is advisable to be cold, and if there is muscular tension, it is more advisable to apply heat. An ointment bandage with, for example, Voltaren ointment to reduce pain and swelling is usually perceived as pleasant.
A metacarpal fracture is either immobilized with a plaster cast for a few weeks or treated surgically, depending on the type of fracture. Plates or nails are used here to fix the bone in its aligned shape. A plaster cast or splint must also be worn after an operation.
In the case of tendinitis, a conservative immobilization and infiltration of the tendon sheath with cortisone preparations are tried first. If this does not achieve the desired effect, an operation in which the tendon sheath is split lengthways can achieve better and painless movement again. After such an operation, the hand should be moved again immediately.
When a finger is diagnosed, the corresponding ring ligament that triggers the symptoms can be split in an operation. This is a procedure that can be performed on an outpatient basis and only takes about 15 minutes. Other causes may require various other operations.
Read more on the topic: Treatment of finger arthosis
The duration of the treatment also depends on the cause of the pain. For example, if there is a broken bone, healing can take several weeks to months. Subsequent treatment in the form of physiotherapy is often necessary until the hand can be fully inserted again.
In the case of short-term pain due to improper or excessive strain on the hand, the symptoms can improve after a few days if the stressful activity is no longer carried out.
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Smaller interventions, such as splitting the ring ligament on a flickering finger, are usually also quickly overcome. However, the finger should not be fully stressed for two weeks. Exercise can also be helpful. If the pain persists even after treatment, and generally longer than expected, a further visit to the doctor is indicated.
