Sore fingers are not always arthritis. A finger that clicks or locks is trigger finger. Tingling in the thumb and first two fingers is carpal tunnel. Fingers that turn white then blue in the cold are Raynaud’s. A firm cord in the palm that stops the hand lying flat is Dupuytren’s. An ache across the back of the hand after typing is tendon overload. Each has a different fix.
Where the joints themselves are the problem and stiffness is worst first thing in the morning, the exercise programme for that is set out in PhysioHub’s guide to hand and finger exercises.
Each of these has one giveaway feature, which is what makes hand pain easier to sort than it first appears. Find the row that matches the thing your hand actually does.
| Cause | The giveaway sign | Where it sits | What helps first |
|---|---|---|---|
| 1. Trigger finger | Finger catches, clicks or locks bent | Base of the finger, in the palm | Night splint holding the finger straight |
| 2. Carpal tunnel syndrome | Tingling in thumb, index and middle fingers at night | Palm side of the wrist and hand | Neutral wrist splint at night, nerve gliding |
| 3. Tendon overload | Aching along the back of the hand after typing | Back of the hand and forearm | Reduce the load, fix the setup, then reload |
| 4. Raynaud’s phenomenon | Fingers go white, then blue, then painful red | Fingertips, both hands | Keeping the whole body warm, not just the hands |
| 5. Dupuytren’s disease | Firm cord in the palm, hand will not lie flat | Palm, usually ring and little fingers | Monitoring, then a hand surgeon opinion |
None of these produce the pattern osteoarthritis produces, which is bony swelling at the joints themselves with stiffness that eases within half an hour of getting up.
This is a documentary review of published evidence and clinical practice rather than a diagnosis of your hand. The five here account for most non-arthritic hand and finger pain in adults. Others considered and left out because they are less common or need a different pathway include ganglion cysts, mallet finger, cubital tunnel syndrome, cervical nerve root problems referring into the hand, complex regional pain syndrome, gout, and infections.
The order reflects how often each explains hand pain in adults, weighed against how clearly each can be recognised from a single sign.
The sources read were NICE guideline NG226 on osteoarthritis, used here to describe what the arthritic pattern actually looks like so it can be told apart, and the 2017 Cochrane review of exercise for hand osteoarthritis. Evidence checked in August 2026.
What could not be checked: the conditions on this page have thin randomised evidence individually, and much of what follows is standard clinical practice rather than trial-derived. A hand that is hot, red and swollen with a fever, constant numbness, visible muscle wasting at the base of the thumb, or a finger fixed in a bent position all need assessing rather than managing at home.
Ask where the swelling is. Arthritis produces firm, bony swelling at the joints. A soft lump in the palm, a cord under the skin, or no swelling at all points away from it.
Time the morning stiffness. Osteoarthritis stiffness eases within about half an hour. Stiffness lasting more than an hour in several joints points at inflammatory arthritis, which is a GP conversation rather than a self-management one.
Notice whether anything catches or tingles. Catching is a tendon. Tingling is a nerve. Neither is a joint problem, and neither responds to what helps joints.
Watch the colour. Fingers that change colour in a defined sequence with cold are a circulation response, and no amount of hand exercise changes it.
What it is
A thickened section of a flexor tendon catching as it passes under the first pulley at the base of the finger, so the finger sticks in a bent position and releases with a click.
Who it affects
More often women, most often between 40 and 60, and considerably more often in people with diabetes. The ring finger and thumb are the usual culprits.
How it presents
Catching, clicking or locking as the finger straightens, worst first thing in the morning. A tender nodule can often be felt in the palm at the base of the affected finger.
What helps
A lightweight splint holding the affected finger straight overnight, so the tendon is not sitting swollen inside the pulley for eight hours. Warm water and gentle tendon gliding in the morning. Reducing sustained gripping where it can be reduced.
Limits and cautions
A finger that has become fixed in a bent position and will not straighten even when you help it with the other hand has moved past what splinting achieves and needs a hand opinion. Repeatedly forcing a locked finger straight is worth avoiding.
Why it ranks first
It is the most common non-arthritic finger problem, it is the most immediately recognisable from one sign, and the first-line treatment is something you can start tonight.
What it is
Compression of the median nerve where it passes under a tight band at the front of the wrist, producing symptoms in the hand rather than the wrist.
Who it affects
Very common. More often women, and more often in pregnancy, diabetes and thyroid conditions.
How it presents
Tingling and numbness in the thumb, index and middle fingers, waking people at night and eased by shaking the hand. The little finger is characteristically spared, which is a useful distinguishing detail.
What helps
A neutral wrist splint worn at night is the highest-value single step. Nerve gliding exercises, covered in our guide to median nerve glides. Adjusting keyboard and mouse height so the wrists are not held bent upwards.
Limits and cautions
Constant numbness, dropping objects, or a flattened look to the muscle at the base of the thumb all mean sustained pressure on the nerve and need assessing rather than waiting.
Why it ranks second
It is extremely common, it is frequently mistaken for arthritis because people describe it as sore fingers, and the treatment is entirely different.
What it is
Irritation of the tendons running from the forearm to the fingers, from a sustained increase in use rather than from any single injury.
Who it affects
Anyone whose hand use has stepped up: a new job, a new instrument, a new game, a deadline, a house renovation. It is the commonest cause of hand pain in people under 40.
How it presents
A diffuse ache across the back of the hand and into the forearm, worse during and after long sessions, easing overnight at first and then persisting. No catching, no tingling, no colour change.
What helps
Reducing the volume rather than stopping altogether, changing the setup so the wrist stays in line with the forearm, and taking a genuine break every 30 to 40 minutes. Then rebuilding capacity with grip and wrist strengthening once symptoms have settled.
Limits and cautions
Complete rest works while it lasts and the pain returns when the work does, because the tissue capacity has not changed. This is the same principle behind tendon problems everywhere else in the body.
Why it ranks third
It is the most common cause in younger adults and the one most reliably solved by changing the setup rather than treating the hand.
What it is
An exaggerated narrowing of the small arteries in the fingers in response to cold or emotional stress, temporarily cutting off blood flow.
Who it affects
Common, more often women, and often starting in the teens or twenties. It runs in families.
How it presents
Fingers turning white, then blue, then a painful throbbing red as blood returns. Numbness and clumsiness during an episode. Triggered by cold hands, cold air, taking something out of a freezer, or stress.
What helps
Keeping the whole body warm rather than only the hands, since the response is driven by core temperature as much as by what the fingers touch. Gloves before going out rather than after the hands are already cold. Stopping smoking, which makes it markedly worse. Medication is available where episodes are frequent or severe.
Limits and cautions
Raynaud’s appearing for the first time after around 40, affecting only some fingers, or accompanied by skin changes or ulcers on the fingertips can be associated with other conditions and should be raised with a GP.
Why it ranks fourth
It is common but usually recognised quickly by the people who have it, and it is on this list because the pain it causes is genuinely mistaken for joint pain during the recovery phase.
What it is
Gradual thickening of the layer of tissue under the skin of the palm, forming nodules and then cords that pull the fingers towards the palm.
Who it affects
More often men, more often over 50, and more often in people of northern European descent. It runs strongly in families and is associated with diabetes.
How it presents
A firm lump or cord in the palm, usually below the ring or little finger, that is often painless. Over years the affected finger bends towards the palm and will not straighten fully.
What helps
In the early stages, monitoring. Stretching and splinting do not reverse it, which is worth knowing before spending months on either. Once the hand will not lie flat on a table, treatment options include needle release, injections that dissolve the cord, and surgery.
Limits and cautions
Hand therapy has an important role after a procedure rather than instead of one. The tabletop test is the practical threshold: when the palm and fingers will not lie flat, a hand surgeon opinion becomes worthwhile.
Why it ranks fifth
It is the least common of the five in a general population and the one where the honest answer is that physiotherapy does not fix it, which is more useful to know early than late.
| Cause | Pain | Tingling | Catching | Colour change | Responds to exercise |
|---|---|---|---|---|---|
| Trigger finger | At the base of the finger | No | Yes, the defining sign | No | Partly, splinting matters more |
| Carpal tunnel syndrome | Often more numbness than pain | Yes, 3 fingers | No | No | Partly, splinting matters more |
| Tendon overload | Diffuse, back of hand and forearm | No | No | No | Yes, after load reduction |
| Raynaud’s phenomenon | On rewarming | During episodes | No | Yes, white to blue to red | No |
| Dupuytren’s disease | Often none | No | No | No | No |
The last column is the honest one. Two of these five respond well to hand exercise, two respond mainly to a splint or a setup change, and one does not respond to physiotherapy at all.
If a finger catches or locks, worst in the morning, splint it straight at night and use warm water and tendon glides before you start the day.
If the thumb and first two fingers tingle at night, use a neutral wrist splint in bed and start nerve gliding.
If the back of the hand aches after long spells of typing or playing, cut the volume, fix the wrist position, then rebuild grip and wrist strength.
If your fingers change colour in the cold, warm the core rather than just the hands, and get gloves on before you go out.
If a cord in the palm stops your hand lying flat on a table, that is the point to ask for a hand surgeon opinion rather than to stretch it.
If several joints are hot, swollen and stiff for more than an hour every morning, that pattern is inflammatory and belongs with a GP rather than on this page. Our guide to exercising with rheumatoid arthritis covers what follows.
The belief that arrives with almost every sore hand in the Uckfield clinic is that it must be the start of arthritis. It is an understandable assumption and it is wrong more often than it is right, particularly under 50. What people actually walk in with is a tendon that catches, a nerve that tingles overnight, or a hand that has quietly absorbed a large increase in typing since a job changed.
The distinction matters because the treatments barely overlap. Joint exercise programmes do very little for a trigger finger, and a splint that holds a finger straight overnight does very little for a stiff arthritic knuckle. The clinical work is short: press the joints, watch the finger straighten, ask which fingers tingle and when, and look at the palm with the hand flat on the table. Four checks, most of the answer. Autumn adds one more thread, because the first cold weeks across the High Weald bring out Raynaud’s in people who had put the colour changes down to poor circulation and never mentioned them.
Where you are not sure whether what you have needs physiotherapy, a GP, or nothing at all, a free discovery and triage call will point you at the right one.
Why does my finger lock in a bent position in the morning?
That is trigger finger. A thickened section of the flexor tendon catches under a tight pulley at the base of the finger, so the finger bends easily and then sticks on the way back, releasing with a click. It is worst first thing because the tendon swells slightly overnight. A splint holding the finger straight at night is the usual first step.
Why do my fingers turn white and go numb in the cold?
That is Raynaud’s phenomenon, an exaggerated narrowing of the small arteries in the fingers in response to cold or stress. The classic sequence is white, then blue, then a painful red as blood returns. It is common and usually harmless on its own, though new Raynaud’s starting after about 40, or affecting only some fingers, is worth mentioning to a GP.
What is the tabletop test?
Place the hand palm-down flat on a table. If the palm and fingers will not lie completely flat because of a firm cord pulling in the palm, that is a positive tabletop test for Dupuytren’s disease. It is the standard threshold at which a hand surgeon opinion becomes worth having.
Can typing cause hand and finger pain that is not arthritis?
Yes, and it is common. A sustained increase in keyboard, mouse or phone use overloads the tendons running to the fingers, producing an ache across the back of the hand and into the forearm. It builds over weeks rather than starting suddenly, and it settles with load reduction plus a setup that keeps the forearm and hand in a straight line.
How do I know if my finger pain is arthritis or something else?
Osteoarthritis produces stiffness first thing that eases within about half an hour, bony rather than soft swelling at the joints, and pain located at the joints themselves. The five problems here sit outside the joints: a tendon that catches, a nerve that tingles, arteries that spasm, fascia that thickens, or tendons that ache along their length. Where several joints are hot, swollen and stiff for more than an hour each morning, that points at inflammatory arthritis and needs a GP.
Do steroid injections work for trigger finger?
They are a common and often effective treatment, particularly for a finger that has been triggering for a few months and has not responded to splinting. Recurrence is not unusual, and a finger that has become fixed in a bent position and will not straighten passively is usually a surgical conversation rather than an injection one.
When should hand or finger pain be checked?
If a finger is stuck bent and will not straighten, if numbness is constant rather than intermittent, if the muscle bulk at the base of the thumb looks flattened, if a finger is hot, red and swollen with a fever, or if a cord in the palm stops the hand lying flat on a table. Raynaud’s starting for the first time after about 40 is also worth raising with a GP.
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