Our hands are our main tools to interact with our physical environment. As with pain anywhere in the body, palm pain can be very distressing. Sometimes it may even be a symptom of a very serious underlying condition. Palm pain may be acute or chronic and the single isolated episode may not be a cause for concerns. Some of the more common conditions that cause palm pain are usually not serious and resolves on its own within a few hours to days.
What is palm pain?
Palm pain is where pain is isolated to the palm of the hand only, rather than affecting the entire hand as is the case with hand pain or the entire arm as is the case with arm pain. The pain may arise from the skin, tissue underneath it (subcutaneous tissue), nerves, blood vessels, ligaments, tendons, muscles and bones that make up the hand. The more common causes for palm pain includes overuse of the hand and injuries to the palm, like a cut or burn.
With the palms making constant contact with the physical environment and playing a central role in enabling humans to conduct various life activities, it is naturally prone to overuse and injuries. Therefore the palm has the thickest skin than any other area of the body, apart from the soles of the feet. However, this does not make it impervious to the host of insults that it faces on a daily basis as well as various disorders and diseases.
Palm pain is a symptom and may be accompanied by other symptoms, such as:
- Redness of the skin on the palm
- Heat over the affected area
- Swelling of the hand or on the palm
- Muscle weakness
- Diminished range of motion
- Loss of sensation
NOTE: The sudden onset of pain with symptoms such as bluish discoloration of the skin or severe muscle weakness should be considered as a potentially dangerous condition. It therefore requires immediate medical attention.
Causes of Palm Pain
There are a number of different conditions that may cause palm pain. These conditions may present with different signs and symptoms apart from the pain depending on the underlying cause. Identifying the exact cause can sometimes be difficult without these other symptoms or specific events that may have triggered the pain.
Injury to the palm is one of the most common causes of palm pain. It is usually not intentional and may occur as an accidental injury or with overuse and strain. The injury can occur on the surface, penetrate to deeper layers or even arise internally with no surface damage. Injuries may be seen with blunt and sharp force trauma like cuts, sprains, muscle and tendon strain, burns and electric shock. Fractures of the palm bones can occur with severe and deep trauma. The break in the bones are very painful and sometimes the broken bone may pierce through the skin.
A range of infections can affect the hand, and the palm specifically. Viral infections are usually not specific to the palm alone and may cause lesions on the palm as part of a systemic infection. Fungal infections may also affect the hand and some of these fungi cause characteristic lesions on the palm, like tinea nigra. However, viral and fungal infections usually do not cause pain in the palm.
Bacterial infections are more likely to occur following an injury when bacteria enter the skin and deeper tissue through a break in the skin. This may cause superficial infections like impetigo or deeper infections like cellulitis or even bone infections (osteomyelitis). These infections are painful and the infected area is tender. There may be open wounds on the palm with pus oozing.
A number of nerve problems can cause palm pain even though other tissues of the palm are not damaged nor diseased. Nerves relay a range of signals and pain is one of these signals. If a nerve is diseased or damaged, it may incorrectly relay pain signals from the palm to the brain although there is no injury or disease in the palm itself. This is mainly seen with carpal tunnel syndrome where the median nerve is compressed at the point of the wrist.
The main disorders that affects the joints is rheumatoid arthritis (RA) and osteoarthritis (OA). Rheumatoid arthritis is an autoimmune condition where the immune system attacks the joint lining. It mainly affects the small joints, like that of the fingers.
Osteoarthritis arises with wear and tear of the joint cartilage. Gouty arthritis occurs when uric acid crystals form in the joint space and irritate the joint lining. It mainly affects the big toe but could occur in other joints. Septic arthritis occurs due to a joint infection while traumatic arthritis arises with joint injury.
The hands are laden with muscles that are in constant use, specifically to control the fingers. Tendons run from these muscles and are connected to the bones of hand and fingers. Cramps is one of the more common muscle conditions that can cause pain in the palm. Muscle and tendon strain usually arises with overuse. Less commonly, muscle conditions such as dermatomyositis occur which is an autoimmune disease.
Disturbances in blood flow to the hand can lead to symptoms like palm pain. Peripheral arterial disease (PAD) is where the blood supply is restricted due to a narrowing of the artery. In Raynaud phenomenon the small arteries of the hand become narrowed due to spasms of the muscles in the artery wall. Vasculitis is inflammation of the blood vessels usually due to an infection, injury or an autoimmune condition.
Most skin conditions present with symptoms like a rash and itching but sometimes pain and tenderness may be present. It is mainly seen with inflammatory skin conditions and where there are breaks in the skin thereby exposing the underlying tissue. Contact dermatitis is where the skin becomes inflamed either due to contact with an irritant or allergen.
- Gouty arthritis
- Tumors – benign and malignant
- Insect bites and stings