The fingertips contain more touch and temperature receptors than any other part of the body, except for the genitals. This means that the fingertips are highly sensitive. It allows us to sense danger in terms of a sharp or hot object before we are poked or burned. It also allows us to interact with our environment and particularly other living beings in way that has emotional consequences as much as it does with physical contact. Naturally we are more likely to perceive injuries more acutely when it occurs on the fingertips. The fact that the hands and fingers in particular are in such close contact with the external environment also means that injuries to the area are more likely to occur.
Sensation and Inflammation
Pain is a sensation that we understand well. It means that the area where the pain is emanating has been injured and some degree of tissue damage has already occurred. Sometimes our fingertips feel tender which means that there is a sensation of discomfort or even pain when pressure is applied on it. Here as well it may mean that the tissue has been injured to some degree even though it is not as obvious. When the fingertips are very sensitive, it could also mean that there is injury or for some reason the sense of touch and temperature are heightened in the area.
Inflammation is the body’s response to tissue injury. It presents as heat, swelling, redness and pain. Any inflammatory condition of the fingertips may therefore cause pain, irrespective of the cause of the inflammation. Sometimes it is due to trauma, infections, autoimmune factors and restricted blood flow. However, the cause of fingertip pain is not always associated with inflammation. It can also occur with overexertion, nerve irritation or injury, muscle tears, ligament stretching (sprains) and so on. There may not be any inflammation in some of these instances despite the presence of pain and tenderness of the fingertips.
Causes of Pain, Tenderness or Increased Sensitivity
Injury to the fingers is by far the most common cause of fingertip pain and tenderness. It can occur in a number of different ways. Lacerations (cuts) are common and it is not only with sharp objects like a knife or broken glass but even with paper. In fact many shallow paper cuts occur without a person knowing it until they apply pressure to the finger and experience pain. Blunt force trauma may include stubbing the finger against objects or between objects.
The tissue injury may be limited to the superficial layers like the skin and connective tissue or it may extend deeper to the muscle, tendons, ligaments and bone. Mallet finger, also known as baseball finger, is one type of injury that occurs when an object strikes the fingertip. It causes damage to the extensor tendon that is responsible for straightening the finger. The fingertip is also prone to chemical damage from contact with corrosive substances like acids or strong alkalis. It is also a common site for burns when touching hot objects or electrical burns.
Tapping away on a computer keyboard or mobile device keypad may not seem like a possible cause of overexertion as most of us are accustomed to it. However, there is a point where such activity can cause irritate the fingertips and lead to inflammation characterized by swelling, redness, heat and pain. It is more likely to occur when we do an activity that we are not physically conditioned to manage for long periods or at high intensity. Overexertion may occur with just about any activity where the fingertips are used a lot.
Frostbite is probably the best known cold injury to tissues. It occurs when the skin and underlying tissue freeze. Frostbite is preceded by frost nip, both of which are freezing cold injuries. Other cold injuries may be of the non-freezing type such as chillblains. Here the tissue in the affected area does not freeze and the tissue damage is often reversible. Tingling and numbness of the fingers may be expected but it is usually preceded by tenderness and pain. These types of injuries are seen when there is exposure to ice or snow but it can also occur in other situations like with direct contact with liquid nitrogen.
Raynaud phenomenon is a condition where the small blood vessels of the fingers narrows excessively thereby reducing blood flow to the area. It is usually triggered by cold or stress and can also occur on the toes, ears and nose. This blood vessel narrowing (vasoconstriction) is not unusual under these circumstances but with Raynaud phenomenon it is much more severe. As a result the blood flow to the area is severely restricted thereby starving the tissue of oxygen and nutrients. Pain is one of the symptoms that may be felt at the fingertips.
Compression of the nerves supplying the fingers with sensory fibers can cause pain. This is commonly referred to as a pinched nerve. The compression may occur anywhere along its course, from its root at the spine or even much lower down closer to the fingers. There is a number of reasons for this compression. One of the common causes of nerve root compression is bulging of the intervertebral discs (herniated discs). Another common condition where the nerve is pinched is carpal tunnel syndrome. Here the media nerve becomes compressed within the carpal tunnel as a result of the inflamed muscle tendons lying next to it.
Any skin condition where pain may be present and when it occurs on the fingers can be the cause of fingertip pain. It is usually seen in inflammatory skin conditions particularly when the skin is severely cracked or peeling. Infections may also a problem. Shingles (herpes zoster) is a reactivation of the chickenpox virus which causes neuralgia. It is mainly seen on the upper body and can involve the hands as well as the fingers. Cellulitis is a deeper infection involving the tissue under the skin and is usually caused by bacteria.
The fingernails are also prone to a host of conditions that may be the cause of fingertip pain. The nail bed is very sensitive and is usually protected by the hard fingernails. However, it can become injured for a number of reasons as discussed above. In addition it can be injured while clipping or manicuring the nails. Sometimes the skin folds on the side of the nails may become infected. This is known as paronychia. It can be very tender or painful.
- Peripheral neuropathy
- Cardiac pain
- Iatrogenic (finger prick tests)
- Foreign body (example a splinter)
- Insect bites or stings
- Rheumatoid arthritis