Burning in the hands is almost always a NERVE symptom rather than a joint or tendon one.
- Joints ache.
- Tendons hurt when you load them.
Nerves…on the other hand (pardon the pun, ahem) – always causes weird uncomfortable sensations: burn, tingle, and behave oddly — worse at rest, worse at night, and often in a shape that doesn’t match where you think the problem is.
Where it burns, and whether your feet burn too, does most of the sorting.
Burning in a nerve’s territory
One hand, part of the hand, following a map. Thumb-side burning points at the median nerve. Little-finger-side points at the ulnar nerve.
This is compression, and it usually starts as tingling before it graduates to burning.
Burning tends to arrive when the nerve has been irritated for a while, which makes it a symptom worth acting on rather than waiting out. See carpal tunnel, cubital tunnel, and the nerve map of the hand.
Burning in both hands and both feet
Symmetrical, gradual, worse at night, described as burning or walking on gravel. Feet usually before hands.
If your feet burn as well, this is not a wrist problem and a wrist splint will not touch it. Diabetes is the commonest cause worldwide, but B12 deficiency, thyroid disease, alcohol and several medications including some chemotherapy agents all produce it.
This one needs blood tests, not hand therapy.
See peripheral neuropathy or carpal tunnel and the diabetic hand.
Burning after an injury or surgery, out of proportion
This is the one to know about, because the window on it is narrow.
Constant burning that is worse than the injury justifies, with a hand that is swollen, colour-changed, sweaty or hairy in a way the other one isn’t, and skin so sensitive that a bedsheet is intolerable.
That combination is CRPS, and early recognition changes the outcome more than almost anything else in hand rehabilitation.
Do NOT wait to see whether it settles.
Aching is a joint. Burning is a nerve. And burning that arrives with a hand that looks different is a same-week problem.
The other causes worth ruling in or out
- A neck problem. Burning down the arm in a stripe, with neck or shoulder blade ache. See cervical radiculopathy
- Burning on rewarming. Fingers go white, then blue, then burn red as they warm up. That sequence is Raynaud’s, and the burning is the recovery phase rather than the problem
- A healing nerve. Burning and electric shocks along a repaired nerve are a sign of regrowth, not failure. See nerve repair recovery
- Scar and burn injury. Healed burn scars and grafts burn and itch for months as the skin reorganises. See burns to the hand
- A hand you can’t feel properly. Reduced sensation plus burning is a nerve that is both damaged and irritable, which is common and needs the diagnosis nailed down
What actually helps nerve burning
Not the things people reach for first.
- Position beats temperature. Ice and heat do very little to a compressed nerve. Taking the pressure off does. See ice or heat
- Night splinting if it is worse at night, because that is when the position is worst. See which splint
- Desensitisation for a hypersensitive hand — graded textures, several times daily, over weeks. Tedious, and it works
- Anti-inflammatories are usually the wrong drug class. Nerve pain responds to different medication, which is a conversation with a doctor
- Blood tests if both hands and both feet are involved. Some of the causes are correctable and stay undiagnosed for years
People with burning hands have usually tried three creams and a brace before anyone asks whether their feet do it too. That question takes four seconds and changes the entire direction.
See someone promptly if
- Burning is constant rather than intermittent
- It followed an injury, cast or operation and is worse than the injury explains
- The hand looks different from the other one — color, swelling, sweating, nail or hair change
- Your feet are involved
- There is weakness or visible muscle wasting alongside it
Burning is the nervous system reporting a fault, not the tissue reporting damage. Treating the tissue rarely fixes it.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.