Painful fingers, hands, wrists, forearms and elbows. That’s what I treat every day in clinic, and that’s what this section covers. Each article tells you what the condition actually is, why it happens, what recovery looks like week by week, and the point where it stops being something you can wait out. This page is the overview: the conditions I see most, how each one typically behaves, and the full index of everything this site covers.
The 3 to 7 day rule
Most minor hand and wrist pain settles within 3 to 7 days. A wrist you strained in one heavy gym session. A jammed finger that still bends all the way. A sore elbow after a weekend of DIY. Rest it, protect it, and your body does the rest.
Past that window, different story. Tendons thicken where they rub. Joints stiffen in whatever position you’ve been guarding them in. Then your other fingers start helping out, then the wrist, then the shoulder, and now you have compensation problems stacked on top of the original one.
I see this every week. Someone comes in at month three with a finger that locks. At week two, a splint would have settled it. Now we’re talking injection, sometimes surgery. Not because they were careless. Because waiting felt reasonable, and nobody told them their condition wouldn’t wait with them.
So the rule I give patients: pain that’s clearly improving by day 7, let it finish healing. Pain that’s the same or worse at day 7, get it looked at. You lose nothing by being assessed early. You can lose a lot by being assessed late.
Red flags that skip the waiting rule entirely
Some signs mean get assessed now, not at day 7. Numbness or pins and needles that don’t pass. A finger you cannot straighten or bend, even gently, with your other hand helping. A joint that looks bent, rotated or shortened compared with the same finger on the other hand. Pain in the wrist below the thumb after a fall, even if the X-ray “looked fine”, because a scaphoid fracture hides from first X-rays and a missed one can kill the bone’s blood supply. A cut over a finger or palm where anything afterwards feels weak. And any fingertip that’s white, blue or cold. None of these are wait-and-see problems.
The conditions I see most
Trigger finger
A flexor tendon catches on the first pulley at the base of the finger, the A1 pulley, because the tendon or its sheath has thickened. Early on it’s a click and some morning stiffness. Later the finger locks in a bent position and has to be pulled straight with the other hand. Caught early, a small splint worn at night and some activity changes settle a large share of cases in about 6 weeks. Once it’s locking daily, you’re usually looking at a steroid injection, and long-standing locked fingers end up in surgery. The gap between those outcomes is mostly time.
De Quervain’s tenosynovitis
Pain on the thumb side of the wrist, worst when you lift something with your thumb pointing up, a kettle, a pan, a baby. The two tendons that pull the thumb out are inflamed in their shared tunnel. I see it in new parents so often it has a nickname, mummy wrist, and it also loves phone-heavy thumbs. A thumb spica splint plus load changes does the early work; the stubborn ones need an injection.
Carpal tunnel syndrome
Numbness and tingling in the thumb, index and middle fingers, classically waking you at night and easing when you shake the hand out. The median nerve is being compressed in its tunnel at the wrist. Night splints help early cases genuinely well. What worries me is the late ones: constant numbness and a flattening of the muscle pad below the thumb mean the nerve is dying, and a nerve that’s been compressed too long doesn’t fully come back even after surgery. Tingling that comes and goes is a warning. Numbness that stays is a deadline.
Tennis elbow and golfer’s elbow
Tennis elbow is pain on the outer bony point of the elbow, golfer’s on the inner. Neither needs the sport. Both are overload of the tendons that anchor your gripping and wrist muscles, which is why shaking hands, lifting a mug or wringing a towel can hurt at the elbow. These are slow conditions in both directions: months to build, and typically 6 to 12 months to fully settle even with good rehab. Rest alone rarely fixes them, because the tendon needs graded loading to rebuild, not just absence of use.
Mallet finger
A ball hits the fingertip, the tip droops, and you can’t straighten the last joint on its own. The thin tendon that lifts the fingertip has torn, sometimes pulling a fragment of bone with it. Treatment sounds easy and isn’t: a small splint holding the tip dead straight, worn continuously for 6 to 8 weeks. Continuously means continuously. Let the tip bend once at week 4, even for a second while washing, and the healing tendon pulls apart and the clock restarts. I tell patients this on day one because the splint is simple and the discipline is the actual treatment.
Wrist fractures
The distal radius fracture, a fall onto the outstretched hand, is the one I rehabilitate most. Whether treated in a cast or with a plate, the fracture itself usually knits in about 6 weeks. The recovery is what happens after: a wrist that’s been still for 6 weeks is stiff, weak and often frightened of load. Weeks 6 to 12 are where outcomes are actually decided, and they’re exactly the weeks many people are discharged into with a sheet of exercises and no follow-up. Full function takes months, and that’s normal, not a sign something went wrong.
Scaphoid fractures
Small bone, big consequences. The scaphoid sits below the thumb side of the wrist and its blood supply enters backwards, from the far end, so a fracture can starve part of the bone. It’s also famous for hiding on the first X-ray. The pattern I warn every patient about: fall, sore wrist, normal X-ray, told it’s a sprain, pain fades, and months later the wrist aches because the bone never actually healed. A fall followed by tenderness in the hollow at the base of the thumb needs either repeat imaging in 10 to 14 days or a scan, full stop.
Tendon and nerve injuries
A cut across the palm side of a finger or wrist can divide the cords that bend your fingers or feel the world. Repaired flexor tendons are the most protocol-driven rehab in hand therapy: the repair is weakest around week 3, right when it’s starting to feel fine, which is precisely when a moment of normal use can snap it. If you’re in a post-repair protocol, the boring rules exist because of that gap between how strong the repair feels and how strong it is. Nerves are the slow ones: they regrow at roughly a millimetre a day, so sensation returning over months, with tingling marching slowly down the finger, is the system working, not failing.
The full index: every condition this site covers
This is the complete map of finger, hand, wrist, forearm and elbow conditions, injuries and post-surgery diagnoses I treat and write about. Each entry here becomes its own full article with symptoms, recovery timeline, and the week-by-week detail. If the one you need isn’t linked yet, it’s in the writing queue, published in the order people need them most.
Finger and thumb
- Trigger finger and trigger thumb
- Mallet finger
- Jersey finger (flexor tendon avulsion)
- Boutonnière deformity
- Swan neck deformity
- PIP joint sprains and volar plate injuries
- PIP fracture-dislocations
- Finger collateral ligament sprains
- Sagittal band rupture (boxer’s knuckle)
- Flexor tendon injuries of the finger
- Extensor tendon injuries of the finger
- Climbing pulley injuries
- Skier’s thumb / gamekeeper’s thumb (UCL injury)
- Thumb base (CMC) arthritis
- Bennett’s and Rolando fractures of the thumb
- Phalangeal (finger bone) fractures
- Tuft fractures and nail bed injuries
- Fingertip injuries and amputations
- Finger osteoarthritis (Heberden’s and Bouchard’s nodes)
- Dupuytren’s contracture
- Mucous cysts and ganglions of the finger
- Paronychia and felon (finger infections)
Hand and palm
- Metacarpal fractures, including boxer’s fracture
- Hand osteoarthritis
- Rheumatoid arthritis of the hand
- Gout in the hand and fingers
- Flexor tendon sheath infections
- Ganglion cysts of the hand
- Crush injuries of the hand
- Complex regional pain syndrome (CRPS)
- Hand stiffness and intrinsic muscle tightness
Wrist
- Distal radius (wrist) fractures
- Scaphoid fractures
- Hook of hamate and other carpal fractures
- Scapholunate ligament injuries
- TFCC injuries
- Carpal tunnel syndrome
- Ulnar tunnel (Guyon’s canal) syndrome
- De Quervain’s tenosynovitis
- Intersection syndrome
- ECU tendinopathy and subluxation
- Wrist ganglion cysts
- Kienböck’s disease
- Wrist osteoarthritis and SLAC wrist
- Wrist sprains
- Gymnast’s wrist
Forearm
- Forearm fractures and rehab after fixation
- Pronator teres syndrome
- Radial tunnel syndrome
- Anterior and posterior interosseous nerve syndromes
- Exertional and overuse forearm pain
Elbow
- Tennis elbow (lateral epicondylitis)
- Golfer’s elbow (medial epicondylitis)
- Cubital tunnel syndrome
- Olecranon bursitis
- Distal biceps rupture
- Triceps tendinopathy
- Radial head fractures
- Olecranon fractures
- Elbow dislocations and the stiff elbow after
- Elbow osteoarthritis
- Thrower’s elbow (UCL injury of the elbow)
- Little league elbow
Recovery after surgery
- Flexor tendon repair rehab
- Extensor tendon repair rehab
- Nerve repair and nerve graft recovery
- Tendon transfer rehab
- Carpal tunnel release recovery
- Trigger finger release recovery
- Dupuytren’s surgery and needle release recovery
- Trapeziectomy / thumb CMC surgery recovery
- Plating (ORIF) of wrist fractures: rehab
- Scaphoid fixation recovery
- TFCC repair and wrist arthroscopy rehab
- Ganglion excision recovery
- Finger joint replacement rehab
- Wrist and finger fusion recovery
- Replantation rehab
- Cubital tunnel release and nerve transposition recovery
- Tennis elbow surgery recovery
- Elbow release for stiffness: rehab
How to use this section
Find the condition closest to your symptoms and start with the recovery timeline. Check yourself against the red flags above. If your pain is already past the 7 day mark and not clearly improving, read the article, then get assessed in person. A website can explain what’s happening in your hand. It can’t examine you. I wish it could, it would save everyone a lot of 2am googling, but it can’t.
Every article here is written by me, Nigel Chua, hand occupational therapist in practice since 2005. Tens of thousands of hands, wrists and elbows assessed and treated. My credentials are here.