Hand Pain in Vienna
The hand is in constant use in everyday life. Pain at the thumb, the wrist or the fingers is therefore noticed at once. Here I sort the most common causes by location and trigger and show how I assess them in my practice in Vienna-Döbling.
In short
Hand pain often comes from worn joints, irritated tendons, compressed nerves, torn ligaments, a ganglion or a fracture after a fall. Where it hurts and what brings it on already narrows the cause down. I begin with the conversation and the clinical examination, add ultrasound in the practice and arrange an X-ray, an MRI or a nerve conduction study where needed. The findings decide the route: I usually treat irritation and wear conservatively; an unstable ligament after a fresh tear, a severed tendon, a flexor tendon torn from its attachment, an unstable fracture, a fracture with a displaced joint surface and a compressed nerve with marked loss of function, by contrast, speak for an operation early on.
Possible causes of hand pain
Sorting by location and trigger does not replace an examination, but it helps to place the complaint.
Pain in the thumb when gripping and turning
Pain at the base of the thumb when opening a bottle, turning a key or gripping firmly points to thumb base osteoarthritis (rhizarthrosis); loss of strength in the pinch grip and tenderness over the joint fit with it. If the pain sits instead on the thumb side of the wrist and increases when the thumb moves, an inflammation of the tendon sheath comes into question: de Quervain’s tenosynovitis. If the thumb gets caught in the strap of a ski pole or is bent outwards during ball sports, the collateral ligament at the metacarpophalangeal joint of the thumb can tear: skier’s thumb.
Pain on the little-finger side of the wrist
If the pain increases when you lean on the hand or turn it, the TFCC (triangular fibrocartilage complex), the ligament complex between the ulna and the carpus, is often injured or worn. An ulna that is too long in relation to the radius also comes into question: ulnar impaction syndrome.
A finger snaps or locks
If a finger catches when bending or straightening and then springs through with a jerk, there is usually a narrowing at the pulley: trigger finger (tendovaginitis stenosans). A firm cord in the palm that increasingly pulls a finger into a bent position points instead to Dupuytren’s contracture.
A firm bulge at the wrist
If a firm, rounded lump bulges out at the wrist, a ganglion is usually behind it, commonly known as a ganglion cyst. It arises from the joint capsule.
Fingers go numb at night
If the thumb, index and middle finger go numb at night, that is a classic sign of carpal tunnel syndrome, a compression of the median nerve. If the numbness affects the ring and little finger, the cause is usually cubital tunnel syndrome, a compression of the ulnar nerve at the elbow.
Pain after a fall on the hand
After a fall onto the outstretched hand, a fracture of the radius (distal radius fracture) comes first. If the tenderness on the thumb side remains, I think of a scaphoid fracture, which is often not visible on the first X-ray. If pain in the middle of the back of the hand and a sense of instability persist, the SL ligament between the scaphoid and the lunate may be torn. After a direct blow, finger and metacarpal fractures come into question.
Painful, thickened joints in the hand and fingers
Start-up pain, meaning pain with the first movements after a period of rest, and hard nodules on the finger joints point to osteoarthritis of the wrist and fingers. In the fingers it tends to run in families; in the wrist an old injury is often behind it. If several joints swell at the same time, an assessment in internal medicine is sensible.
When hand pain should be assessed promptly
Most hand pain can be assessed without hurry — but not with these signs:
- Deformity or marked swelling — after a fall or a direct blow, especially with bruising.
- A finger cannot be actively straightened or bent — a pointer to a tendon injury.
- Increasing numbness or fading strength — when gripping and holding.
- Redness, warmth, fever — above all after a puncture, cut or bite injury.
- Tenderness on the thumb side after a fall — even when the first X-ray is unremarkable.
With a deformity after a fall or a direct blow, a bite or deep puncture wound, any wound with loss of movement or sensation, or redness or warmth with fever (after an injury, even without fever), please go to an emergency department without delay. For the other signs, please call promptly via the Orthozentrum Döbling on +43 1 2080145 (Mon – Fri, 9:00 – 16:00); for acute cases there are appointments outside the consulting hours as well. Outside the telephone hours you can reach me by email at ordination@ortho-eigenschink.at.
How I assess hand pain
It begins with the conversation: since when, during what, where exactly, what load at work and in sport. Then I examine clinically — movement, pressure points, strength, sensation and stability compared side to side. In the practice I use ultrasound to assess tendons, tendon sheaths, nerves and ganglia, including during movement. X-ray, MRI and nerve conduction studies I arrange where needed; they do not take place in the building, and I go through the results with you afterwards.
You do not need a referral. My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. More on this on the page about billing in a private practice.
Treatment: the findings decide
Which treatment fits depends on the diagnosis. For irritation and wear I usually proceed in the same way: adjust the load, treat in a targeted way, build back up.
- Splint and adjusted loading — a night splint for nerve complaints, a thumb orthosis for thumb base osteoarthritis.
- Physiotherapy and exercise therapy — in the same building at the Orthozentrum Döbling.
- Ultrasound-guided injection — under vision, exactly where the irritation sits.
- Shockwave therapy — focused and radial, for irritated tendon attachments.
- PRP therapy — your own prepared blood, injected under ultrasound guidance.
- Magnetic field therapy — as an accompanying measure.
When an operation is necessary
If the symptoms persist, or if the findings speak for a procedure early on, I discuss the surgical route with you. Where it makes sense, I work minimally invasively: with arthroscopy (keyhole inspection of the joint) I treat ligament injuries in the wrist and injuries of the TFCC through small incisions; further operations on the hand, such as the release of the median nerve in carpal tunnel syndrome, are shown on the page on hand surgery in Vienna. I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. Whether we operate, we decide together according to the findings.
Frequently asked
Frequently asked questions about hand pain
An assessment makes sense when the symptoms persist, keep coming back or restrict daily life. Pain and swelling after a fall, increasing numbness, fading strength and a finger that can no longer be actively straightened or bent should be assessed promptly. With a deformity after a fall or a direct blow, a bite or deep puncture wound, any wound with loss of movement or sensation, or redness or warmth with fever (after an injury, even without fever), please go to an emergency department without delay.
If the thumb, index and middle finger go numb at night, that points to a compression of the median nerve in the carpal tunnel. Many patients wake up with tingling and shake the hand out. If the numbness affects the ring and little finger instead, the ulnar nerve is usually compressed at the elbow. Examination and a nerve conduction study tell the two conditions apart.
Pain when leaning on or turning the hand often sits on the little-finger side of the wrist. This is where the TFCC, the ligament complex between ulna and carpus, lies; injury to it causes exactly these symptoms, as does an ulna that is too long in ulnar impaction syndrome. A tear of the SL ligament between scaphoid and lunate, by contrast, tends to hurt centrally on the back of the hand. Early joint wear is also possible. Ultrasound, X-ray and, if needed, MRI narrow down the cause.
First come the conversation and the clinical examination, testing movement, pressure points, strength and sensation. In the practice I add ultrasound and use it to assess tendons, tendon sheaths, nerves and ganglia, including during movement. If a fracture or wear is suspected I arrange an X-ray, for ligament questions an MRI, and for nerve complaints a nerve conduction study.
The findings decide. An unstable ligament after a fresh tear, a severed tendon, a flexor tendon torn from its attachment, an unstable fracture, a fracture with a displaced joint surface and a compressed nerve with marked loss of function speak for an operation early on. For irritation and wear I usually begin with a splint, adjusted loading, physiotherapy and, depending on the findings, an ultrasound-guided injection, shockwave therapy or PRP therapy.
Bring everything you have: your e-card, previous reports, medical letters and X-ray, CT and MRI images, older ones too. The documents help me to place the course of the problem. You do not need a referral. Appointments are arranged by telephone from Monday to Friday between 9:00 and 16:00 or by email; the consulting hours themselves are by arrangement.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.