During a consultation, your doctor will use various techniques in his assesment of the symptom: Hand pain. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
Why: to establish if acute or chronic.
Why: to determine if local or generalized pain and to determine if finger joints may be involved.
Why: can help determine the cause of hand pain e.g. carpal tunnel syndrome wakes the person in the middle of the night ; cervical spondylitis wakes the person with pain and stiffness that persists well into the day; people with thoracic outlet syndrome find it difficult to fall asleep due to pain.
Why: helps determine the cause of hand pain e.g. carpal tunnel syndrome symptoms may be relieved by dangling the arm over the side of the bed.
Why: e.g. whiplash injury, fall onto outstretched hand, direct trauma to hand - can determine possible cause of pain.
Why: e.g. Osteoarthritis, Rheumatoid arthritis, Gout.
Why: diabetes or porphyria can be a cause of painful peripheral neuropathy; diabetes may be associated with erythermalgia ; hypothyroidism may cause carpal tunnel syndrome; possible causes of Raynaud's phenomenon include rheumatoid arthritis, lupus erythematosus, systemic sclerosis, polyarteritis nodosa, Buerger's disease, polycythaemia, leukemia, polymyositis , dermatomyositis.
Why: e.g. beta-blocker blood pressure medications and ergotamine can cause Raynaud's phenomenon.
Why: certain occupations and sports requiring repetitive motions are at risk of causing overuse disorders e.g. process and meat workers are at risk of carpal tunnel syndrome and De Quervain's tenosynovitis due to rapid finger thumb and wrist movement; vibrating machinery workers are at risk of Raynaud's phenomenon.
Why: can be a cause of painful peripheral neuropathy.
Why: smoking aggravates Raynaud's phenomenon and is a major risk factor for peripheral microemboli and Buerger's disease.
Why: e.g. arsenic or thallium poisoning can cause painful peripheral neuropathy.
Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:
Why: if also paresthesia in the involved hand this usually suggests herniated cervical disc , spinal cord tumor or cervical spondylosis. Other conditions to consider are brachial plexus neuropathy, thoracic outlet syndrome, cervical rib, Pancoast's tumor, Raynaud's disease, sympathetic dystrophy or various entrapment syndromes such as carpal tunnel syndrome and ulnar nerve entrapment at the elbow.
Why: pain originating from disorders from the neck can transmit to distal parts of the arm and sometimes the hand.
Why: can indicate septic arthritis, osteomyelitis.
Why: may suggest osteoarthritis, rheumatoid arthritis, gout, lupus erythematosus, psoriatic arthritis.
Why: e.g. frequency of urination, excessive thirst, weight loss (especially in Type 1 Diabetes mellitus), tiredness, fatigue, increased infections especially of the skin and genitals, blurry vision - Diabetes mellitus is a cause of painful peripheral neuropathy.
Why: e.g. weakness and wasting of the small muscles of the hand, numbness over the inner side of the hand and forearm, unequal radial pulse.
Why: e.g. sequential discoloration of the digits from pallor to blueness to redness upon exposure to cold. When fingers become red they are painful.
Why: e.g. abrupt onset of lower arm and hand pain, hand coldness, hand numbness, arm weakness and absent pulses.
Why: e.g. recurrent episodes of sudden pain, blueness, coldness or numbness in a digit. These changes characteristically improve over several days, only to reappear perhaps in a different area of the hand.
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