The knuckles are where the two phalanges, or finger bones, meet each other and where they meet the metacarpals, or hand bones. Most people have 14 knuckles in each hand, three on each finger, and two on each thumb.
This article discusses four common causes of knuckle pain and their symptoms and treatments.
Throbbing, aching, or shooting pain in the knuckles can result from an injury or an underlying medical condition.
Complex networks of nerves, muscles, tendons, and ligaments allow the knuckles to move, giving rise to precise finger movements, such as typing, holding utensils, and scratching the head.
Most people have 14 knuckles in each hand, three on each finger, and two on each thumb.
A knuckle is a finger joint. The knuckles are where the two phalanges, or finger bones, meet each other and where they meet the metacarpals, or hand bones.
Typically, four main issues cause knuckle pain.
Injury
Injuring any of the structures that make up the knuckles can lead to knuckle pain. Types of knuckle injuries include:
Strains: including stretched or torn muscles and tendons
including stretched or torn muscles and tendons Sprains: stretched or torn ligaments
stretched or torn ligaments Fractured or broken knuckles: can occur when a person punches something or falls on their hand
can occur when a person punches something or falls on their hand Dislocated knuckle: when a phalanx, or finger bone, moves out of its original position
Learn about the differences between a strain and a sprain here.
Symptoms of a knuckle injury
The symptoms of a knuckle injury vary depending on the type and severity of the damage.
People may feel mild to severe pain in the injured knuckle or knuckles. This can feel like a dull ache or a sharp, stabbing sensation.
The pain may worsen with movement.
Symptoms of a strain or sprain near a knuckle include:
pain
swelling
limited flexibility
stiffness or reduced range of motion
Symptoms of a fractured or broken knuckle include:
bruising
limited or no range of motion
numbness or tingling in the affected finger
visible changes, such as swelling and discoloration
finger appears bent at an abnormal or extreme angle
Treatments for knuckle injuries
People can treat sprains, strains, and other mild knuckle injuries with RICE therapy:
Rest: Avoid moving or using the injured knuckle while it heals. Consider immobilizing the knuckle in a splint or brace.
Avoid moving or using the injured knuckle while it heals. Consider immobilizing the knuckle in a splint or brace. Ice: Apply an ice pack or cold compress on the injured knuckle. This will help reduce swelling and relieve pain.
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Apply an ice pack or cold compress on the injured knuckle. This will help reduce swelling and relieve pain. Compression: If the knuckle appears swollen, consider wrapping it with a bandage or buddy tape.
If the knuckle appears swollen, consider wrapping it with a bandage or buddy tape. Elevation: Keep the injured finger raised above the heart. This may help reduce swelling.
A healthcare provider can diagnose a fractured, broken, or dislocated knuckle.
They will reset broken bones or maneuver a dislocated phalanx back into place. They may recommend wearing a brace or splint while the knuckle heals.
Over-the-counter (OTC) pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can reduce swelling and pain.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is an autoimmune disease that leads to inflammation in the joints. The Arthritis Foundation state that RA typically affects the joints in the hands, wrists, and knees.
According to an overview article in Medical Principles and Practice , RA initially causes painful swelling in small joints, such as the knuckles, before progressing to larger joints and organs.
Symptoms of RA in the knuckles include:
tenderness or pain in the knuckles of one or both hands
knuckles feel stiff, especially in the morning
pain and stiffness occur in other joints, such as the wrists, knees, or hips
RA can lead to widespread symptoms, such as fatigue and weight loss.
The goals of RA treatment include:
relieving inflammation
managing other symptoms, such as pain and fatigue
improving joint function and mobility
preventing long-term complications , such as heart disease, obesity, and reduced quality of life
A healthcare provider may recommend one or more of the following treatments for knuckle pain related to RA:
NSAIDs, immunosuppressants, or corticosteroids to reduce inflammation and pain
topical pain relievers
physical therapy to improve joint mobility
heat therapy to relax the finger muscles and promote joint lubrication
cold therapy to reduce inflammation and pain
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Osteoarthritis (OA) is the most common type of arthritis, affecting more than 32.5 million adults in the United States.
It is an age-related degenerative disease that involves cartilage loss and bone changes. OA can affect any joint in the body, including the knuckles.
OA most often affects the joints at the tip and middle of the fingers. OA can also cause swelling at the base of the thumb.
Symptoms of OA include:
swelling in multiple knuckles
deep, aching pain in the affected knuckles
joint stiffness, especially in the morning
reduced flexibility and limited range of motion in the affected knuckles
muscle weakness near the knuckles
a clicking or popping sound when bending the knuckles
There is no cure for OA. However, combining medication, physical therapy, and lifestyle changes, such as exercise and weight control, can help relieve OA symptoms and prevent long-term complications.
Medications for OA include:
OTC pain relievers, such as acetaminophen and ibuprofen
topical creams or gels that contain lidocaine, menthol, or capsaicin
oral or injectable corticosteroids
platelet-rich plasma (PRP) injections
Non-drug therapies for OA include:
physical therapy exercises to strengthen the joints and reduce stiffness
surgery to remove damaged cartilage, for example
Ganglion cyst
A ganglion cyst is a round, fluid-filled growth that usually develops on the back of the wrist and the base of the fingers. Ganglion cysts can also appear on the knuckle closest to the tip of the finger.
Only about 10% of ganglion cysts form on joints other than the wrist.
A ganglion cyst may feel painful or tender to the touch. The pain only affects the knuckle where the cyst developed.
A ganglion cyst may resolve suddenly without medical treatment. A healthcare provider may also use a needle to drain a ganglion cyst.
A doctor may need to surgically remove a ganglion cyst if it returns or does not respond to other treatments.
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