What should you know about hand pain after a fall with no swelling?

A fall can strain ligaments, bruise bone, irritate a tendon, or cause a small fracture. Swelling may be subtle, delayed, or hidden by the hand's shape. Pain with gripping, pressing, twisting, or moving one finger can help a clinician identify the injured structure. A wrist fracture, including a distal radius fracture, may cause hand or wrist pain and can be missed if attention is focused only on swelling. Ongoing pain is a reason to arrange an examination rather than using appearance alone to judge the injury.

Rest the hand from lifting and forceful gripping. Keep it supported in a comfortable position and use a cool pack wrapped in cloth for short periods if it helps. Remove rings before swelling develops. Avoid repeatedly testing the painful movement or trying to straighten a finger by force. A clinician may check sensation, circulation, movement, and tenderness, then decide whether an X-ray or other imaging is appropriate. Use pain medicine only as directed on its label or by a healthcare professional.

Seek urgent care if the hand looks crooked, a finger cannot move normally, pain is severe, or the fingers become numb, cold, pale, or blue. Prompt review is also needed for an open wound, increasing pain, or symptoms that are not settling after the fall. Do not wait for swelling to appear before checking a painful hand.

Ask which movements suggest a bone, ligament, tendon, or nerve injury; whether imaging is needed now or later; how long to protect the hand; and which activities are safe. Mention exactly how you landed and where the pain is most focused.