Pain and swelling on top of the hand: what to know

The back of the hand contains small joints, tendons, ligaments, nerves, and soft tissue. A fall or blow can cause a sprain or a [Distal Radius Fracture](/conditions/distal-radius-fracture/), especially when pain is closer to the wrist. Repeated gripping, keyboard use, or lifting may irritate the extensor tendons and produce pain with finger or wrist movement.

Swelling in several finger joints, stiffness after rest, or symptoms on both hands can occur with inflammatory conditions such as [Rheumatoid Arthritis](/conditions/rheumatoid-arthritis/). General [Hand Swelling](/symptoms/hand-swelling/) may also be influenced by fluid retention or other medical problems, so the pattern and other symptoms matter.

Remove rings early if swelling is increasing. Rest from forceful gripping and keep the hand raised when practical. A wrapped cold pack used briefly may reduce discomfort after a recent injury. Move the fingers gently within comfort, but do not force a painful joint or repeatedly test it.

Note the exact area, whether one or several joints are involved, the time of day stiffness is strongest, and any bruising, tingling, or reduced grip. A clinician may check alignment, tendon movement, sensation, circulation, and tenderness; an X-ray or other test may be considered when the examination suggests it.

Get urgent help after an injury if the hand is misshapen, numb, unusually cold or pale, or impossible to move normally. Seek prompt care for rapidly increasing swelling, severe pain, a spreading red area, fever, or a wound near the painful region. Arrange an appointment if symptoms continue, keep returning, or interfere with writing, dressing, driving, or work.

Could this involve a bone, joint, tendon, or nerve? Do I need an X-ray or another examination? How should I protect the hand while keeping it mobile? What symptoms would suggest an inflammatory condition rather than a local injury?