What is stiffness in the hand?

The commonest cause of stiffness in the hand is inflammation in the flexor tendons. This is often called flexor tendinitis. This is surprisingly common in patients with diabetes. It is also common in patients who have jobs where their hands are particularly busy. They can be generalised inability to fully extend the fingers or perhaps just one finger. It is commonly worse in the morning when the swelling has had a chance to develop overnight. Patients sometimes experience triggering whether tendon flicks into extension. If this does not settle then steroid injections can be very effective. If particularly refractory surgical intervention is sometimes required.

A progressive inability to fully extended finger may also be due to Dupuytren’s contracture. There is a genetic element to this condition. Again it is more common in patients with busy hands. Minor trauma seems to accelerate its progression. This is generally a very benign condition and treatments range from injection with an enzyme and rupture 1 to 2 days later, cutting the cord with a needle, or open surgery. An inability to place the hand flat on the table with good palm contact is often stated as an indication for intervention.

Isolated stiffness of finger joints may be due to wear and tear change. If the stiffness follows an injury to the joint then a soft tissue contracture of the joint can sometimes be improved by surgical release.

Specialised physiotherapy, or hand therapy, is often required after interventions for stiff fingers, and sometimes prior to intervention.