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What Are the Causes of Metacarpophalangeal Joint Pain?

By Susan Abe
Updated Mar 03, 2024
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Arthritis is the most common cause of metacarpophalangeal joint pain, though the condition can be attributed to a number of different problems, including trauma, either from repetitive use or injury, bone cysts, and other underlying conditions like gout. People typically have one metacarpophalangeal joint, also known as an MCP or MC joint, per finger. These joints play a critical role in finger and hand movement, and pain can inhibit a number of everyday tasks. Most of the time the pain happens all at once, which it to say that all the joints in a single hand flare up together, but not always. A lot depends on a person’s structural anatomy and the underlying cause of the pain.

Joint Basics

In people, the MCP joints are essentially the knuckles where the bones of the hands first connect to the long middle bones of the fingers. Speaking more scientifically, they are where the heads of the metacarpal bones meet the bases of the proximal phalanges. The meeting involves a number of ligaments and small tendons and plays a critical role in finger movement and precision. Metacarpophalangeal joint pain is often disabling because these "hinge" joints are essential to a number of both fine motor tasks and larger power, or grip, activities.

Rheumatoid Arthritis

The most common cause of metacarpophalangeal joint pain is rheumatoid arthritis. This inflammatory disease happens when the lining of joints, particularly those in the hands and fingers, produces substances that erode the cartilage, ligaments, and tendons of the area. When rheumatoid arthritis happens in the MCP joints it can cause not only pain but also lasting damage, sometimes causing a shift of the fingers toward the ulnar side of the hand — the little finger's side. This can be disfiguring and can dramatically impair movement and hand functionality.

Other Forms of Arthritis

Osteoarthritis and post-traumatic arthritis are generally the second-most common causes of pain in this joint. These are more general forms of joint deterioration that typically happen as a facet of old age or, in the case of post-traumatic flare-ups, accident or injury. The main symptom is a wearing down or deterioration of the protective cartilage covering the bone at the joint. These types of arthritis typically impact larger joints before they hit the fingers, but not always, particularly not when the hands have been injured or somehow compromised.

Repetitive Use and Trauma

Trauma or injury to the hands and fingers can also cause pain, stemming from either the soft tissue edema limiting the joint movement or actual damage to the joint. This sort of pain will sometimes go away on its own once the fingers have healed, particularly if the injury wasn’t severe enough to cause lasting damage. A hand bruised by being smashed in a door, for instance, is more likely to make a full recovery than one requiring surgery or one in which the bones were actually broken. In these cases joint pain may be longer lasting, particularly if the joints healed improperly.

Repetitive use can also wear down the cartilage of the joints, though this often happens slowly over time so it’s harder for people to pinpoint a specific cause. People with repetitive injuries often complain of an aching or deep joint pain during fine motor activity, but the pain isn’t necessarily always present and it rarely comes with the deformity that is apparent with rheumatoid arthritis.

Gout and Skin Disorders

Another non-traumatic cause of pain is gout. Gout is a very painful accumulation of uric acid that most often occurs in the joint of the big toe, but it can also manifest in the MCP joints, particularly where the thumb joins the hand. Joints impacted by gout tend to be bright red, swollen, and often hot to the touch.

Psoriasis is an autoimmune disorder that is best known for its impact on the skin, but it sometimes causes pain and disability in the body’s joints before the reddened skin lesions so characteristic of the disease appear. People who suffer from this condition typically have scaly, flakey skin over large swaths of their bodies. The discomfort and itchiness of the condition sometimes causes them to overlook MCP joint pain because their attention is more focused on the external symptoms, but in many cases, if there is psoriasis on the hands there is likely inflammation in the finger joints, too.


Benign bone cysts might also be the culprit, particularly if the sufferer is a young boy or teenager. Young men are more prone to bone cysts than young women in part because of the rate at which their bones shift and develop during puberty. A cyst is basically a errant bobble of fluid that builds up and forms a growth; when this happens on or near the finger joints, people often feel pain until the area is drained or the cyst is otherwise removed.

Other types of cysts, such as ganglion or dermoid cysts, might also be to blame, though diagnosing these can be more invasive and are usually only considered when health care providers have ruled out most other potential causes. Even known joint conditions that are rarely seen in the hands and fingers, such as osteochondromatosis, might need to be investigated in really perplexing cases, and sometimes even rarer conditions like Systemic lupus erythematosus may be diagnosed as the true cause in the process.

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Discussion Comments
By anon288760 — On Aug 31, 2012

@Izzy78: I have rheumatoid arthritis and I also work in genetics research. I’m responding to your assertion that "...things that happen in your lifetime probably won't have much affect on it." because it is entirely wrong. Nothing could be further from the truth, and you could be misleading people who come to this article for information.

Any rheumatologist or researcher in clinical and genetic rheumatology will tell you that there are two factors in the disease. One is genetic and one is environmental. Most patients inherit the mutations that can cause the syndrome (it's not a "disease" until a cause is known, and you're right -- we have no exact cause yet, only symptoms and part of the triggers) when they are all (or most are) expressed. But, you can have the genes your whole life and never present the syndrome.

It's worth saying that we don't yet know all of the genes involved in what is called the "pathway" of the syndrome. We know a handful of them, eight of which were only recently discovered in whole-genome studies of arthritis.

Most people who develop or begin to present symptoms of RA and/or other forms of arthritis begin to do so partly because of a prolonged infection or illness, and sometimes due to an injury or prolonged stressors in their lives. This is theorized to push the immune system into a kind of overactivity, possibly causing different immune traits to be expressed, leading to the development of whichever form of arthritis the patient ends with -- in my case, RA -- through inherited traits brought to expression from a long-term infection.

Also, one of the key treatments of many forms of arthritis is suppression of the immune system, either through a combination of anti-inflammatories and steroids (such as prednisone), or more targeted immunosuppressant drugs that have recently been created for that purpose, and in some more intractable cases, low dose chemotherapy drugs are used, such as methotrexate.

The immune system is suppressed specifically because it is the patient's own immune system mistakenly attacking healthy native tissue that causes the inflammation and damage of arthritis. Anything that causes the immune system to become active and start sending out fighting cells, even a simple cold, will cause the arthritis to get worse as well. And of course, with a suppressed immune system, even a cold can be dangerous.

So you see, what you do can most definitely affect your arthritis, even if you have an age-related form and aggravated it by doing too much strenuous exercise. What happens to you in your life and what you do in your life can most definitely affect whether or not you develop it and how quickly it progresses.

If you think you have arthritis, please make an appointment to see your primary care doctor and ask their opinion, and possibly ask for a referral to a rheumatologist if they are unsure or if you would like a second opinion.

By stl156 — On Dec 11, 2011

@Izzy78 - The thump pain could very well be part of carpal tunnel. I am assuming you have the obvious wrist joint pain, as well, with all of this.

I know when my mom started to get carpal tunnel, she noticed she was having trouble picking things up off of a desk and holding on to them. Things like pens and scissors and things. I don't know if carpal tunnel would directly lead to metacarpophalangeal joint injury or not, though. My advice would be to see your doctor, especially if you have already noticed some of the other signs. If you catch it soon enough, you can do things to stop it from progressing to the point of needing surgery.

By Izzy78 — On Dec 10, 2011

@jmc88 - As far as rheumatoid arthritis goes, I know that is an autoimmune disorder, but no one really knows what the cause is yet. More than likely, it is something genetic, so things that happen to you during your lifetime probably won't have much effect on it.

For regular arthritis on the other hand, I think you may actually be more at risk of developing if you have had joint injuries in the past. I don't know if it is true or not, but I figure everyone has been told that you aren't supposed to pop your joints, because it will make you more likely to develop arthritis.

The thing I was wondering was if something like carpal tunnel syndrome would have anything to do with causing thumb joint pain? I don't know if I have carpal tunnel, but it seems like I might be developing some of the early signs of it, and I am wondering if that might be another.

By jmc88 — On Dec 10, 2011

@kentuckycat - I have had similar problems in the past, and they always went away after I stopped using the mouse for a little bit. If you really need to keep working, though, something you can always try is moving your fingers over so that your middle finger is on the scroll wheel. At least in my case, I have always traced my pain to using the scroll wheel, not so much clicking. If the problem keeps happening, you could always invest in an ergonomic mouse, as well.

Besides having finger joint pain from the computer, I find I always have a little bit of stiffness once or twice a month. I still am not really sure what the cause is. When I was younger, though, I used to play a lot of sports, and I have jammed or broken the metacarpophalangeal joint of many of my fingers at least once, so I always figured that probably had something to do with it. Does anyone know whether things like that contribute to having rheumatoid arthritis later on in life?

By kentuckycat — On Dec 09, 2011

I have been having a little bit of pain in the joint of my right index finger. Since that is the only finger that really hurts, I would have to assume it is because I have been spending a lot more time than usual on the computer, and it is aching from using my mouse. Does anyone have any suggestions about how to get some joint pain relief?

I haven't really done anything about it yet, but it has been like this for a couple of days and doesn't seem to be going away. Would ice be something that might help, or should I just make an effort to not use my computer for a couple days and see if the pain goes away. Is there anything you can do while you are using the computer that will help you prevent the joint pain in the first place?

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