Diseases & Conditions
Sprained Finger
A sprained finger occurs when the ligaments that support the finger joint(s) are stretched. This commonly happens when a strong force bends the finger backwards, away from the palm of the hand, such as:
- When you fall onto an outstretched hand.
- When the finger is forced to the side or hit on end (i.e., "jammed"), such as while catching a ball
Treatment for a sprained finger may involve a short course of immobilization followed by guided return to motion. For more severe sprains where ligaments holding the joint together are torn, surgery may be needed to restore stability to the joint.
Anatomy
Each finger (not the thumb) has three bones with joints between them.
- The distal phalanx is the last bone of the finger at the very tip. It connects to the middle phalanx, the middle bone of the finger, via the DIP joint.
- The middle phalanx connects to the proximal phalanx, the bone in the finger closest to the hand, via the PIP joint.
- The proximal phalanx connects the finger to the hand (metacarpal) via the MCP joint.
While each of these joints is slightly different from the others, they share several similarities.
- On the sides of each finger are collateral ligaments. Ligaments are strong, fibrous tissues that typically connect bones to other bones. The ligaments in the finger help keep the bones in proper position while allowing for motion at the joints.
- On the palm-side of each finger joint is a strong thick structure called the volar plate.
- Surrounding each finger joint is a structure called the joint capsule.
The collateral ligaments, volar plate, and joint capsule work together to allow motion of the finger joints while keeping the joints aligned and stable.
Sprains of a finger may affect one or several of these structures.
Description
Most finger sprains involve the proximal interphalangeal (PIP) joint, which is the joint in the middle of the finger.
- An injury to this joint typically causes pain and swelling.
- In severe cases, it may make the joint unstable.
- Following a sprain, the finger typically becomes stiff, and it can be hard to completely flex the finger (i.e., make a fist) and extend the finger (i.e., extend or straighten the finger).
Sprains may also involve the metacarpophalangeal (MCP) joint of the finger, where the finger attaches to the hand, or the distal interphalangeal (DIP) joint of the finger, the last joint of the finger closest to the fingertip.
Symptoms of these sprains are similar to the symptoms of PIP joint sprains but commonly improve faster. PIP joint sprains may take up to 12 months to fully heal. Swelling may remain for a long time.
Grades of Finger Sprains
Sprains occur when the ligament is stretched, which can also cause small, incomplete tears in the fibers that make up the ligament. Beyond a sprain, ligaments can also be torn completely either:
- In the middle of the ligament, or
- At the end(s) of the ligament, where it can pull off of the bone
Sprains are graded based on the degree of injury to the ligament:
- Grade 1 sprain (mild). The ligament is stretched, but not torn.
- Grade 2 sprain (moderate). The ligament is partially torn. This type of injury may involve some loss of function.
- Grade 3 sprain (severe). The ligament is completely torn or is pulled off its attachment to the bone. These are significant injuries that require medical or surgical care. If the ligament tears away from the bone, it may take a small chip of the bone with it. This is called an avulsion fracture.
Cause
Any strong force that bends the finger backwards or sideways, or hits the finger on end (i.e., "jams" the finger), can stretch or tear the ligaments of finger joints. This most often occurs by falling onto an outstretched hand.
Sprained fingers are common in athletes who participate in sports that involve catching and throwing a ball, such as football, baseball, softball, and basketball. However, they may occur during everyday activities, falls, or other accidental traumas to the hand.
Symptoms
- Depending on the severity of the sprain, you may or may not experience pain at the time of the injury.
- You may have bruising, tenderness, and swelling around the affected finger joint.
- If a ligament is completely torn, the finger joint may feel loose or unstable.
It is important for your doctor to evaluate even a mild finger sprain if it does not improve quickly.
- Proper and prompt diagnosis and treatment of a finger injury is necessary to avoid long-term complications, including chronic pain, instability, and arthritis.
- In addition, some finger sprains are not sprains at all; they are misdiagnosed fractures or dislocations of the finger, which need to be addressed promptly to avoid permanent dysfunction.
Doctor Examination
Physical Examination
Your doctor will ask how and when your injury occurred and will ask you to describe your symptoms. They will then carefully exam your finger and hand.
To help determine if ligaments in your finger are completely torn, your doctor will move your finger in different positions to test the stability of the joint(s).
If the joint(s) is loose and unstable, it is an indication that the ligament may be completely torn.
Imaging Tests
X-rays. X-rays provide images of dense structures, such as bone. Your doctor may order X-rays of your finger and hand to ensure that you do not have an avulsion fracture or any broken bones.
Your doctor may also order a special type of X-ray called a stress X-ray. During this test, your doctor will apply tension to your finger while it is being X-rayed to learn more about the stability of the joint(s).
Other imaging tests. If more information is needed, your doctor may order a magnetic resonance imaging (MRI) scan or an ultrasound. These tests can help your doctor learn more about the severity of your injury and make decisions about your treatment and return to activity.
Treatment
Treatment for a sprained finger depends on the severity of the injury.
Home Care
Mild finger sprains will usually improve with home treatment that includes the RICE protocol:
- Rest. Try not to use your hand strenuously for at least 48 hours.
- Ice. Apply ice immediately after the injury to keep the swelling down. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
- Compression. Wear an elastic compression bandage to reduce swelling. Do not make the bandage too tight, as this could cut off blood flow to the finger.
- Elevation. As often as possible, rest with your hand raised up higher than your heart.
Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, can help reduce pain and swelling. However, if pain and swelling continue for more than 48 hours (2 days), see a doctor.
Nonsurgical Treatment
For a moderate sprain, your doctor may briefly immobilize your finger and then transition you to buddy strapping.
Buddy straps are exactly what they sound like: They connect the injured finger to a neighboring finger using the healthy neighbor as a moving splint for the injured finger. This provides support while allowing the injured finger to move to avoid stiffness.
To ease pain and swelling, you can apply a cold pack to your finger several times a day for 20 minutes at a time for 2 to 3 days after the injury. Do not apply ice directly to the skin.
Depending on the severity of the injury, you may be instructed to wear the buddy straps at all times. It is important to avoid applying any pressure or resistance to your finger until you are permitted to do so by your doctor.
Because immobilization may cause stiffness in an injured finger, your doctor may recommend some stretching exercises to help you regain full range of motion when the doctor feels you are ready to do so.
Surgical Treatment
For a severe sprain or tear, surgery may be needed to restore the stability of your finger joint and help you regain function. Surgery involves:
- Reconnecting the ligament to the bone and/or
- Repairing the avulsion fracture (ligament with a pulled-off piece of bone attached to it) using a pin, screw, or special bone anchor.
After surgery, you may have to wear a short arm cast or a splint for a few weeks to protect the ligament while it heals. You will then likely start therapy to get the finger moving and avoid stiffness.
Outcomes
When diagnosed and treated properly, most finger sprains will heal well with few complications. However, ignoring a sprained finger with the hope that it will heal on its own may lead to long-term problems, including chronic instability, weakness, stiffness, and arthritis.
In addition, as mentioned above, some finger fractures or dislocations are misdiagnosed as finger sprains. Finger fractures and dislocations may require urgent treatment to avoid permanent dysfunction. It is therefore important to be seen promptly by your doctor for concerning finger injuries.
Most finger sprains improve over time. This may take weeks to months. Symptoms of PIP joint sprains — including stiffness, swelling, and pain — may linger for up to 1 year or longer.
Last Reviewed
July 2025
Contributed and/or Updated by
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AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.