Claw Hand

What is claw hand?

Claw hand causes your fingers to bend in toward your wrist. You might see it referred to as ulnar nerve palsy. It can also make it hard (or impossible) for you to straighten all your fingers. This stuck flexed in position is what gives claw hand its name — your hand is frozen in a claw shape.

Claw hand can be a type of congenital hand difference that you’re born with, or it can be caused later in your life by an injury or another health condition.

Most cases of claw are caused by damage to your ulnar nerve, the nerve that controls some of the muscles that flex and extend your fingers.

Claw hand vs. Dupuytren’s contracture and trigger finger

Claw hand, Dupuytren’s contracture and trigger finger all make it hard to straighten your fingers. The difference is what causes them.

Claw hand is usually caused by damage to your ulnar nerve, which controls muscles in your ring and pinkie fingers. If your ulnar nerve is damaged, the muscles it controls don’t get some or all of the electrical signals that tell them to straighten.

Dupuytren’s contracture is a genetic disorder that makes the tissue under the skin of your palms and fingers thicken and tighten. Small bumps (nodules) grow on your hand’s fascia — the rubber-band like ligament that supports your hand and fingers and helps them move properly. Eventually, these growths can cause your fingers to pull in towards your wrist so much you can’t straighten them.

Trigger finger and trigger thumb are caused by swelling in your hand’s tendons. Overusing your tendons can irritate them and cause inflammation. This swelling makes it harder for them to move as smoothly as they usually do. If the swelling is severe enough, the fingers can remain locked in a flexed or extended position, requiring surgery to correct.

Who does claw hand affect?

Claw hand can affect anyone. Men and people assigned male at birth are slightly more likely to develop it than women or people assigned female at birth.

How does claw hand affect my body?

Claw hand makes it hard to use your hand the way you’re used to, especially if you weren’t born with it, as it can affect your ability to touch, grasp and move objects.

It might also be hard to do your job or schoolwork with a claw hand, especially if you need to hold tools or type on a keyboard.

What are the symptoms of claw hand?

The most obvious symptom of claw hand is your hand being stuck in a claw shape with your fingers flexed in toward your wrist. It might be hard to extend your fingers away from your wrist — you might not be able to move your fingers at all.

You might have trouble “opening” your hand — spreading your fingers wide away from the center of your palm like you usually can.

If the claw hand is caused by damage to your ulnar nerve, you might feel tingling or numbness along your forearm into your wrist, ring and little fingers.

What causes claw hand?

Causes of claw hand include:

• Injury to your ulnar nerve or the branches that make up the ulnar nerve: Any injury to your neck, chest or arm can damage your ulnar nerves that run from either side of your neck down through your arms to your wrists.
• Cubital tunnel syndrome: Cubital tunnel syndrome, also called ulnar nerve entrapment, happens when your ulnar nerve gets irritated or compressed (squeezed) on the inside part of your elbow. The pressure on your ulnar nerve can interfere with its ability to control the muscles in your hand and can cause numbness and tingling to the forearm, wrist, ring and little fingers. People who put a lot of repeated pressure on their elbows and wrists, or perform repetitive elbow and wrist-bending movements are more likely to develop ulnar nerve problems.
• A congenital hand difference: Congenital means "present at birth." A congenital hand difference is a variation in the usual formation of the hand that occurs when a baby is in the womb. People with congenital claw hand have it from the time they are born.
• Cervical spondylosis: Cervical spondylosis is a general term for age-related wear and tear in your cervical spine (neck) that can lead to neck pain, neck stiffness and other symptoms. Some people with cervical spondylosis lose some function in their hands.
• Scar tissue: If the skin on your arm or hand is damaged after a severe burn injury it can be tight enough to cause claw hand.
• Infections: It’s rare, but infections like leprosy that affect your nerves can cause claw hand.

How is claw hand diagnosed?

Your healthcare provider will diagnose claw hand with a physical exam and an electromyography (EMG) test.

They’ll look at your hand and check its function — how well you can bend and move your fingers compared to your usual ability. If your provider suspects you have claw hand or another nerve issue, you’ll need an EMG.

Electromyography testing

An EMG is a diagnostic test that measures how well your muscles and nerves work. Your provider will insert thin needles through your skin into your muscles. When you move your muscles, electrodes on the end of the needles measure their electrical activity. If your ulnar nerve is damaged, an EMG will show how and where.

If present, your provider would diagnose congenital claw hand when your baby is born.

How is claw hand treated?

Your provider can treat claw hand in a few different ways. Which treatment you’ll need depends on what’s causing it and how severe your symptoms are. Treatments include:

• Stretching exercises for your forearm, wrist and hand.
• Wearing a splint or brace on your affected fingers.
• Physical therapy to increase your strength and flexibility.
• Surgery.
• Medication to treat the infection that’s causing claw hand.

Claw hand surgery

You might need surgery to release your fingers and relieve your claw hand symptoms. Claw hand surgeries include:

• Nerve repair.
• Tendon release.
• Skin grafts.
• Tendon transfer.

Your provider or surgeon will tell you which type of surgery you need and what to expect.

How soon after treatment will I feel better?

How long it takes to feel better depends on which kind of treatment you needed. People who need a splint usually have to wear it for a few months. Stretching exercises and physical therapy are longer-term treatments that can take a year or more.

If you need surgery to repair claw hand, your surgeon will give you a recovery timeline. Most people need at least a few months to recover from claw hand surgery and physical therapy to regain their strength. However, if the ulnar nerve is the cause, and the nerve is severely damaged, there may be long-term nerve-related symptoms.

How can I prevent this?

Many causes of claw hand can’t be prevented, especially if you’re born with it.

You can prevent damage to your ulnar nerve and cubital tunnel syndrome by:

• Avoiding leaning on your elbow.
• Avoiding putting pressure on the inside of your arm.
• Not resting your elbows on your computer chair armrest if you use it frequently. Keep your chair high.
• Sleeping with your elbow straight.
• Avoiding overusing your arms and elbows.
• Giving your body time to rest and recover after intense physical activity.

What can I expect if I have claw hand?

Claw hand can be a temporary condition, but it can also be a long-term issue. How long it affects you depends on what causes it and how your fingers and hand respond to treatment.

Some people fully recover after wearing a brace and working with a physical therapist. Others have some impaired hand function, even after having claw hand surgery. Talk to your provider or surgeon about how much improvement you should expect based on your unique situation.

Will I have to miss work or school with claw hand?

If you use your hands for your job or usually use all your fingers to do your schoolwork, you might need to miss work or school while you’re recovering. Talk to your provider about what activities you can do with your affected fingers, and if there are any accommodations you might qualify for.

How do I take care of myself?

If you have a splint or brace, wear it as often as your provider asks you to. Similarly, if you’re working with a physical therapist, try to do your stretches and exercises as often as you can.

Talk to your provider if your symptoms are getting worse, or if you’re experiencing any pain.

When should I see my healthcare provider?

Visit your provider as soon as you notice any changes in your hand or fingers, including pain or stiffness that doesn’t get better in a few days.

When should I go to ER?

Go to the emergency room if you’ve experienced a trauma like a fall or a car accident, or if you have any of these symptoms:

• You can’t move or use your hand like you usually can.
• You lose feeling in your hand or arm.
• You think you have a broken bone.

What questions should I ask my doctor?

• Do I have claw hand or another condition?
• Which treatments will I need?
• Will I need surgery?
• How long will I need to wear a brace or go to physical therapy?

A note from Cleveland Clinic

Anything that prevents you from using your hand the way you always have can be scary and frustrating. Claw hand can be caused by lots of issues, so visit your provider as soon as you notice any changes in your fingers, hand or arm.

Treating claw hand takes time, so be patient, stick with it and celebrate every bit of progress you make.