Lump in Palm of Hand below middle finger: Symptoms, Causes, Treatments

The human hand is chock full of nerve endings and sensory apparatus. Any alterations therefore or changes to the physicality of our hands is not only clearly visible but very easily felt.

What is so special about the construction of the human hand?

The strength of the rock climber, the dexterity of the surgeon, the finesse and delicacy of the concert violinist, the human hand can do it all. With a huge concentration of nerve endings and four types of skin receptors responding to pain, temperature, touch and soft and hard pressure, it is no wonder that malaise or damage to our hands is immediately and instantly evident to the human brain via sensation.

Reading your palm

Beloved of fortune tellers, the palm with its natural lines and creases has always had a special significance in the human story. So a lump appearing under the skin of your palm is unfortunately not a welcome premonition of a tall, dark handsome stranger or that you are about to come into a sizeable inheritance. The most common lump to appear on the hand and the wrist is a Ganglion which is a category of cyst.

Harmless and full of tissue fluid similar to synovial fluid, if they are located near a joint they may grow to become quite large. However, they are downright ugly and can impede function and effective biomechanics. Gone are the days when the local medicine man thwacked them with the family Bible although this old wives’ tale has persisted for a worryingly long time.

There is some pretty gruesome footage on YouTube demonstrating that people are still prepared to give this a try. Unsurprisingly, ganglia are still referred to as ‘Bible Cysts’ or ‘Bible Bumps’. Modern 21st-century medicine prefers to aspirate the fluid with a fine needle but the cyst may re-form. In this scenario, the root is removed with a minor surgical procedure.

What other conditions exist which can cause a lump in the palm of my hand below the middle finger?

There is a disorder called Dupuytren’s contracture or Dupuytren’s disease named after the physician who actually gained more notoriety treating the haemorrhoids of Napoleon Bonaparte. The French anatomist and army surgeon first performed this surgery in 1831 and his findings were published in that august publication, The Lancet, in 1834.

Beneath the skin of the palm and fingers lies thick elastic tissue which promotes a sophisticated range of movement. Known as fascia, this tissue incorporates fibrous stands running from the palm up towards the fingers, the longest being underneath the middle finger. As the name of the disease suggests, these pulleys and strings become permanently taut and tightened causing the hand to curl round in a gross deformity and imposing considerable disablement. The symptoms are plain to recognise but the causes remain a mystery.

There are noted predisposing factors such as gender and ethnicity – Northern European and Scandinavian descent is one characteristic and being male is another. There also seems to be a hereditary link, a genetic predisposition. This nasty and distressing infirmity commences with a feeling of stiffness and limitation before a small lump or pad may begin to develop in the palm of the hand below the middle finger. Diagnosis occurs over a period of time as the condition worsens. Treatment involves long-term management, for example, with steroids, rather than instant surgical cure.

Repetitive Strain Injury

In the modern technological era, millions of people spend their working lives sitting at a computer. Herald the arrival of RSI which affects the neck, arms, shoulders, back and hands. RSI in the hands does not evince with a hard lump initially, it can be tingling, numbness, pins and needles in the fingers and loss of co-ordination. Distortions and malformations can evolve if the situation goes unchecked including swollen areas and lumps. Man was never designed to sit for hours inert at a machine. The best way to combat RSI is to change your routine even if it is just breaking up the day into sessions.

Pictures of lumps and disfigurements on the palm

Browse pictures of various lumps all sited on the palm of the hand and representing a variety of problems.

Can you identify your particular issue from these visual images?

Do lumps on the hand portend serious illness?

Arthritis can affect the hands but this disease focuses more on the finger joints and the large joint on the hand near the base of the thumb. Lumps or masses on the hand are often described in medical jargon as tumours. Tumours can, of course, be benign and so a reference to a tumour does not suggest the presence of cancer. The most common ‘tumour’ on the hand is a giant cell tumour of the tendon sheath, the lubricated sleeve which covers each tendon. Usually present on the side of the middle or index digit, these can be incredibly painful and considerably impair the ability to bend the affected finger. But they are not terminal. At the end of the day, it could be something as simple as a mole or a wart running a bit riot which is responsible for the lump on your hand, nothing more.



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