Isla Bennett
Smashing your finger is a painful experience that can be caused by a number of common household accidents, such as catching your finger in a door or hitting it with a hammer. Symptoms of a smashed finger include severe finger pain, swelling, stiffness, and bruising. If left untreated, the fingernail on the smashed finger may fall off within a week or two of the injury. However, there are several steps you can take to relieve the pain and promote healing.
| Characteristics | Values |
|---|---|
| Pain | Severe pain may require medical attention. Over-the-counter painkillers can help relieve pain. |
| Swelling | Reduce swelling by icing the injury and elevating the hand. |
| Bleeding | Apply pressure with a clean cloth. If there is bleeding under the nail, a doctor may need to drain the blood to relieve the pressure. |
| Bruising | Bruising is common and can cause throbbing, aching, or numbness. |
| Stiffness | Keep the finger moving to prevent stiffness. |
| Loss of sensation | If you lose sensation in the finger, call your healthcare provider. |
| Discoloration | Discoloration is common and may be red, maroon, purple, blue, or black. |
| Fingernail falling off | A fingernail may fall off due to injury or pressure. A doctor may be able to prevent this. |
| Broken bones | If there is a broken bone, seek medical attention. |
| Damage to nail bed | Damage to the nail bed may require stitches. |
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What You'll Learn
Reduce swelling and redness with ice
A smashed finger can be extremely painful and may cause swelling, stiffness, and bruising. To reduce the swelling and redness, one of the best immediate treatments is to ice the injured finger.
To ice your finger, wrap an ice pack or a cold compress in a paper towel and place it on your finger. Apply the ice for 10-15 minutes at a time, with 20-minute breaks in between. Do this for the first few hours after the injury. Icing your finger will help to minimise swelling, bleeding, and pain. Make sure not to apply too much weight or pressure with the ice. Simply place your finger on top of the wrapped ice pack.
It is also important to elevate your hand to reduce the throbbing. Keep your hand elevated above your heart to slow down the blood flow. If you let your hand dangle, the pain and swelling will increase.
Over-the-counter painkillers and anti-inflammatory drugs can also help to reduce swelling and pain. Examples include ibuprofen (Advil), Tylenol, Motrin, and Aspirin.
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Drain blood from under the nail
If you have a smashed fingernail, you may experience a subungual hematoma, which is when blood pools under the nail, causing it to turn purple, blue, or black. This can be extremely painful due to the pressure generated by the pooled blood.
When to Drain
If the subungual hematoma is causing pain or makes up 50% or more of the nail, doctors recommend draining it. If the injury is small, you may not need to drain it at all, but you should still see a doctor before making that judgment.
How to Drain
It is important to note that you should not attempt to drain a subungual hematoma at home. Home methods, such as using a heated pin or paper clip to make a hole in the nail, may cause infection from bacteria entering the wound. Infections can often cause much more damage than the initial injury.
If you experience severe pain or pressure due to a subungual hematoma, your doctor may perform decompression, also called trephination, to drain the underlying blood and relieve pain and pressure. They may numb the affected finger with a nerve block and then use one of the following methods:
- Cautery: The doctor uses a heated wire (electrocautery device) or carbon laser to burn a hole or holes. The heated tip of the wire is cooled by contact with the hematoma, preventing injury to the nail bed.
- Needle: The doctor uses a needle to make a hole in the nail. After the procedure, your doctor will bandage your nail. You will need to keep the finger bandaged and elevated and may also need to use cold compresses during the first 12 hours after decompression.
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Recognise when to seek medical attention
A smashed fingernail can be extremely painful. While most smashed fingers don't require medical treatment, you should seek medical attention in the following cases:
- If you have a deep wound that may require stitches.
- If you suspect a broken finger or fracture.
- If you are unable to move your finger or feel numbness.
- If you notice your finger is noticeably bent or crooked.
- If the pain and swelling persist or worsen after 48 hours of home care.
- If there is significant injury to the base of the nail, or you have trouble controlling bleeding.
- If the pressure beneath the nail is too painful.
- If you have trouble controlling bleeding or the wound becomes infected.
- If you experience severe pain or the injury involves more than just the fingertip.
If you are unsure whether your finger injury is serious, it is always best to err on the side of caution and seek medical care.
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Treat pain with over-the-counter medication
A smashed finger can be extremely painful, and you may experience severe pain, bruising, stiffness, or even loss of sensation. While most smashed fingers don't require medical treatment, you should seek treatment if there are signs of a fracture, the injury looks severe, or the pain and swelling persist.
Over-the-counter (OTC) oral anti-inflammatory or pain killers can help manage the pain and reduce inflammation. These include:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
- Acetaminophen (Tylenol)
- Aspirin
These medications can help reduce inflammation and associated pain. It is important to follow the dosage guidelines on the packet or your healthcare provider's advice.
In addition to OTC medication, you can also try the following to help manage the pain:
- Ice application: Apply ice wrapped in a clean cloth for 15-20 minute intervals, several times a day for the first few hours. This can help to reduce pain and swelling.
- Elevation: Keep the injured finger raised above the level of your heart to slow the blood flow and reduce throbbing.
- Keep the area clean: Wash your hands with mild soap and warm water, then dry them with a clean towel to prevent infection.
- Move your finger: If possible, keep using the finger to promote circulation. If you can't move it or begin to lose sensation, call your healthcare provider.
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Keep the finger moving
Keeping your finger moving is an important part of treating a smashed finger. This is because smashed fingers can cause stiffness and loss of sensation in the injured digit. Moving the finger helps promote circulation and prevent stiffness. However, it is important to avoid any movements or actions that cause your pain to increase significantly.
If you can't move your finger or feel it after a few minutes, you may need to seek medical attention. Call your healthcare provider if you begin to lose sensation in the finger. If you can't straighten your finger, it's also important to seek medical attention.
While your finger is healing, it's a good idea to stay away from any activities that increase pain or involve a lot of finger strain. This includes lifting or grabbing things.
Gentle massage may also help the finger to recover by promoting blood flow and helping clear dead cells.
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Frequently asked questions
To reduce swelling and redness, you should ice your finger. Wrap an ice pack or cold compress in a paper towel and place it on your finger for 10-minute intervals with 20-minute breaks.
A few days after the injury, you can drain the blood from under the nail to relieve pain and pressure. You can use a heated paperclip or a heated wire to do this. Make sure to sterilise any tools with rubbing alcohol.
You should seek medical attention if you are experiencing severe pain, if the injury looks severe, or if you are unable to move or feel the tip of your finger.
