August 4, 2019

Have a Carpal Boss?

Here’s what you need to know about the bony protrusion on your hand

Hand resting on a desktop computer mouse mouse

What is that bony lump on the back of your hand? Meet your carpal boss. Like your 9-to-5 boss, a carpal boss can be annoying. (But it probably won’t cause the same level of pain and suffering.)


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“A carpal boss occurs on the back of the wrist where the pointer finger and middle finger meet the wrist bones,” says hand specialist Yuji Umeda, MD, PhD. “Most people can live with it when it’s just an unsightly condition. But if it involves pain, there are options that provide relief.”

What causes the carpal boss?

The hand lump is also known as a carpometacarpal boss or a bossing. While you can call it whatever you want (maybe Howie?), it’s a good idea to have a physician rule out other conditions like a ganglion cyst or a tumor. “Usually, an X-ray or ultrasound is all that’s needed to diagnose a bossing,” says Dr. Umeda.

Doctors don’t always know how carpal bossings originate but believe they may be related to:

  • Osteoarthritis: Breakdown of cartilage at the finger joints, so bones rub together.
  • Congenital issue: Incorrect formation of bones at birth.
  • Overuse: Repetitive wrist motions from sports (such as tennis) or occupations (such as construction).
  • Trauma: Smacking the back of your hand.

The carpal boss believes in equal opportunity: It occurs at similar rates in men and women. Typically, the boss strikes around age 40, but could be earlier. You’ll usually have a boss on just one hand, but it may affect both.


Hey, Howie, stop bossing me around!

“Only 10 to 20% of people get a carpal boss, and the majority don’t have any symptoms other than the protrusion,” says Dr. Umeda. “About 3% of people have pain along with the bossing.”

If you have a carpometacarpal boss that doesn’t cause pain (and you don’t mind the lump), your doctor will likely keep an eye on it but not actively treat it.

If your boss causes pain, these treatment options may help:

  • Wrist splint immobilizes the wrist so it rests.
  • Ice contracts the blood vessels in the area and reduces inflammation.
  • Pain relievers help you feel better and reduce swelling.
  • Steroid injections can reduce pain and inflammation when icing and pain relievers aren’t successful.

“These conservative measures provide pain relief 70 to 80% of the time,” says Dr. Umeda. “But when they don’t, surgery is a safe alternative.”


In an outpatient procedure with local anesthesia (so you are awake but don’t feel pain), surgeons will remove the boss from your life. Voila! No more pain. Well, you may have a short recovery, but eventually you’ll forget all about that overbearing boss.

Related Articles

Person working on computer with hurting wrist.
November 23, 2023
11 Exercises and Stretches for Wrist Pain

Wrist flexor and extensor stretches are the best stretches for wrist pain

Person holding wrist at computer desk.
December 15, 2022
3 Stretches To Prevent or Relieve Carpal Tunnel

These movements can help with pain, numbness and tingling in your hands and fingers

Person clutching wrist.
August 3, 2022
Pain in Your Hand, Wrist or Elbow? When To Seek Help

What to know before seeking medical attention

carpel tunnel brace on wrist while working on computer
August 12, 2021
How To Get Relief for Carpal Tunnel Pain at Home

7 tricks to try to ease the tingling pain

woman putting on splint for carpel tunnel wrist pain
December 7, 2020
3 Steps to Fight Your Carpal Tunnel Syndrome

Finding relief starts at getting a proper diagnosis

Individual typing on a laptop.
June 30, 2019
Typing Troubles: How to Avoid Wrist Pain

Desk work doesn’t have to leave you hurting

Did Typing Cause My Carpal Tunnel Syndrome?
April 24, 2018
Did Typing Cause My Carpal Tunnel Syndrome?

The Short Answer from an orthopaedic surgeon

Top view of person sitting in bathtub with cold water and lots of ice.
November 26, 2023
Brrr! What To Know About Cold Plunges

An ice bath can ease sore muscles and decrease inflammation after a workout

Trending Topics

close up of keto gummies
Do Keto Gummies Work for Weight Loss? Are They Safe?

Research is inconclusive whether or not these supplements are helpful

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

Older person postioned sideways showing dowager hump.
Dowager’s Hump: What It Is and How To Get Rid of It

The hump at the base of your neck may be caused by osteoporosis or poor posture