Here'* part of my issue with pain and fatigue:
If you look carefully from the pinky knuckle to the wrist (5th metacarpal) you can see a series of scars from an old injury. When the plate was removed, two screws broke, and were left in the bone. For good reason. The new bone would have been weakened by digging the screws out. The bone (75% of the 5th metacarpal) is actually grafted from the rim of my pelvis. This is why SilverBullet'* signature is what is is.
The problem is this:
See the bump? One of the screws (with the head broken off) is 'surfacing'. In other words, it'* digging through the skin from the inside out. Hurts like hell when I make a fist or bang my hand on something. I'll have a surgery to correct this soon, but for now, my schedule doesn't permit it. I usually work on the car with two bandages stacked over this for a cushion, and a set of mechanic'* gloves.