What’s causing your hands to swell?
When hands swell, it’s hard to ignore. Especially as the swelling often comes with pain. And it may be more difficult to hold objects and carry out daily activities.
Hand swelling is typically caused by fluid retention, arthritis, or a rise in your body temperature. Some causes will improve on their own and are not cause for alarm. Others can become more serious and damage the structures of the hand. Hand swelling may also indicate an underlying illness.
Treatment depends on the cause of your hand swelling, but in general, following the R.I.C.E. (rest, ice, compression, and elevation) protocol can usually treat most causes of swelling. You may also need medication for underlying conditions.
- Pain (dull or burning), especially when using the hand (or after using it)
- Swelling around the joint
Arthritis is a leading cause of swollen hands and fingers. It is an inflammation in the joints, and causes swelling and pain. As swelling and joint inflammation worsen, using the hands can become more difficult. Types of arthritis include osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and gout.
- Osteoarthritis: Breakdown of protective cartilage from daily wear and tear.
- Rheumatoid arthritis: An autoimmune disorder that causes swelling of joints and tends to occur in the hands first. It affects both hands at the same time.
- Psoriatic arthritis: Sausage-like swelling of one or more fingers associated with psoriasis (chronic inflammatory skin condition).
- Gout: Usually pain, swelling, and redness of a single or a few joints due to the formation of crystals in the joint.
2. Retained fluid
- Swelling of both hands and/or fingers
Your body has many processes that work to maintain the fluid balance. But sometimes you can have an accumulation of fluid, which leads to swelling in your hands. Fluid retention has a number of causes:
- Diet (eating too much salt or carbohydrates).
- A number of medical conditions including thyroid, liver, or kidney disease.
- Pregnancy can cause women to retain water. If you are pregnant and suddenly develop swelling, call your doctor. This may be a sign of a serious condition called pre-eclampsia, which causes an increase in blood pressure. If left untreated, it could be life-threatening for you and the fetus.
- Being perimenopausal or menopausal.
- Some medications may cause hand swelling including steroids, pain medications (aspirin, ibuprofen), hormonal therapy (estrogen, testosterone), diabetes medications, or blood pressure medications.
3. Dependent edema
- Swelling of one or both hands
Dependent edema is caused by your hand being held lower than the heart for a prolonged amount of time. This can be because of its position when sitting or sleeping. Or it can happen after being kept in one position for a long time—like when traveling.
Certain environmental conditions—heat, hot weather, exercising—cause blood vessels to dilate, leading to swelling. It should go away soon after changing the position of your hand or when no longer being exposed to the environmental factors. But you may also need to elevate your hands or use compression bandages.
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- Pain near the injury site
- Painful to move your fingers or joints
- Possible bruising, deformity, and/or swelling
Hand injuries include fractures (broken bones), dislocations (bones no longer aligned properly), sprains (overstretched ligament), and strains (overstretched tendon/muscles). You can also have crush injuries when the hand or part of the hand is crushed. This leads to swelling from muscle damage.
Finger and hand infections spread quickly and deeply. It is very important that these infections are diagnosed and treated early. Do not wait to see your doctor. Take care of your hands! —Dr. Chandra Manuelpillai
- Either local or generalized swelling and/or pain.
- Usually associated with red discoloration and/or warmth to touch.
- Sometimes has lesions or is oozing pus.
Infections can involve the skin, nail, tissue, joints, and/or tendons. This includes:
- Paronychia: infection involving cuticle area of nail.
- Felon: infection involving fingertip.
- Herpetic whitlow: herpes infection leading to blisters on fingers.
- Flexor tenosynovitis: infection of the tendon leading to sausage-like swelling and a bent finger. It causes severe pain if you try to straighten it.
- Septic joint: infection within the finger joint leading to pain, swelling, and redness, and being unable to move your finger.
- Cellulitis: infection of skin leading to pain, swelling, and redness.
- Bite wounds: infection from bite wounds most commonly from dogs, cats, or people.
6. Lumps and bumps
- Swelling on your hands.
- Itching particularly with insect bites or allergic reactions.
- Nodules in the palm due to abnormal tissue thickening with Dupuytren’s disease. This leads to tightening of tissue, visible bands, and what’s called contractures (pulling of fingers—most commonly ring and pinky finger—towards palms).
Rather than swelling of the entire hand, you may notice a smaller mass. These have several possible causes:
- Cancer such as skin cancer (basal cell carcinoma, melanoma, squamous cell carcinoma) or sarcoma (bone or tissue cancer).
- Cysts such as a ganglion cyst (fluid-filled cyst usually by finger joint or wrist) and epidermal inclusion cyst (filled with skin protein).
- Non-cancerous tumors such as a lipoma (fat tumor), giant cell tumor (painless mass at end of bones near joint), neuroma (nerve tumor), and fibroma (connective tissue tumor).
- Warts: skin-colored growths due to human papillomavirus (HPV).
7. Deep vein thrombosis (DVT)
- Pain which may initially be just by the affected vessel then spreads to the area
- Swelling which may initially be just by the affected vessel then spreads to the area
- Possible redness and/or warmth
A deep vein thrombosis (DVT) occurs when a clot forms in a blood vessel. The clot blocks blood flow and leads to swelling. The clot may be caused by trauma, infection, or catheter placement. It may also be caused by conditions that increase your risk of forming clots such as cancer, pregnancy, or a blood clotting disorder.
- Swelling usually in one arm, but may be both
The swelling associated with lymphedema is caused by abnormal drainage of lymph nodes, which are part of your immune system. It is often due to a complication from cancer treatment such as removal of lymph nodes or damage from radiation treatment.
It could also occur because a cancerous mass is blocking lymphatic drainage. Or it can be due to a complication from other surgeries, as well as from infections. Elastic bandages are often used to decrease swelling and help with drainage.
9. Contact dermatitis
- Red, itchy rash on your hand
- Swollen skin
- Dry, cracked skin
- Blisters in serious cases
Contact dermatitis is a skin reaction caused by touching an irritating substance, such as soap, bleach, cleaning agents, or other chemicals. Treatment includes avoiding the substance and using steroid or barrier cream/ointment on hands until the dermatitis clears.
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- Swelling or puffiness—fingers may resemble sausages
- Thickened, shiny, or discolored skin
- Pale or blue fingers that get numb when exposed to cold or stress
Scleroderma is a connective tissue disease leading to thickening of skin. It causes swelling and stiffness of skin and joints of the fingers and hands. It’s often associated with Raynaud’s syndrome, which causes blood vessels to narrow, leading to a lack of blood flow. Scleroderma causes scarring of many body parts, leading to problems in the lungs, kidneys, heart, digestive tract, and other areas.
11. Thoracic outlet syndrome
- Pain in arm and/or hand
- Swelling in arm and/or hand
- Numbness which may include neck, shoulder, arm, and/or hand
- Cold fingers/hand
- Weak grip
Thoracic outlet syndrome is caused by compression of nerves and/or blood vessels in the area between your collarbone and first rib. It causes pain, swelling, and numbness. This may be due to trauma, malignancy, pregnancy, or being born with an extra rib.
Causes of hand swelling in children
- Kawasaki disease: Hand swelling can be one sign of a syndrome that also involves high fever, swollen lymph nodes, and a red tongue.
- Sickle cell disease: Swelling of the fingers and hands is a common sign of sickle cell disease in young children.
- Multisystem Inflammatory Syndrome in children (MIS-C) associated with COVID-19: Redness and/or swelling of hands and/or feet in children with a history of COVID-19 or exposure to the coronavirus. This may lead to multisystem organ involvement.
When to call the doctor
I can’t tell you how many times I have had a patient with a clear bite wound on the hand from a fight who adamantly denies it until I read them the riot act of the potential complication of delayed treatment. Your doctor is not there to judge you, so just be honest. —Dr. Manuelpillai
- You are concerned about a child who has hand swelling and has been diagnosed with sickle cell disease, or the child also has a fever.
- You are pregnant.
- You recently started a new medication.
- You were previously diagnosed with arthritis, sickle cell disease, or organ failure.
- You have a persistent growth on the hand.
- You develop open sores on the hand or fingers.
Should I go to the ER for hand swelling?
You may need to go to the ER if you’re having the following symptoms.
- You have a hand injury with tingling, numb, weak, or cold fingers.
- You have difficulty breathing or facial swelling.
- You have decreased ability to move one or more fingers.
- Your hand swelling occurred after a human or animal bite.
- You have pain and swelling after falling onto an outstretched hand.
- You are concerned about progression of an allergic reaction.
How to treat your swollen hands
Hands are important for almost everything we do daily. When they are swollen, it can really interfere with your activities of daily living and decrease your quality of life. —Dr. Manuelpillai
Care depends on the cause of the swelling, but in general, following R.I.C.E. (rest, ice, compression, and elevation) protocol will treat most causes of swelling. You may also need pain medications.
- Ice can help reduce swelling immediately after an injury.
- Take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to help with swollen joints and pain.
- Compression with bandages helps decrease swelling and helps blood vessels remove fluid collecting in an area.
- Elevation will help blood vessels carry fluid away from the affected area.
Other treatment options
Your doctor may prescribe any of the following treatments, depending on the cause of the hand swelling:
- Procedure to remove a lump or mass.
- Treatment for an underlying medical condition.
- A diuretic medication to decrease the amount of fluid in the body.
- Immobilization using sling, splint, ace wrap, cast, or splint.
I worked in my yard a bit. I have fibro and I did more than I should, so I was aching for days full body. My right hand around the pad near the thumb swelled up. It is painful to move and use. I had a similar experience months ago and I had to get steroids. My hands were swollen after using hedge clippers that were new. I wonder if the clippers had a chemical on them. Doc treated it as contact dermatitis. I couldn't close my hands without a lot of pain. Both hands swelled and could see patchy redness under the skin.
I was woken up last 3 nights with back of my hand itchy. I work around a lot of cardboard. It is now swollen driving me crazy with the itch. What could it be??
I have to work with bleach water at work, doing dishes, and will have stiff hands for a good 24 hours after. Why is this? It seems like my knuckles are swollen, too. No pain, no redness. I use tons of moisturizer because my skin gets so dry while working.