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Swollen Index Finger: Causes & Common Questions

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Last updated June 17, 2022

Swollen index finger quiz

Take a quiz to find out what's causing your swollen index finger.

Are you experiencing index finger pain and swelling? This condition may occur after a traumatic injury to the hand, a nail infection, or arthritis. A fracture or dislocation can cause bruising and index finger joint pain that will need immediate medical care. Read below for more causes and treatment options for a swollen index finger.

8 most common causes

Illustration of various health care options.
Black Toenail Fungus
Dislocated Finger
Rheumatoid Arthritis
Illustration of a person thinking with cross bandaids.
Dupuytren's Disease
Psoriatic Arthritis
Cellulitis
Illustration of various health care options.
Boxer's fracture
Illustration of a doctor beside a bedridden patient.
Non-serious finger injury

Swollen index finger quiz

Take a quiz to find out what's causing your swollen index finger.

Take swollen index finger quiz

Swollen index finger symptoms

A swollen index finger — the "pointing" finger — can be a rather mysterious symptom. The index finger gets a great deal of near-constant use no matter what sort of work you do, whether it's manual labor, typing, knitting or playing almost any sport.

If your whole hand is swollen, it could be due to fluid retention from pregnancy, medication, etc. If it's only your index finger, it's more likely to be from trauma, infection, or a chronic inflammatory condition.

Common characteristics of a swollen index finger

If you have a swollen index finger, it can likely be described by:

  • Swelling: This may with or without pain, anywhere on the index finger.
  • Onset: The swelling may appear suddenly and acutely, or gradually and for no clear reason.

Who is most often affected by swollen index finger symptoms

People who fit the following descriptions are more likely to experience these symptoms.

  • Anyone doing long hours of physical work with the hands, whether manual labor or typing
  • Anyone playing sports
  • Older people: Such as finger swelling caused by chronic illnesses

Are swollen index finger symptoms serious?

The severity of your finger swelling will ultimately be determined by the cause.

  • Not serious: A mildly swollen index finger following an injury is probably not serious and will recover with some rest and ice.
  • Moderately serious: Any signs of infection should be examined right away by a medical provider.
  • Serious: Sudden swelling with severe pain, especially after a crush injury, is a medical emergency and must be treated immediately.

Causes of a swollen index finger

Injury-related causes

Your index finger may swell due to a variety of injuries, such as the following.

  • Acute trauma: An acute traumatic injury, such as falling directly onto your outstretched index finger or getting it slammed in a car door or struck by a hammer, can cause a fracture or dislocation. Either of these will result in deformity and swelling of the finger.
  • Sports injuries: These can cause strain, fracture, or dislocation of the finger. A common occurrence is mallet finger, caused by a ball smashing directly into the end of the finger. This can forcibly bend the first joint downward and injure the tendon so that the fingertip is left swollen and pointing downward.
  • Repetitive strain injury or overuse: This can occur from manual labor, or even typing can cause tendinitis of the finger with resultant pain and swelling.

It's also important to keep in mind complications of any injury that may arise, leaving you vulnerable to permanent damage or infection.

  • Breaks in the skin: If the skin is broken, infection can cause redness, swelling, and pain.
  • Compartment syndrome: This can follow a crush injury. Fascia, the sheets of tough white tissue that bind muscles and nerves together into "compartments," are surrounding the injured tissue and limiting room to swell or to drain blood. This very tight, painful swelling can cut off circulation and lead to serious complications.

Inflammatory conditions

Inflammatory conditions that can result in a swollen index finger include:

  • Any type of arthritis: This can cause swelling, pain, and deformity of the joints of the fingers.
  • Gout: A buildup of uric acid in the joints due to gout can cause the sudden appearance of swollen, thickened, painfully inflamed fingers.

Other conditions

Other medical conditions can result in a swollen index finger, such as the following.

  • Paronychia: This is a painful infection and swelling of the cuticle, the skin around the fingernail. It is caused by bacteria or fungus forming an abscess under the cuticle and nail.
  • Fingernail clubbing: "Clubbing" of the fingertips is caused by overgrowth of tissue at the ends of the fingers and beneath the nail bed. It causes the nail bed to appear higher than the finger behind it, while the ends of the fingers bulge outward. Clubbing is a symptom of circulatory, respiratory, thyroid, or other illness and warrants medical evaluation.

Cold intolerance or sensitivity to cold may manifest as a swollen index finger due to the following.

  • Raynaud's disease: You may find your fingers turning cold and very pale when you are exposed to cold air or stress (Raynaud's Disease).
  • Cold exposure: Exposure to cold can also cause an itchy, painful, cold, pale swelling on the back or side of the finger, which may ulcerate.

Rare and unusual cause types

Tumors of the fingers are rare, but can happen. They appear most often as a swelling beneath and/or just beside the fingernails.

This list does not constitute medical advice and may not accurately represent what you have.

Swollen index finger quiz

Take a quiz to find out what's causing your swollen index finger.

Take swollen index finger quiz

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Psoriatic arthritis

Psoriatic arthritis is a complication of psoriasis, which causes the skin to become thickened, red, and scaly. Arthritis may appear before or after the psoriasis appears.

Both conditions are autoimmune diseases, where the body attacks itself, and are thought to be caused by genetic and environmental factors.

Most susceptible are people from 30 to 50 years of age with a family history of the disease and who already have psoriasis.

Symptoms include the joints on one or both sides of the body becoming painful, swollen, and hot; swelling and deformity of the fingers and toes; pitted, flaking fingernails; foot pain in the heels and soles; and joint pain in the low back pain.

It is important to seek treatment, as psoriatic arthritis can permanently damage the joints, eyes, and heart.

Diagnosis is made through physical examination, x-rays, and MRI. Blood tests and joint fluid tests can confirm psoriatic arthritis.

Treatment includes over-the-counter, nonsteroidal anti-inflammatory drugs; anti-rheumatic medication; immunosuppressants; and steroid injections for the joints. Surgery to replace damaged joints may also be tried.

Non-serious finger injury

Finger injuries are very common & rarely need medical treatment.

You can treat this at home with ice and rest. An X-ray would be necessary to rule out a fracture if you had swelling and difficulty moving the finger.

Rarity: Common

Top Symptoms: recent finger injury, finger pain from an injury, swollen finger, severe finger pain

Symptoms that always occur with non-serious finger injury: recent finger injury

Symptoms that never occur with non-serious finger injury: bent or crooked finger

Urgency: Self-treatment

Nail infection (paronychia)

Paronychia is an infection of the skin of the fingers or toes, at the place where the skin folds down to meet the nail.

Acute, or sudden onset, paronychia is caused by the staphylococcus bacteria. The organism can gain entry if the nail is cracked, broken, bitten, or trimmed too closely.

Chronic, or ongoing, paronychia is caused by a fungus. Anyone whose work requires their hands to be wet much of the time is susceptible.

People with diabetes or a weakened immune system are more susceptible to nail infections.

Symptoms include sore, reddened, swollen skin around the nail, sometimes with pus collecting under the skin.

Diagnosis is made through physical examination and sometimes skin culture to identify the organism involved.

Treatment for acute paronychia involves having a medical provider clean the wounded nail and drain any infection, and sometimes provide a course of antibiotics.

Treatment for the chronic form involves keeping the skin dry and using an antifungal medication on the affected nail.

Rarity: Rare

Top Symptoms: spontaneous finger pain, fingernail pain, fingernail swelling

Urgency: Phone call or in-person visit

Dupuytren disease

Dupuytren disease, also known as Dupuytren's contracture, is a condition that causes tissue under the skin of the palm to thicken. This thickening can occur slowly over many years. Its cause is not known, but it is more common in men and people over the age of 40. Symptoms include hard bumps or bands of tissue under the skin, finger stiffness, and trouble fully straightening the fingers.

You should consider visiting a medical professional to discuss your symptoms. Dupuytren disease can be evaluated with a review of your symptoms and a physical exam. Once diagnosed, symptoms of mild cases can be relieved with hand exercises, warm baths, and stretching. More severe cases can be treated with steroid injections, surgery, radiation therapy, or a needling procedure.

Rarity: Uncommon

Top Symptoms: finger joint stiffness, hand bump, thickened skin on the finger, swollen hands, hand injury

Urgency: Primary care doctor

Dislocated finger

Dislocations of the finger at the base of the finger are relatively rare. However, when they do happen, they can damage the blood supply to the finger and its nerves.

You should go immediately to an urgent care or emergency room, where a physician can "reduce" - put the finger back into place - safely. Simple dislocations typically require just buddy tape to a nearby finger. Complicated fractures (need an x-ray) would need immobilization with a splint. Following reduction, the doctor should ensure that blood is flowing to the tips of the finger properly. If he/she cannot put it back into place, they should consult a hand surgeon.

Swollen index finger quiz

Take a quiz to find out what's causing your swollen index finger.

Take swollen index finger quiz

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptoms of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Rarity: Uncommon

Top Symptoms: fever, chills, facial redness, swollen face, face pain

Symptoms that always occur with cellulitis: facial redness, area of skin redness

Urgency: Primary care doctor

Boxer's fracture

Boxer's fracture is a term for a fracture of one of fingers and generally occurs after a closed fist makes contact with a hard object.

Apply ice to relieve pain and swelling. If there is an open wound, gently clean with soap and water. Proceed to your nearest urgent care clinic.

Rarity: Common

Top Symptoms: finger pain, swollen finger, finger bruise, punched a hard object

Symptoms that always occur with boxer's fracture: finger pain, swollen finger, punched a hard object

Urgency: In-person visit

Swollen index finger treatments and relief

At-home treatment

Swollen index finger remedies that you can try at home include the following.

  • Ice or heat: This can address swelling. You can alternate the two or decide which provides you with more relief. Try to only keep either on for 20 minutes at a time.
  • NSAIDs: Use over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or other NSAIDs such as naproxen (Aleve) or aspirin for pain and inflammation.

When to see a doctor

You should schedule an appointment to see your doctor for the following.

  • There is a suspected fracture
  • The finger becomes numb, pale, and cold
  • You have a visibly deformed finger: Or you cannot straighten it
  • There is pain, redness and a drainage of pus: This is especially serious if you also develop a fever, numbness, or tingling along with the swelling.
  • You have a child with any of the above symptoms: That's because the growth plates — the areas of the bone which create length — can be damaged by an untreated injury and become deformed after that.
  • You notice clubbing of the fingertip: Especially if you also have heart or lung disease

When it is an emergency

Seek immediate swollen index finger treatment in the emergency room or call 911 if you have:

  • Severe, acute pain and swelling in any part of the finger
  • Obvious fracture
  • You are also experiencing a fever

Questions your doctor may ask about swollen index finger

  • Have you ever been diagnosed with diabetes?
  • Have you ever been diagnosed with cancer?
  • Do you have these contractures that limit the movement of your fingers? (See picture)
  • Do any of your body parts (e.g., toes, hands, ears) feel cold?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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