Swelling is a manifestation of inflammation. It is caused by a buildup of fluid between tissues, in an area called interstitial compartment. This area has some fluid naturally, but when there is active inflammation, our cytokines change the permeability of blood vessels, and they allow more fluid to leak into the interstitial compartment. It is often associated with redness and warmth because inflammatory swelling increases the blood circulation in the area.
The resulting pain is due to an increase of pressure that stimulates nerve terminals all around the affected tissue. Other causes of swelling include low protein levels in the blood and organ dysfunction.
However, we are all used to see patients with swelling in their feet, or a recent lesion of the skin. The area usually gets tender and may become reddened and warm when it is due to inflammatory causes. Conversely, swelling between your knuckles is not a very common symptom, and it causes a type of debilitating pain that may impair your day-to-day activities.
with thanks www.ncbi.nlm.nih.gov
Why would you experience this type of pain? And what can you do about it?
This type of pain can be debilitating and frustrating, very uncomfortable, and causing many difficulties in your everyday life. It is sometimes associated with stiffness of the affected joints, or severe pain that does not allow you to bend the fingers. In many cases, it is accompanied by redness of the area, swelling and warmth. You may even feel that something is beneath the skin in the tender area between your knuckles.
Pain can be either dull and sustained over time, or sharp and very severe, not allowing you to use your hands at all. You may have heard about arthritis and how this disease usually starts in the small joints of the hands. You may even have heard about arthritis causing deformation in the hands, and you’re probably worried about it.
As you will see in this article, arthritis is one likely cause, but not the only one and definitely not the most common.
What causes swelling in the knuckles?
One of the most common causes of pain and swelling in the knuckles is a traumatic injury or an overuse injury. You can start experiencing the symptoms above after you’ve been lifting heavy weights you’re not used to, and doing manual work. For example, if you had an emergency and needed to help your an overweight relative to an emergency room or after moving to a new house and helping transport the furniture, or even after buying a bulky heavy desk for your house and assembling the whole thing by yourself without any help.
The thing is that this pain and swelling typically go away after a while. It should not last for a very long time, unless you had a significant injury, as in a joint dislocation or fracture, which causes a severe pain you’re not likely to bear for long.
Thus, if you’ve had this swelling and pain in the knuckles or in between the knuckles, there are other causes you might need to rule out:
- Arthritis: After trauma and overuse injuries, arthritis is a very important diagnosis if you have a dull and persistent pain in any given part of your hands. Swelling is an important part of arthritis, and patients often feel stiffness of the articulations.
- Tendonitis: Tendons are stretch bands running from the end of the muscle to the insertion in the bone. There are many tendons in your hands, and each one of them moves a different articulation of the fingers. Tendonitis pain is often located in the knuckles but may irradiate to in-between the knuckles when more than one is taken by inflammation.
- Gout: In gout, patients have a very high level of uric acid in the blood. Excess of this substance is deposited in the articulations, and soon enough, it forms crystals that cause severe pain. It is often located in the articulations of the feet, but some forms of gout may sometimes appear in the hands, as well.
- Connective tissue diseases: There are many types of connective tissue diseases, and all of them have various and unpredictable symptoms. One of the most popular is systemic lupus erythematous, but you also have polymyositis, scleroderma, and many others. Each one of them has different characteristics, but they are sometimes very hard to differentiate, and various tests may be necessary before making a diagnosis.
- Side effects of certain medications: In some cases, drugs to treat other diseases may be involved in swelling symptoms in your hands and feet. If you have arthritis, kidney disease, or hypertension, ask your doctor about your medications and if they are causing your symptoms.
Home treatment for swelling episodes between the knuckles
There are many diagnoses to rule out, but there is good news. Home treatment of this type of pain usually follows a very similar pattern.
During acute episodes of swelling between the knuckles, you can use hot packs in combination with cold compresses to stimulate blood circulation and reduce swelling, respectively. When you do, avoid extreme temperatures, and if you’re using ice, do not put it in direct contact with the skin. Alternating hot and cold for a few minutes may improve your symptoms significantly.
You can also stretch your hands to allow excess fluid to circulate. It is recommended to live an active life and reduce your intake of salt in your day-to-day, especially if you have recurrent episodes of swelling in your hands and feet.
If you still don’t have any improvement, do not neglect your condition and talk about it with your doctor. You might need a few tests to figure out what is causing your symptoms, and they will depend on individual features, and only a doctor will be able to determine the severity of the injury. RR
Yaghoubian, A., & Rolfe, K. W. (2020). Chronic Right-Hand Pain. In Surgery (pp. 377-384). Springer, Cham.
Wang, Z., Zhan, S., Yang, T., Zhang, L., & Wang, Y. (2018). Interventional treatment of swelling hand syndrome. Journal of Practical Radiology, 34(5), 762-764.
Foltz, M., & Derkash, R. (2020). Trauma of the Hand and Wrist. In Global Orthopedics (pp. 179-191). Springer, Cham.