Swelling Of The Hands : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 02/09/2022

Edema of the hands can be physiological or pathological, local or widespread. They arise as a result of injuries, local infections, diseases of the joints, lesions of the blood and lymphatic vessels, and some other pathologies. Manifested by an increase in the volume of the limb, pain, a feeling of heaviness, clumsiness when performing fine movements are possible. For the diagnosis of diseases that cause swelling of the hands, data from a survey, external examination, radiography, ultrasound, CT, MRI, and laboratory tests are used. Treatment is determined by the cause of the symptom.

Why do hands swell

Physiological causes

Unilateral edema can appear when the lymphatic and blood vessels of the arm are squeezed by the body or clothing during sleep. Small symmetrical swelling of the fingers and distal parts of the hands, especially noticeable when wearing a wedding ring, is observed after drinking alcohol, eating salty foods and a large amount of liquid in the evening.

In women, swelling of the hands, due to hormonal changes, is often expressed during the gestation period. As the gestational age increases, the symptom increases from mild pastiness to a significant increase in volume. Some patients note morning swelling of the fingers before the onset of menstruation, especially against the background of premenstrual syndrome.

Traumatic injuries

Local edema while maintaining limb function is typical for bruises. Accompanied by minor or moderate pain, hyperemia, sometimes - abrasions, bruising. With hematomas, the symptom is more pronounced, fluctuation can be determined. With sprains, tears, torn ligaments, swelling, as a rule, is more noticeable than with bruises. The pain intensifies when trying to move, deviating the arm to the side opposite to the injured ligament. With a complete rupture, part of the functions of the limb is lost.

Fractures are manifested by rapidly increasing edema, deformity, loss or significant limitation of function, pathological mobility, and severe pain. In case of injuries without displacement of fragments, epiphyseolysis in children, pathological fractures, some of the listed symptoms are absent or mild, swelling is insignificant. For dislocations, a well-marked, rapidly progressive swelling is typical, which is complemented by a sharp deformation in the joint area, pain, springy resistance when trying to move.

With frostbite, swelling captures the fingers, spreads to the hands. It can reach a significant volume, because of which the hands resemble pillows. Against the background of increasing swelling, a tingling sensation occurs, turning into a burning pain. Perhaps the formation of blisters, areas of necrosis, with severe damage, rejection of part of the fingers occurs. In patients with burns, edema is combined with sharp pain, redness, and blistering.

Local infectious processes

Edema, rapidly growing twitching pain, cyanosis, hyperemia are the main symptoms of all forms of panaritium. In patients with superficial forms of the disease, swelling of the finger is local, slight or moderate. With deep forms of panaritium, the edema is significant, extending beyond the finger to the hand. A more rare lesion of the fingers is chinga, a disease that occurs in people who cut carcasses of marine animals. More often, the proximal joint of the finger swells.

Furuncles and carbuncles occur on the shoulder, forearm, less often on the back of the hand - where there are hair follicles. The edema in these pathologies is limited, a dense cyanotic-purple formation is found with one or more yellowish areas in the follicle zone. With abscesses, the purulent focus is larger in size, the edema covers a significant part of the segment. The phlegmon does not have clear boundaries, following the pus, the edema spreads along the limb.

With infected wounds, the edges and nearby tissues swell, serous, and then purulent discharge appears. For erysipelas, a pronounced swelling is typical, the presence of a clearly defined red spot, reminiscent of a geographical map. The appearance of swelling and other symptoms is preceded by fever, in severe cases, disturbances of consciousness, delirium are possible.

Severe edema is accompanied by purulent lesions of bones and joints - purulent arthritis, osteomyelitis. Pathologies are characterized by intense twisting, tearing, jerking pains, local hyperemia and hyperthermia, and a sharp limitation of movements. Fever, severe intoxication are noted.

Swelling of the hand


Joint diseases

Local swelling is observed in all forms of arthritis. The severity of edema, as a rule, correlates with the severity of the process, increases during periods of exacerbations.

  • Rheumatoid arthritis. There is a symmetrical lesion of the joints of the fingers and hands. Swelling is combined with transient or permanent stiffness, redness, restriction of movement.
  • Gouty arthritis. Manifestation of the disease with symptoms of polyarthritis in the fingers is more common in women. In young people, damage to the elbow, wrist, shoulder joint is possible. The rheumatoid-like form proceeds according to the type of oligo- or monoarthritis of the fingers. Typically, a rapid increase in edema, severe pain, dysfunction, general hyperthermia.
  • Psoriatic arthritis. Shoulder joints, small joints of the hands and fingers suffer. The onset may be acute or gradual. Patients complain of swelling, pain in the affected joints. The pain syndrome intensifies at rest, at night, weakens with movements, throughout the day. Local swelling, purple-bluish color of the skin are visually determined.
  • infectious arthritis. It is provoked by viral and bacterial infections. With viral damage, volatile arthralgias, transient edema are noted. For gonorrheal arthritis, the involvement of the elbow joint, hands is typical. With the syphilitic form of the disease, the fingers suffer.
  • Occupational arthritis . Pain and swelling are detected in the most loaded joints, the localization of the lesion depends on the profession. Typists, pianists, office workers have swollen finger joints. Builders and loaders are often concerned about pain, swelling, and limitation of movement in the shoulder joint.

Deforming arthrosis is chronic. Swelling of the hand occurs some time after a decrease in resistance to stress, discomfort and pain. In the post-traumatic form of the disease, a connection with a previous injury (dislocation, fracture-dislocation, periarticular fracture) is revealed. In idiopathic arthrosis, there are no obvious causes; a history of joint overload is possible.

Vascular lesions

Swelling of the hand with thrombosis of the vessels of the upper limb occurs below the localization of the thrombus. Accompanied by a feeling of fullness and excruciating heaviness, aggravated by palpation, lowering the arm. On examination, there is a thickening of the tissues, a purple-cyanotic shade of the skin. There may be numbness, goosebumps, decreased sensitivity.

Lymphatic edema of the arm can be determined in patients who have undergone a mastectomy with removal of regional lymph nodes. Sometimes puffiness develops against the background of malformations of the lymphatic system, scars after burns, with post-thrombophlebitic syndrome, lymphangitis, lymphadenitis. At the initial stage, swelling appears in the evening, disappears on its own during the night. Then the puffiness becomes constant, combined with tissue compaction. A distinctive feature of edema against the background of lymphedema is a fossa that does not disappear for a long time after pressure.

Other reasons

Other conditions that cause hand swelling include:

  • Erythromelalgia. Attacks occur suddenly, provoked by compression or overheating of the limb, accompanied by sharp pain, swelling, intense hyperemia, and an increase in the local temperature of the fingers and toes. All symptoms disappear within a few minutes, sometimes - a few hours.
  • Heart failure. Initially, edema is hidden, manifested by an increase in body weight. In the final stages, there is swelling of the legs, arms, face, in combination with ascites, hydropericardium, hydrothorax.
  • Diseases of the kidneys. Edema is observed in the morning, with prolonged hanging of the hands down. At first, they are hardly noticeable, they are determined by the difficulties when trying to remove the wedding ring from the finger. Later they become more obvious. They are soft, watery, combined with a yellowish skin color.


Traumatologists-orthopedists are more often involved in determining the cause of swelling of the hands. If there are indications, patients are referred to surgeons, rheumatologists, vascular surgeons, and other specialists. The diagnosis is made on the basis of the results of the following procedures:

  • Questioning, physical examination . The specialist establishes the circumstances and time of the appearance of puffiness, identifies other symptoms, monitors the dynamics of the disease. Assesses the localization, prevalence, severity of edema, range of motion in the joints, color, density, tissue temperature.
  • Radiography . It is prescribed for injuries, diseases of the joints, some purulent processes. Allows you to confirm the presence of fragments or displacement of the articular ends of the bone, inflammatory and degenerative changes.
  • Ultrasound procedure. It is carried out to confirm thrombosis, determine the state of venous, lymphatic vessels, and assess the prevalence of purulent processes.
  • Other visualization methods . In doubtful cases, MRI is performed for a detailed study of soft tissues, and CT is performed for the study of solid structures.
  • Laboratory Research . Analyzes help to detect signs of inflammation, markers of rheumatic diseases, impaired kidney function.

Hand pressure therapy



Help at the prehospital stage

General recommendations include giving the limb an elevated position. In case of traumatic injuries, the hand should be fixed with a splint or scarf bandage, apply cold, and give the victim an anesthetic. In diseases of the joints, local preparations with analgesic and anti-inflammatory effects can be used. The presence of a rapidly growing edema, intense pain syndrome is the basis for an immediate appeal to a specialist.

Conservative therapy

In case of injuries, anesthesia of the injury site is performed, the arm is set or repositioned, and a plaster cast is applied. For burns and frostbite, dressings are performed. The treatment regimen for diseases accompanied by swelling of the hand may include the following methods:

  • Protective mode . The patient is advised to limit the load on the arm. Orthopedic devices are used according to indications.
  • NSAIDs . They are used for diseases of the joints in the form of topical agents, tablets or injections. Reduce the severity of pain syndrome. Eliminate inflammation and, as a result, swelling of the hands.
  • Glucocorticoids . Blockades with hormonal drugs are performed with joint lesions. Indications are intense pain, an active inflammatory process that is not stopped by other drugs.
  • Vascular funds . Angioprotectors, phlebotonics and antispasmodics are recommended for diseases of the veins, lymphatic vessels.
  • Physiotherapy . To reduce pain, relieve inflammation, improve blood circulation, drug electrophoresis, magnetotherapy, laser therapy, UHF, mud therapy, lymphatic drainage massage are prescribed.
  • Therapeutic gymnastics . Special exercise therapy complexes are used in the period of rehabilitation after injuries, in diseases of blood vessels and joints. Physical therapy is complemented by massage, manual therapy.


Taking into account the characteristics of the pathology that causes swelling of the hands, the following surgical interventions can be performed:

  • Injuries : osteosynthesis of the humerus or forearm bones, open reduction of dislocations of the shoulder and elbow joints, opening of hematomas, excision of necrosis zones in case of frostbite, plastic surgery for burns.
  • Infectious processes : opening of panaritium, furuncle, carbuncle, abscess or phlegmon, arthrotomy, sequestrectomy.
  • Joint diseases : arthroplasty, arthrodesis, arthroplasty.
  • Vascular pathologies : regional thrombolysis in venous thrombosis, tunneling in lymphedema, lymphovenous shunting.

After operations, painkillers are prescribed, antibiotic therapy is carried out, and rehabilitation measures are carried out using physiotherapeutic methods.