What causes swelling in the hands?

From the Guidelines

Swelling in the hands is most commonly caused by fluid retention, inflammation, or injury, and treatment should focus on addressing the underlying cause to improve morbidity, mortality, and quality of life. The causes of hand swelling can be diverse, including fluid retention (edema) due to poor circulation, high sodium intake, pregnancy, or certain medications like blood pressure drugs 1. Inflammatory conditions such as arthritis, tendonitis, and autoimmune disorders like lupus or rheumatoid arthritis frequently cause hand swelling and pain 1. Injuries including sprains, fractures, and overuse injuries can lead to localized swelling. Medical conditions like kidney disease, heart failure, and liver problems may cause swelling as they affect fluid balance in the body 1. Infections in the hand or fingers can cause painful swelling with redness and warmth.

Some less common causes of hand swelling include erythromelalgia, a rare disorder characterized by episodic, burning pain associated with erythema and warmth of the extremities, which can cause swelling in the hands during symptoms 1. Lymphedema, which can occur after breast cancer surgery and/or radiation, is another potential cause of hand swelling, particularly if the lymph nodes in the arm are affected 1. Hereditary angioedema, caused by a deficiency of the serine protease inhibitor C1 inhibitor, can also lead to episodes of angioedema involving the extremities, including the hands 1.

Key Considerations for Treatment

• Rest, elevation, and ice application can help reduce swelling and alleviate pain.
• Over-the-counter anti-inflammatory medications like ibuprofen (200-400mg every 6-8 hours with food) or naproxen (220mg every 8-12 hours) may be used to manage pain and inflammation.
• Reducing salt intake and maintaining proper hydration can help prevent fluid-related swelling.
• Early identification and management of underlying conditions, such as erythromelalgia or hereditary angioedema, are crucial to prevent severe complications and improve outcomes 1.

Importance of Medical Evaluation

Persistent or severe swelling should be evaluated by a healthcare provider, especially if accompanied by fever, severe pain, or if it affects your ability to use your hand normally. This is crucial for diagnosing the underlying cause and initiating appropriate treatment to prevent long-term morbidity and mortality. Given the potential for significant morbidity and mortality associated with some causes of hand swelling, such as hereditary angioedema, prompt medical attention is essential 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Causes of Swelling in Hands

• Swelling in hands can be caused by various factors, including minor trauma to the hand, as seen in a case study where a 63-year-old woman presented with a swollen right hand after closing her hand in a car door 2.
• Certain medical conditions, such as hyperlipidemia, can also contribute to swelling in the hands, as noted in the same case study 2.
• Additionally, swelling in hands can be a side effect of certain medications, such as vasodilators used to treat hypertension, which can cause vasodilatory edema 3.
• Fluid retention in the body, often associated with liver disease, such as cirrhosis, can also lead to swelling in the hands, as well as other parts of the body 4.
• Physiological nocturnal hand swelling is a normal occurrence in healthy individuals, where hand volume increases overnight and decreases over the course of the day 5.

Medical Conditions Associated with Hand Swelling

• Cellulitis, a bacterial skin infection, can cause swelling in the hands, as seen in the case study of the 63-year-old woman who was initially diagnosed with cellulitis 2.
• Decompensated heart and liver diseases, or kidney failure, can lead to generalized edema, including swelling in the hands 6.
• Cirrhosis, a liver disease, can cause fluid retention, leading to swelling in the hands and other parts of the body 4.

Other Factors Contributing to Hand Swelling

• Certain medications, such as diuretics, digitalis preparations, and theophylline, can affect the pharmacokinetics of other drugs in edematous diseases, potentially contributing to swelling in the hands 6.
• The use of vasodilators, such as minoxidil or hydralazine, can cause vasodilatory edema, leading to swelling in the hands 3.
• Physiological factors, such as age, body mass index, and sex, do not appear to influence changes in hand volume, according to a study on healthy volunteers 5.