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Our hands are particularly sensitive as turning points in blood flow and metabolism. On the other hand, we also perform a wide range of motor activities with them, which requires special networking of the nerve pathways in this area of the body. Unfortunately, both functional aspects of the hand make them susceptible to certain complaints if there is a malfunction. Swollen hands occur here in the context of numerous interference. Therefore, below you will find an overview of the peculiarities and causes of hand swelling.
The hand (manus) belongs to the extremities of the body, which are medically known as acren. Both terms originate from antiquity, with the word extremities coming from Latin extremus for "extreme". The word Akren is related to ancient Greek acros for "extremely" borrowed and also emphasizes the special position of the extremities, which include the arms, legs and feet as well as the protruding parts of the head (for example ears and nose) and the external parts of the primary and secondary sexual characteristics. Each of these areas of the body is characterized by a particularly strong blood circulation, which opens up a possible cause for the swelling of the hands.
Heart and vascular problems
If the blood vessels in the hand become diseased or injured, the surrounding hand tissue often reacts with tissue swelling. For example, an injury-related bruise (hematoma) under the skin is conceivable, which then provokes local swelling. It should be mentioned that a hematoma on the hand does not necessarily have to be caused by major vascular damage, such as in
- Stab or cut injuries
arise. Even microscopic perforations in the blood vessels gradually allow small amounts of blood fluid to migrate into the tissue. Such damage to the vessel walls is usually caused by arteriosclerosis. The calcification of the vessels not only favors damage to the blood vessels, but also increases the risk of
- Circulatory disorders,
- High blood pressure,
- and vascular inflammation,
These are all factors that can also be the cause of the swollen hands. Chronic high blood pressure can also promote the development of thrombosis, which puts additional pressure on the tissue.
Swollen hands can also appear as a symptom in connection with heart failure (heart failure). The disease not infrequently causes edema in the extremities, which is due to the deteriorated blood transport caused by heart failure. The blood often builds up here, which increases the vessel pressure and thus more blood fluid pushes through the vessel walls into the adjacent tissue. In addition, the blood congestion itself can cause the tissues of the hand to swell, provided the blood is backlogged there. The risk of this is relatively high, because a reduced pumping power of the heart has a particularly massive effect on the extremities far away from the body.
As with all extremities, the hands are given a special role when it comes to motor skills and sensor technology. They are essential for feeling, touching, grasping, holding, lifting and for complex manual work and are therefore particularly challenged in everyday life. Nerve disorders and joint disorders as the cause of a swollen hand should therefore always be carefully observed to avoid permanent damage. Joint diseases such as osteoarthritis tend to promote irritation-related swelling. In the hand area, finger arthrosis is the most common form of joint wear. In addition, the arthrotic processes can lead to inflammation in the wrists and fingers as an accompanying symptom of the swelling. One speaks of arthritis in said joint inflammation.
Arthritic and inflammatory processes of the wrists and fingers are particularly common in people who perform an above-average number of fine motor activities with their hands. This means, among other things, typing on the keyboard, filigree needlework and manual wellness and cosmetic professions. Accordingly, the following jobs with regard to swollen hands constitute a special risk group:
- Office workers,
- Workers in product and textile manufacturing,
For occupations in the cosmetics sector, it is further aggravated that affected persons come into contact with a variety of care products on a daily basis, which may not be tolerable by the hands and thus lead to irritation reactions with hand swelling as an accompanying symptom.
Scleroderma is a dermatological disease that is particularly often associated with hand swelling. The name describes a pathological hardening of the skin's own connective tissue, which rarely causes pain, but always causes edema on the extremities of the hands and feet. Chronic skin diseases such as neurodermatitis or psoriasis can also cause irritation-related swellings due to the skin changes typical of the disease and therefore cause swollen hands if the extremities are involved.
Inflammatory skin diseases are a particularly tricky area of causes that can cause swelling in the hands and fingers. Dyshidrosis is a phenomenon that has become increasingly common in recent years. It is a disease that is initially noticeable by small blisters under the skin, which are filled with an inflammatory liquid. After a while, these vesicles burst, causing the inflammatory secretions to flow into the surrounding tissue. A more or less severe inflammatory reaction follows, which can lead to extremely annoying swellings on the affected hand or on the phalanges.
It is not yet known what causes dyshidrosis. However, experts suspect that certain metabolic breakdown products are stored in the hands in the course of the disease and thus provoke the inflammation and swelling. Dyshidrosis is also occasionally mentioned as a preliminary stage to skin diseases such as neurodermatitis, which may also give the disease immunological aspects. Stress and wet and cold weather, as is known for spring and autumn, are also associated with the disease.
Temperature and weather aspects
Already the dyshidrosis, which occurs increasingly in wet and cold seasons, shows that our hands not only feel temperatures, but can also react extremely extremely to them. Who doesn't know the clammy and sometimes swollen hands in winter?
The reason for this is the fact that the blood flow to our hands can get a little out of rhythm in the cold. This is all the more true since the hands are among the most distant from the rest of the body. In the course of exposure to cold, the blood vessels narrow relatively quickly, which on the one hand increases blood pressure and on the other hand changes the flow properties of the blood. Cold blood becomes thicker, which in particular hinders oxygen transport. The lack of oxygen in the hands and fingers can then cause the skin to turn blue, better known as cyanosis. In addition, the effects of cold also promote the development of frostbite, a swelling of the tissue that is caused by persistently cool temperatures, preferably on fingers and feet.
Conversely, very high heat can irritate the hand tissue and cause swelling. The best example is the blister during a combustion. Burn injuries are specifically enriched with tissue water by the body in order to seal the injury airtight against wound contamination. What looks very threatening, especially with large blisters, is a natural protective mechanism for the body to prevent wound infections.
Speaking of infections, if a wound on the hand is actually contaminated by germs, inflammation and swelling must also be expected here. Quite a few insect bites, in which germs from the insects' saliva get into the puncture wound, kindle a fairly extreme swelling on the hand. Warts, which are usually caused by an infection with papilloma viruses, also cause tissue proliferation that does not take place without a certain swelling.
Not to be forgotten are allergies as the cause of a swollen hand. Especially with allergies to certain insecticides, but also with food allergies (e.g. nut allergy) or contact allergies, swelling can occur as an allergic reaction.
Hormone disorders and diseases such as dropsy cannot be excluded as the cause of the hand swelling. In addition, systemic diseases such as gout and rheumatism are known to cause swelling in the extremities.
Swollen hands can be very restrictive for those affected, since the increase in the size of the hands and fingers is often associated with other accompanying symptoms such as:
- Feelings of tension,
- Restricted movement,
- Discomfort and pain,
- Symptoms of paralysis,
- Circulatory disorders,
- Skin discoloration.
The affected hand, and especially the fingers, feel swollen, the skin taut and jewelry can suddenly cut in. The swelling can also limit the usual range of motion in the fingers and wrists. The fingers can no longer be adequately stretched and bent, grasping and thus the entire fine motor skills are considerably more difficult.
The perceived feeling of tension on the skin and the restricted movement sometimes culminate in serious pain conditions or even in sensations and paralysis. This happens when the swelling of the hand exceeds a dimension tolerable by the body and pushes the surrounding anatomical structures. For example, nerves can be compressed, which can result in abnormal sensations (for example tingling or pricking) or paralysis of individual fingers and even the entire hand. The supplying blood vessels can also be pinched off by the increase in circumference. This results in a circulatory disorder, which can also be recognized by a bluish-pale discoloration of the fingertips and whitish discoloration of the nails. If you press the fingernails of those affected in this state, you can observe that the smallest blood vessels at the fingertips no longer fill with blood, or only very slowly - an indication of a circulatory disorder. In a healthy person, the whitish-colored nails would return to their typical rosy color within less than three seconds, which suggests a healthy capillary filling time.
The skin itself can also develop other accompanying symptoms due to the swelling of the swollen hand, because it can only withstand the increasing pressure to a certain degree. At some point the accumulated tissue water makes its way out and emerges through small micro cracks or collects in so-called tension bubbles. In this state, the skin is very susceptible to further external injuries. Since this in turn creates gates of entry for pathogens, the swollen hand must be protected from external influences with an increased risk of injury.
If a local inflammatory reaction is the cause of the swelling of the hand, the latter can also occur in combination with redness and painful overheating of the skin area in question. Additional caution should be exercised when fever, fatigue and loss of performance become apparent, as these accompanying symptoms indicate that the inflammation is no longer local to the hand, but is about to spread throughout the body.
If heart failure is present, in addition to swelling of the extremities due to edema formation, other accompanying symptoms can also occur, which usually occur gradually and at first glance are not related to the swollen hands. These include:
- Loss of performance,
- Shortness of breath,
- dry cough,
- frequent urge to urinate at night (nocturia),
- noticeable irregular heartbeat.
If the swelling of the hands does not go away on its own within a short time using the acute measures described below and cannot be explained by physiological processes such as end pregnancy or excessive heat in the summer months, those affected should definitely consult a doctor.
Swollen hands become apparent to the medical practitioners through the increase in the circumference of the hands. In the course of the consultation, the doctor will pay particular attention to changes in skin color, obvious skin defects and restricted movement during the physical examination. In addition, specific questions are asked as part of the anamnesis in order to get a first focus on the underlying cause. Questions are asked in the following areas:
- Other accompanying symptoms,
- current changes in life (e.g. pregnancy, fertility treatment, menopause, travel abroad or new medication),
- previous events (e.g. insect bites, injuries or operations).
Depending on the focus that the doctor reveals as possible causes for the swollen hands based on the physical examination and medical history, this is followed by other different diagnostic methods:
- Laboratory diagnostics: As part of laboratory tests, various values can be determined in the blood that support or rule out the suspected causes. These include the inflammation values, hormone values, rheumatoid factors, heart enzymes, liver and kidney values, electrolytes.
Imaging methods (e.g. X-ray, CT or MRI) can be used to examine orthopedic diseases as possible causes.
- Cardio diagnostics:
If the focus is on a cardiological cause, this is followed by a very broad spectrum of possible examinations. This includes:
- Chest x-ray,
- Blood pressure measurements,
- Cardiac cardiography,
- Stress tests (ergometry).
Depending on the numerous causes of a swollen hand, the treatment options are also very different. You can treat with medication, but you can also find various approaches in the area of home remedies and naturopathy that can provide relief.
As a first measure for suddenly swollen hands, it is advisable to take some immediate measures to see if the symptoms can be managed. For example, it makes sense to hold the affected arm above heart level. This facilitates blood flow to the extremities and can help with mild circulatory disorders without a certain disease value (e.g. in cold weather). If necessary, you can also support the arm with a pillow.
It is also a good immediate measure to stimulate muscle activity by performing gentle, uniform movements with your wrist and fingers. Slight circular movements and alternating tensing and loosening of the hands are particularly recommended here.
A third step is to carry out local cooling, which, however, only makes sense if cold is not considered to be the trigger for the swelling. It is possible, for example, to let cool water run over your hand, to perform a lukewarm hand bath or to briefly put on cooling elements (for example cool packs or ice cubes). In the case of the latter, however, care must be taken not to freeze to frostbite and to only use the refrigeration for a limited time with appropriate breaks.
In order to work on swollen hands, the patient can also use some home remedies in addition to the immediate measures already mentioned. In some cases, for example, hand swelling can be achieved through nutrition. Important steps are here:
- Adhere to the right amount of drink:
As long as your doctor has not prescribed otherwise, you should drink at least two liters of liquid. However, if the event is due to a weak heart, it may be that a drinking volume restriction of one and a half liters or, in severe cases, even less is prescribed. Mainly water and unsweetened teas should be selected as drinks.
- Low salt diet:
A very salt-rich diet favors the storage of water in the tissue. And those who regularly use ready meals and fast food do not even have to actively use the salt shaker to eat an excessively salty diet. Finished products, snacks from the food stall, sausages and pickled meat products as well as pasta are seasoned with many salts during the manufacturing processes. In order to establish a low-salt diet, one should rely on fresh ingredients if possible and reduce the consumption of the above foods to a minimum.
Hand massages and light stretching exercises can be used to stimulate circulation in the tissue of the swollen hand. To do this, apply light pressure starting at the fingertips, which is carefully continued towards the wrist. You can also spread your fingers apart, stretch and bend. You can do this exercise for five to ten minutes and then you should feel a noticeable improvement in symptoms.
If hand massages and stretching exercises intensify the symptoms, a doctor should be consulted immediately, as this can be an (arterial) circulatory disorder.
In naturopathy you can also find some treatment approaches and medicinal plant applications that quickly provide relief for swollen hands. For example, a little salt or apple cider vinegar can be added to the lukewarm hand bath. The salt water supports the swelling of the hands by promoting an escape of the tissue water due to the concentration gradient. In turn, apple cider vinegar is said to have a flushing and detoxifying effect. Plants that have such an effect help in the field of medicinal herbs. These include:
- Green oats,
- Asparagus root,
- Birch leaves.
The medicinal herbs mentioned can be added to a hand bath as an additive, generally using about one tablespoon of the dried herb per application.
Alternatively, you can also enjoy the medicinal plants several times a day in the form of a tea. To do this, mix one or two teaspoons of a maximum of three of the herbs in a cup and pour boiling water over them. After a brewing time of seven to ten minutes, the tea can be drunk. However, it should not be more than the recommended dose or brewing time, otherwise the tea will become inedible.
The Schüßler salts can also be found as a supportive treatment for swollen hands. For example, the Schüßler salt number 10 is the so-called discharge salt. Two to three tablets of the sodium sulfuricum salt twice a day should promote all excretion processes and thus ultimately contribute to swelling of the swollen hands.
Calcium fluoraticum, on the other hand, is often used in homeopathy to treat osteoarthritis. The same applies to Silicea. Homeopathic preparations such as Belladona are recommended for inflammation. In the case of joint inflammation in particular, as well as rheumatism, homeopaths, on the other hand, tend to use Bryonia or Rhus toxicondendron. Arnica, a medicinal plant that can be used not only as a homeopathic solution, but also as an additive for spas or envelopes, is said to help with swelling caused by overexertion or strain.
When it comes to medication, it is selected depending on the underlying cause. For heart failure, for example, hypotensive drugs such as ramipril or valsartan can be used. Heart-strengthening medications (e.g. digitalis preparations or Carvedilol) and draining medicines such as furosemide or torasemide are also conceivable.
A hormonal imbalance can only be remedied by hormone replacement products that compensate for a lack of estrogen or testosterone, for example. Swellings from allergies or insect bites are commonly treated with an antihistamine.
In the case of joint inflammation or rheumatism, experts in turn administer pain relievers and anti-inflammatory preparations. Treatment with acetylsalicylic acid, diclofenac, ibuprofen, paracetamol or pain relievers such as Voltaren is conceivable here. Anti-inflammatory drugs such as cortisone, on the other hand, are only used in extreme emergencies, since they themselves can cause a number of serious side effects.
In very rare cases, a swollen hand hides a muscular and bleeding-related compartment syndrome as a result of a trauma. Under certain circumstances, only the surgical opening of the affected area can provide relief and avert complications such as irreversible damage to nerves and blood vessels.
Possible diseases with swollen hands
- Stab wounds,
- Insect bites,
- Circulatory disorders,
- High blood pressure,
- Vascular inflammation,
- Heart failure,
- Wart infection,
- Hormone disorder,
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Bernhard Hirt et al .: Anatomy and Biomechanics of the Hand, Thieme Verlag, 3rd edition, 2014
- Michael Hammer: Rheumatoid Arthritis (chronic polyarthritis), Deutsche Rheuma-Liga Bundesverband e.V., (accessed August 6, 2019), RheumaLiga
- Michael J. Shea, Andrea D. Thompson: swelling (edema), MSD Manual, (accessed August 6, 2019), MSD
- M. Schneider et al .: Interdisciplinary Guideline for Management of Early Rheumatoid Arthritis, German Society for Rheumatology e.V., (accessed August 6, 2019), DGRH