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What are Common Causes of Knuckle Swelling?

By Maggie J. Hall
Updated Mar 03, 2024
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Medications, medical conditions and trauma can all contribute to knuckle swelling. Certain antibiotics, antihypertensive medications and those prescribed for the treatment of cardiac dysrhythmias may produce edema, causing swollen hands and joints. Numerous medical conditions might cause knuckle swelling, including arthritis, gout, heart or kidney disease and infection. Blunt force trauma, of any kind, to the hand may also produce pain and swelling.

Fluid retention caused by various medications may appear as joint or knuckle swelling, and individuals having an adverse reaction to antibiotics may also develop aching joints or swollen knuckles. In addition to sensitivity reactions, persons taking certain antihypertensive or dysrhythmia medications may experience weight gain and generalized edema, including knuckle swelling, because of alterations in heart rhythm and vascular circulation.

Certain preexisting medical conditions typically contribute to the adverse reactions and effects of medications. In addition to possible side effects, drugs might stress organs in individuals having kidney or liver disease. In this instance, extra body fluid accumulates and prevents the body from processing or eliminating medications, which generally exacerbates symptoms.

Swollen joints are one of a variety of symptoms produced by of dozens of medical conditions. Rheumatoid arthritis is an autoimmune disease that causes the body’s immune system to attack and harm otherwise healthy tissue. Knuckle swelling may occur when the synovial fluid between the joints becomes inflamed. The malady eventually affects the joints and results in bone deformity.

The ailment known as gout results when the blood contains abnormally high levels of uric acid. The accumulating acid often develops into crystals that make their way into connective tissue and joint spaces, causing inflammation, swelling and pain. Advanced cases may produce knuckle swelling. Pseudogout exhibits similar symptoms although the crystals associated with this disorder develop because of excessive calcium pyrophosphate levels.

Knuckle swelling may occur when blood or lymphatic vessels are obstructed due to severe injury or infection. In the presence of extreme trauma, the vessels are damaged directly, or the swelling of surrounding tissues impedes circulation. Localized or systemic infections produce an immune system response, which causes an influx of blood along with pathogen fighting chemicals and white blood cells. During the process of fighting the infection, tissues become reddened, swollen and tender.

Contrary to one popular opinion, knuckle cracking is a relatively harmless action. One of the components of the lubricating synovial fluid is nitrogen gas. Negative pressure forms between the joints when the space expands and may result in the formation of a gas bubble. The popping sound occurs as this gas bubble ruptures. This does not, however, cause the knuckles to swell.

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Discussion Comments
By anon1000213 — On Jul 06, 2018

I have recently been diagnosed with psoriatic arthritis. This gave me "sausage fingers" on my left ring finger and right pinkie. I also have painful knees that feel swollen inside and hard to bend. Both palms now have nodules inside, so it may be connected to the Dupytren syndrome, or trigger finger.

I have been on plaquenil and methotrexate for about 5 months, and I may have to go on stronger meds if there is no improvement. I find the only thing that helps is a couple of ibuprophen as needed, and the swelling goes down a bit. I can walk almost normally on them for a while.

I didn't really have a problem with actual psoriasis, so at first my knee hurt and I got a cortisone shot. Within a month all my joints and even tendons in elbow became painful.

Could the reaction to cortisone caused the arthritic condition to flare up? I always had a strong immune system, never got colds or sick, and I hate to start on meds that take away your immune system.

Thanks, Joan in Cape Breton

By anon289088 — On Sep 02, 2012

I am having problems with my wedding ring finger. This only occurred since I have added my wedding band to my finger. I am not sure if it is the platinum or coincidence and possibly arthritis. It is fine when I don't have my rings on, but plays up when I wear my bands. Has anyone else had this problem?

By anon287603 — On Aug 26, 2012

I have swelling every morning when I wake up in my right hand only. I have ostearthritis, but have never had this happen before. It seems tight but doesn't really hurt. But I would really like to know what is going on with me.

And today the swelling is worse than before. Each day it gets tighter with the swelling. By 1-3 p.m., it is gone usually but still comes back every morning. This isn't right. Any ideas will be a help. Thanks so much. The swollen hand woman in Oklahoma

By indemnifyme — On May 05, 2012

My grandmother has heart disease, and swelling is one of the things we're supposed to watch out for with her. She actually weighs herself every morning, and if she gains 3-5 pounds very quickly, that means she needs to take one of her pills to get the swelling down.

This doesn't happen very often, but last time I did her knuckles got really swollen, too. She knew even before she weighed herself that she probably needed to take one of her pills.

By ceilingcat — On May 05, 2012

@JaneEyre - Wow. You went in for what you thought was wrist pain treatment, but you really ended up having an allergy! Very interesting. I had no idea an allergic reaction could cause knuckle swelling.

I've only ever had knuckle swelling from injury, but arthritis does run in my family. My dad has it pretty badly, and he gets knuckle swelling from time to time. He's on medication for his arthritis though, so I'm not sure why his knuckles continue to swell up. Either way, it looks very unpleasant, so I'm hoping I won't get arthritis when I get older.

By JaneAir — On May 04, 2012

I've actually had my knuckles swell because of an allergic reaction to an antibiotic. It was horrible. I had wrist pain, and pain in all of my joints along with the swelling. At first I thought I had hurt myself somehow, but when I went to the doctor they didn't think that was the case.

At first, my doctor thought I might have contracted Lyme disease. However, they eventually figured out that I was having an allergic reaction to the antibiotic I was taking (I also had a sinus infection at the time). I stopped taking the antibiotic and they put my on some allergy and anti-inflammatory medicine. I didn't feel better for a few days though!

By cloudel — On May 03, 2012

@StarJo – I think you are right about this. I have noticed swelling in my knuckles after a long, brisk walk, and I always keep my hands by my sides, too.

The worst knuckle swelling I have ever had, though, came from a wasp sting. I had walked under a red wasp nest, and one of them swooped down and popped me in the knuckle.

If you've ever been stung by a wasp, you know that the area swells up a lot and becomes red. It hurts so much for the first hour, but after that, you are left with swelling and itchiness.

I put an antihistamine cream on the sting, and that helped keep the swelling down a little. There's really nothing you can do to totally prevent it, though.

By kylee07drg — On May 03, 2012

I have polycystic kidney disease, and sometimes, my knuckles swell up with fluid, along with my ankles and feet. This condition causes me to have high blood pressure, and I believe that contributes to the swelling.

I was surprised the first time I noticed the swelling. I was simply working at my computer desk, not doing anything strenuous, and I looked down to find my knuckles swollen severely.

After that, my doctor put me on blood pressure medication, and now, I rarely have any knuckle swelling. I have to watch my sodium intake, because too much of it could undo the work of the medication and make me swell up again.

By StarJo — On May 02, 2012

My knuckles swell whenever I go roller skating. I guess it is because I have them down by my sides the whole time. Maybe the blood can't circulate as well because of this.

It never happens when I do any other type of workout. Of course, my aerobics videos I use all involve moving my hands around a lot.

I think it might have something to do with having my hands below the level of my heart the entire time. I've always heard you should elevate an injury above your heart level to keep it from bleeding too much, so I guess the accumulation of blood in my hands is what is making my knuckles swell so much.

By Oceana — On May 01, 2012

@LisaLou – I know how frustrating it is to love gardening but ache every time you do it. I began to develop arthritis when I was thirty-two, and it got so much worse after I yanked weeds from my garden.

Because I have a medical condition, I can't take any sort of arthritis medication, like aspirin or ibuprofen. So, I decided to use compression gloves instead.

These gloves are designed for people with arthritis. They apply gentle pressure when you have them on, and this stimulates circulation while reducing the swelling in my knuckles. It also keeps my hands warm, and warmth always eases arthritis pain.

By discographer — On Apr 30, 2012

@LisaLou-- I'm sorry to hear that. I don't have arthritis but my grandmother has rheumatoid arthritis. So I know how challenging this condition can be.

Have you ever visited a natural spring spa? My grandmother went to one where they had a pool of warm spring water and it helped a lot. She said that the swelling went down considerably.

Arthritis is probably the condition where knuckle swelling is seen most often, but it's not the only one. One of my cousins has a pretty uncommon condition called "dupuytre." It's when the tissue under the skin becomes too thick. He experiences knuckle swelling too.

By fify — On Apr 29, 2012

@simrin-- I know what you mean. It's not fun not to be able to bend your fingers because your knuckles are huge.

I get swelling in my knuckles often and I think it's because of Hashimoto's hypothyroidism. I've had this condition for the past five years. I haven't told my doctor about the knuckle swelling yet because I'm away at college. I won't be able to see him until next month.

The weird part about it is that it only swells at night. I go to bed just fine but when I wake up, I'll find the knuckles of my right or left hand very swollen. Right now I'm just making sure that I'm taking my medications on time and I try to keep the swelling down with ice.

By SteamLouis — On Apr 28, 2012
I had knuckle swelling during my pregnancy because of pre-eclampsia. Just in case anybody reading this doesn't know, pre-eclampsia is a condition where pregnancy causes high blood pressure. The main symptom of it is swelling in hands, feet and face. I had it all through out my pregnancy and the knuckle pain and swelling was one of the worst to deal with.

I couldn't even wear my wedding ring and it hurt to do chores with my hands. Pre-eclamsia such a terrible and dangerous condition. I'm scared to have another baby because I might have pre-eclampsia again. My first pregnancy went well and I didn't have to have early birth thankfully. But I'm not sure if I could take this risk again.

By John57 — On Apr 28, 2012

We spend a week camping in the mountains every year and the high altitude causes swelling in my joints.

After we are there for a couple of days, I always notice swelling in my hands and feet. My knuckles become so swollen that I can't get my rings off.

We do a lot of hiking and my feet are really swollen in the evening. I can elevate them at night and the swelling goes down some, but my knuckles are swollen the whole time.

I don't have any pain in my hand, but it just seems strange this happens every year. Once we return back home, within a day or two all the swelling in my knuckles is gone.

My rings come off with no trouble and I don't have any more trouble with it. For some reason my body swells up like this any time I spend a few days at higher elevation than normal.

By bagley79 — On Apr 27, 2012

When I slipped and fell on the ice, I sprained my wrist and hand. Not only did I have a lot of hand and wrist pain, but my whole hand was swollen.

This included all of my fingers and even swelling between my knuckles. This happened to my right hand, and of course, I am right handed.

I had to teach myself to use my left hand for a lot of things while that sprain was healing. Even though it seemed to take a long time for the swelling to go down, at least I knew it was temporary.

Eventually my hand returned to normal and I could use my right hand as before. My mom takes medication for high blood pressure, and she often has swelling in her hands and knuckles from this.

She has tried several different blood pressure medications to find one that controls her blood pressure without getting the swelling in her hands and knuckles.

By myharley — On Apr 26, 2012

I have an aunt who has rheumatoid arthritis and her fingers and knuckles are deformed and bony because of this.

As a kid I cracked my knuckles a lot. My sister always told me that my knuckles would become very swollen and I wouldn't be able to wear my rings. She said if I kept doing it, they would just get bigger and bigger.

I stopped cracking my knuckles for awhile because I was afraid my hands would look like my aunts. As I got older I heard that cracking your knuckles wouldn't cause them to swell.

This is still something I find myself doing and my knuckles have never become swollen or large because of this bad habit.

If I had knuckle pain from cracking them, I would stop doing it, but it actually makes my knuckles feel better.

By LisaLou — On Apr 26, 2012
I have arthritis in my fingers and hands, and it is not unusual for my knuckles to swell because of this.

This arthritis affects many of the joints in my body, but the knuckle pain and swelling can be very painful and frustrating.

It is hard to do much with your hands when all of your knuckles are swollen and hurt. On bad days, even typing at the computer can be slower and hurt more than usual.

You don't think about how much you do with your hands until you have trouble using them. Many of my favorite activities such as gardening, cooking and playing the piano are affected by this.

The only way to keep my knuckles from swelling is to try and keep the inflammation down. Medication helps with this much of the time, but still doesn't completely relieve the symptoms.

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