Swollen knuckle with pain

Contents

6 Rheumatoid Arthritis (RA) Signs & Symptoms

By Douglas Roberts, MD, Special to Everyday Health

Medically Reviewed by Alexa Meara, MD

Could your hand or foot pain be caused by rheumatoid arthritis (RA)?

RA is a serious autoimmune disease that is much different from osteoarthritis, the type of arthritis that usually occurs as we age. Rheumatoid arthritis can strike at any age, and if you don’t get diagnosed and treated, you could develop joint damage and painful, crippling deformity.

A devastating disease that can severely damage your joints, RA also affects other organs and reduces your life expectancy. Newer treatments are very successful at reducing joint pain and damage, and remission is a real possibility. But early treatment is essential to avoid permanent joint damage and disability.

Diagnosing 6 Common RA Signs and Symptoms

Sometimes it can be difficult to tell whether your symptoms are those of RA or the more common wear and tear arthritis called osteoarthritis (OA). Either diagnosis should be confirmed by someone who is an expert in arthritic diseases, usually a rheumatologist. Here are six rheumatoid arthritis early symptoms and how they differ from signs of OA.

1. Usually with RA, one or more of your finger knuckle joints will be swollen. The swelling or inflammation is more likely to be in the middle or large knuckles of your hands not the knuckles at the tips of your fingers next to your fingernails. It is often in the same joints on both hands (the swelling is symmetrical). The swelling does not feel “bony,” but rather tender and slightly soft. With RA, you may also feel warmth and notice redness over the inflamed joint.

2. At least one of your middle or large knuckles has been swollen and painful for more than six weeks. If there’s no clear reason or explanation for this, it could be a sign of RA. Large joints, such as your ankles, knees, shoulders, or elbows, may be involved, but you must have swelling and pain in at least two joints to be diagnosed with rheumatoid arthritis. On the other hand, swelling or pain in your small fingertip knuckles, at the base of your thumbs, and in your big toe joints will more often be due to OA.

3. The balls of your feet are also targets for RA. Often, people with rheumatoid arthritis experience a feeling of “walking on golf balls” or swelling under the foot, especially first thing in the morning when getting out of bed. This pain will feel different from pain caused by a bunion. Pain from a bunion is usually at the base of the big toe, and feels worse when you wear tight shoes.

4. You just don’t feel well, and you may notice bumps on your elbows. With RA, you may have flu-like symptoms, such as low-grade fevers, stiffness, and fatigue from inflammation. Occasionally, small tender bumps or nodules under the skin will develop with RA, often near the back of the elbow. These are called rheumatoid nodules.

5. Your joints are particularly stiff for more than an hour in the morning. With rheumatoid arthritis, you may find it difficult to completely make a fist. You may have unusually tender swelling on the top of your wrists along with stiffness. If your elbows are involved, it may be difficult for you to straighten them completely. Usually, you won’t have swelling or pain in your hip joints early in the course of RA. Painful hip joints more often are due to OA, and most people feel the pain in the front of the hip or in the groin region.

6. Certain blood tests may help determine whether you have RA. These are usually ordered by your health provider, but there are companies that allow you to order these tests yourself (Hint: Google search order your own lab tests). Four important tests are usually ordered for an RA diagnosis. Two measure proteins in your blood called antibodies: Rf (rheumatoid factor) and CCP (anti-cyclic citrullinated peptide). The other two measure inflammation: ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein). With RA, at least one Rf or CCP test must be positive and at least one CRP or ESR test must be abnormal.

RELATED: Don’t miss these lifestyle tips from people who have RA. Find answers on Tippi.

ACRs Point System to Confirm an RA Diagnosis

The American College of Rheumatology (ACR) has developed a point system to help confirm the diagnosis of rheumatoid arthritis; your score has to be at least six points for a definitive diagnosis of RA. Here’s a simplified summary of how the points are measured:

The number of Swollen or Tender Joints Can Count for up to 5 Points

  • Two or more large joints (1 point)
  • One to three small joints (2 points)
  • 4 to 10 small joints (3 points)
  • 10 joints with at least one small joint (5 points)

Blood Tests Should Be Positive, and Give Additional Points

  • At least one positive Rf or CCP (2 to 3 points depending on how high)
  • And at least one abnormal CRP or abnormal ESR (1 point)

One additional point is added if you’ve had symptoms for at least six weeks. Many doctors realize that it’s possible to have RA and not meet all the criteria. You should have a detailed discussion with your doctor about whether you should start treatment. Although current RA drugs are very effective, they sometimes have serious side effects.

RA Goals: Early Detection and Treatment

We now know that some forms of RA are very aggressive, and much permanent joint damage can occur within the first 12 months. RA cannot be cured yet, but joint damage can be slowed and sometimes stopped. Understanding the difference between OA “aches and pains and early signs of RA is critical to saving your joints from painful damage and disability. If you’re having trouble explaining your joint pain and possible arthritis symptoms to your doctor, try writing them down in a journal, or visit a website dedicated to pain management, such as my website, PainSpot.com.

Douglas Roberts, MD, has been practicing rheumatology since 1990. He is an associate professor of medicine at the School of Medicine at the University of California in Davis, and an attending physician at UCD Medical Center. He created the PainSpot.com website to help people with painful joints understand possible causes, and get help for serious arthritic conditions, such as rheumatoid arthritis.

9 Possible Back Of The Hand Swelling Conditions

The list below shows results from the use of our quiz by Buoy users who experienced back of the hand swelling. This list does not constitute medical advice and may not accurately represent what you have.

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Rarity: Uncommon

Top Symptoms: fever, chills, facial redness, swollen face, face pain

Symptoms that always occur with cellulitis: facial redness, area of skin redness

Urgency: Primary care doctor

Rheumatoid arthritis

Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness throughout the body. Rheumatoid arthritis (RA) is a chronic condition that is autoimmune in nature, meaning that the body’s immune system which normally protects the body by att…

Dupuytren disease

Dupuytren Disease, also known as Dupuytren’s contracture, is a condition that gradually causes connective tissue (fascia) under the skin of the palm to thicken and become scar-like. Although Dupuytren’s isn’t painful, it does restrict movement. The thickened tissue forces several fingers – usually the ring and pinky fingers – to curl in toward the palm.

Rarity: Uncommon

Top Symptoms: finger joint stiffness, hand bump, thickened skin on the finger, swollen hands, hand injury

Urgency: Primary care doctor

Angioedema

Angioedema is a condition which can cause swelling and puffiness of the face, mouth, tongue, hand or genitals. It is often related to an allergic reaction to food, medicines or insect bites.

Rarity: Rare

Top Symptoms: nausea or vomiting, abdominal cramps (stomach cramps), diarrhea, swollen face, hand swelling

Urgency: Hospital emergency room

Back Of The Hand Swelling Symptom Checker

Take a quiz to find out what might be causing your back of the hand swelling

Bruised hand

A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin, which causes the purple color of the bruise.

Rarity: Uncommon

Top Symptoms: hand injury, hand pain from an injury, pain in one hand, swelling of one hand, palm bruise

Symptoms that always occur with bruised hand: hand injury, hand pain from an injury

Urgency: Self-treatment

Psoriatic arthritis

Psoriatic arthritis is a condition which causes inflammation of the joints. In most circumstances, psoriatic arthritis presents between the ages of 30 and 50 years and occurs after the manifestation of the symptoms of psoriasis, which is a disease of the skin. Psoriatic arthritis…

Frostnip of the upper limbs

Frostnip is damage of the outermost layers of the skin caused by exposure to the cold (at or below 32F or 0C). It is most commonly found in people doing leisurely activities like camping, hunting, or snow sports.

Rarity: Rare

Top Symptoms: hand numbness, hand pain, hand redness, cold hands, cold fingers

Symptoms that always occur with frostnip of the upper limbs: cold fingers

Urgency: In-person visit

Jammed finger

Jammed fingers are common in sports but may occur during daily activity.

Rarity: Uncommon

Top Symptoms: recent finger injury, finger pain from an injury, swollen finger, finger joint stiffness, finger bruise

Symptoms that always occur with jammed finger: recent finger injury, finger pain from an injury

Urgency: Primary care doctor

Motor-vehicle accident

After any motor-vehicle accident, it’s hard to rule out subtle, but maybe dangerous, things that could have happened within the body. You should go see a doctor immediately.

Rarity: Uncommon

Top Symptoms: motor-vehicle accident, arm weakness

Urgency: Emergency medical service

We use our hands every day, which is why having swollen knuckles can be severely encumbering and prevent us from doing the things we love. The knuckles are involved in nearly all functions of finger movement.

When the knuckles become swollen, it becomes exceedingly difficult to flex the fingers properly. Swollen knuckles are often accompanied by pain, making the condition even worse, as it can lead to complete or partial loss of functionality of the affected hand.

What are swollen knuckles?

Swollen knuckle pain can present as stabbing, sharp, dull, or throbbing. Symptoms may present at certain times of the day or arise from certain activities. Depending on the cause of your particular case of swollen knuckles, the intensity of pain will range from mild to severe, limiting movement to various degrees.

Swollen knuckles due to traumatic injury are difficult to move, and there is the possibility of damaged tissue or bone presenting with additional symptoms. In this respect, pain may be localized to a single knuckle that received the brunt of the inflicted trauma.

Several inflammatory medical conditions can lead to joint swelling, which can cause pain and restrict movement.

What causes swollen knuckles?

Traumatic injury: The knuckle joints are a very common site of injury in people who regularly engage in fist fights. The knuckle joint can get abnormally twisted, resulting in a sprain in its ligaments or the fracture of the joint, especially when hitting a hard object. The finger bones are also likely to suffer from fractures or become dislocated.

Osteoarthritis: A medical condition in which the soft tissues of cartilage between joints wear out. When this occurs, adjoining bones in these joints rub against each other, leading to damage and pain. Osteoarthritis is commonly found in the elderly. Repetitive activities such as typing at a computer or playing the piano can irritate the knuckle joints, leading the cartilage in between them to wear down.

Rheumatoid arthritis: An autoimmune disease where symptoms are triggered by an abnormally functioning immune system that attacks healthy cells. In the case of rheumatoid arthritis, antibodies target the healthy tissue of joints, including the knuckles. This leads to inflammation, swelling, and pain in the hand. Due to rheumatoid arthritis’ chronic nature, hand deformity may occur.

Gout: A condition caused by abnormal levels of uric acid in the blood stream, either by reduced excretion or an increased production. Having excess uric acid promotes the production of uric acid crystals, which like to deposit into joints like the knuckles. When this occurs, it often leads to inflammation and swollen knuckles.

Fluid retention: Known medically as edema, fluid retention is characterized by increased levels of fluid in the cells and tissues and can be appreciated in the knuckles, making them appear swollen. Excess fluid retention can be a sign of lymphatic system dysfunction, with serious conditions such as liver disease causing the problem. Other potential conditions that affect lymphatic fluid drainage include problems with the kidney and thyroid gland.

Certain medication: Many prescribed medications come with the risk of causing an adverse allergic reaction, which can present as swelling in places all over the body, including the knuckles. Some medication may put stress on other organs in patients suffering from liver or kidney disease, which can lead to fluid retention.

Other possible causes of swollen knuckles include:

  • Soft tissue injury
  • Lymphedema
  • Venous insufficiency
  • Cellulitis
  • Infection
  • Heart failure
  • Renal failure
  • Allergic reaction
  • Lymphadenopathy
  • Insect bites
  • Venous thrombosis
  • Bone cyst
  • Dermoid cyst
  • Ganglion
  • Septic arthritis
  • Pseudogout

How to treat swollen knuckles

Depending on the cause of your particular case of swollen knuckles, treatment methods will vary. For more acute cases, as with a traumatic injury, treating the wound and bandaging it up will often be enough. In cases where swollen knuckles are due to an insidious cause such as rheumatoid arthritis, the use of over the counter and prescription grade medication to control pain and swelling is recommended. Gout patients will be given medication to help reduce the level of uric acid in the blood.

Visiting a doctor is not always required, especially in mild cases of swollen knuckles. The following are some tips to help relieve knuckle swelling and pain from the comfort of home:

  • Soak your knuckles in a solution of warm salt water. This will help relieve swelling and stiffness of the knuckles and fingers.
  • Use a cold compress on swollen knuckles to help reduce pain.
  • Use of aloe vera on the affected knuckles can help soothe knuckle pain and swelling.
  • Use of over the counter pain medication can help deal with swollen knuckle pain.
  • Gentle massage to the affected knuckle may provide some relief.Swollen knuckles can be a serious problem requiring medical attention. If you have persistent knuckle pain and/or swelling, it is highly recommended to seek emergency medical care right away. This is especially true when swollen knuckles are accompanied by severe bleeding and tissue damage.

Symptoms


Osteoarthritis

The main symptoms of osteoarthritis are pain and stiffness in your joints, which can make it difficult to move the affected joints and do certain activities.

The symptoms may come and go in episodes, which can be related to your activity levels and even the weather. In more severe cases, the symptoms can be continuous.

You should see your GP if you have persistent symptoms of osteoarthritis so they can confirm the diagnosis and prescribe any necessary treatment.

Other symptoms you or your doctor may notice include:

  • joint tenderness
  • increased pain and stiffness when you have not moved your joints for a while
  • joints appearing slightly larger or more “knobbly” than usual
  • a grating or crackling sound or sensation in your joints
  • limited range of movement in your joints
  • weakness and muscle wasting (loss of muscle bulk)

Osteoarthritis can affect any joint in the body, but the most common areas affected are the knees, hips and small joints in the hands. Often, you’ll only experience symptoms in 1 joint, or a few joints at any 1 time.

Your Finger Joint Pain is Probably Caused by Arthritis

Since your fingers are being used constantly, they are at higher risk for pain and injury. Finger pain and soreness are caused by a change in the structure of your blood vessels, joints, tendons, bones, muscles or connective tissues. If your finger joint is swollen, stiff, or painful you most likely have a form of arthritis in your fingers. If you live in the United States, it is highly likely that you have heard of Arthritis, the inflammation of joints. With over 100 specific types, Arthritis is the most common chronic illness in the U.S.

To better understand where your pain may be coming from, it’s important to have a grasp on how your fingers function. Your finger is constructed of three main parts: ligaments, tendons, and bones. Surprisingly, there are actually no muscles in your fingers. You must be thinking… How are my fingers able to move then? Well, the muscles of your forearm pull on the tendons in your fingers, allowing them to move.

Finger Anatomy

There are three different knuckles in your fingers. The knuckle between your hand and your finger is called the metacarpophalangeal joint (MCP). This knuckle is most commonly injured in closed-fist activities. The next knuckle, located in the middle of your finger, is called the proximal interphalangeal joint (PIP). The most common injuries for this knuckle occur during sporting events when an object strikes the finger directly. The third knuckle, nearest to your fingernail, is called the distal interphalangeal joint (DIP). This typically involves a fracture of a torn tendon if there is an injury. If you are experiencing finger joint discomfort and pain, it’s important to identify the where it’s coming from. Let’s take a closer look at forms of arthritis that may be causing this pain.

What’s the Difference Between Joints and Knuckles in your Fingers?

The words ‘joint’ and ‘knuckle’ are nearly interchangeable when the conversation is regarding your fingers. ‘Joint’ is used when referring to any part of your body (where 2 bones join together). ‘Knuckle’ is used when referring to the specific joints in your fingers.

Signs that your Finger Joint Pain is Caused by Rheumatoid Arthritis

  • Joints are warm to the touch
  • Pain and stiffness when you wake up
  • Hand and finger pain
  • Swelling
  • Stiffness

Rheumatoid Arthritis occurs due to an overactive immune system and results in the swelling of joints. It affects the lining of your joints which can result in bone erosion and joint deformity. The tendons and ligaments that hold the joint together can gradually weaken and stretch also.

Rheumatoid Arthritis Treatments

  • Rest
  • Splints and aids that take pressure off
  • Physical therapy

Signs that your Finger Joint Pain is Caused by Osteoarthritis

  • Bump on knuckle at end of finger (Heberden’s node)
  • Bump on knuckle at middle of finger (Bouchard’s node)
  • Local pain
  • Stiffness
  • Tenderness
  • Swelling of affected joints

Osteoarthritis is the common form of arthritis and affects over 20 million people in the United States. This form of arthritis is caused by the breakdown of cartilage. Cartilage is the cushion in between the bones of the joints. When this cartilage breaks down, the bone becomes swollen. This can lead to a bone spur in the joint.

Osteoarthritis Treatments

  • Splinting
  • Anti-inflammatory medications
  • Cold/heat applications

Signs that your Finger Joint Pain is Caused by Juvenile Idiopathic Arthritis (JIA)

  • Joint pain
  • Stiffness
  • Reduced range of motion
  • Redness

Juvenile Idiopathic Arthritis is the most common type of arthritis in children. In some cases, arthritis will only last a few months while other cases may last a few years. It is believed that JIA is an autoimmune disease caused by the immune system attacking harmless cells instead of dangerous cells.

Juvenile Idiopathic Arthritis Treatments

  • Healthful diet
  • Physical therapy

Signs that your Finger Joint Pain is Caused by Systemic Lupus Erythematosus (SLE)

  • Swollen or painful joints
  • Swelling of the whole hand
  • Aching
  • Tiredness
  • Headaches
  • Fever

SLE is an autoimmune disease that affects your joints and other connective tissues. Autoimmune diseases cause your body to attack the parts that are harmless, rather than the harmful parts. SLE is most common among women. It is three times more in African American women than Caucasian women. It is also more common in women of Hispanic, Asian, and Native American descent.

Lupus Treatments

  • Lifestyle modifications
  • Medication

Common Knuckle Pain Symptoms and What They Mean

If your finger joint is swollen or inflamed

  • It is likely that you have some form of arthritis as this is a symptom of almost all forms. You may also be experiencing severe pain when pressed, a cyst-like bump, or stiffness at night or in the morning. It is encouraged that you should see your doctor to help identify which type of arthritis you have and the best treatment options.

If your knuckles feel stiff in the morning

  • It is likely that you are experiencing a symptom of Rheumatoid Arthritis. In order to relieve this pain, you should practice different exercises that help increase flexibility and mobility of your joints. Applying ice to the joint can help reduce pain as well. A splint can also help to hold these joints still.

If your finger joint hurts when pressed

  • You may have a form of arthritis. This pain can occur when driving, using a writing utensil, or anything else that applies pressure to your joints. A splint can help to reduce these symptoms. You should also practice different exercises that help increase flexibility and mobility of your joints. Applying ice to the joint can help reduce pain as well.

If you have a cyst, bump or lump on your finger

  • You may have Osteoarthritis. Other symptoms include tender, aching, and sharp pain in joints. A splint can help to reduce these symptoms. You should also practice different exercises that help increase flexibility and mobility of your joints. Applying ice to the joint can help reduce pain as well.

If you have pain in only your middle finger knuckle joint

  • It could be a symptom of an early onset of arthritis. Pain in only one joint is called monoarticular pain. In most cases, monoarticular pain is the first symptom you experience a condition. You should practice different exercises that help increase flexibility and mobility of your joints. Applying ice to the joint can help reduce pain as well.

If your pinky finger joint hurts

  • You may have a form of arthritis. This pain may occur when you are doing things like using your pinky finger as a balance for your smartphone or anything else that may apply pressure to that area.

If your fingers hurt when you bend or straighten them

  • This could be a symptom of Trigger Finger. Other symptoms may include locking or snap of fingers when you straighten or bend them and swelling of fingers. A brace can help reduce pain from trigger finger.

3 Simple Exercises to Relieve Index Finger Joint Pain & Swelling

Four Finger Extension

  1. Hold fingers out straight
  2. Slowly make a fist
  3. Hold thumb on outside of hand
  4. Open your hand back up and straighten fingers
  5. Repeat 10 times

Single Finger Collapse

  1. Hold hand vertical with fingers straight
  2. Bend index finger toward palm
  3. Straighten index finger again
  4. Bend middle finger toward palm
  5. Straighten middle finger again
  6. Repeat with all fingers

Ball Grip Exercise

  1. Find a soft foam ball
  2. Squeeze ball
  3. Relax hand
  4. Repeat

The sound of popping knuckles has long been a source of bafflement for scientists. Now researchers say they might have cracked its origins.

While previous research has shown that not all joints can make the sound, and that those that do can only be cracked once every 20 minutes or so, quite what is behind the auditory pop has been a topic of hot debate.

“The cavity in between the two knuckles is filled with a fluid that is called the synovial fluid, and when you suddenly change the pressure in that fluid as a result of increasing the spacing between the knuckles, some of the gases in that fluid can nucleate into a bubble,” said Prof Abdul Barakat of the Ecole Polytechnique’s hydrodynamics laboratory, a coauthor of the new study.

Some researchers have suggested that it is the collapse of such bubbles, formed of carbon dioxide and other gases, that causes the well-known crack, but others have proposed another possibility. “As you form this bubble you can cause pressure changes, and that can produce sound,” said Barakat.

In 2015 researchers in Canada appeared to have solved the puzzle, after one of the team had his knuckles cracked in an MRI scanner as images were taken. The verdict: the cracking sound was down to the rapid separation of the joint and bubble formation, not bubble collapse.

Barakat says the idea of delving deeper into the issue came from one of his students, a coauthor of the new research, who chose to study the phenomenon for a course project.

Noting that imaging techniques do not provide the necessary time resolution to capture the high-speed dynamics of knuckle-cracking, the pair developed a mathematical model to explore whether collapsing bubbles could be behind the sound after all.

The model, said Barakat, is based on three components: the change in pressure of the fluid as the knuckles move apart, the growth and collapse of the resulting bubble, and how changes in pressure from the bubble turn into sounds.

The team compared the sounds they would expect from collapsing bubbles produced from joint-popping, according to the model, with sound patterns recorded from a handful of knuckle-cracking participants, and found a good match between the two. By contrast, Barakat says formation of bubbles has not been shown to produce sounds of the observed magnitude or loudness.

Knuckle-cracking graphic Knuckle-cracking graphic

But there is an extra nuance: some have argued that it takes longer for the bubble to collapse than for a crack to be heard, and that this makes it an unlikely source of the sound. Barakat has an answer.

“What we demonstrate here is you don’t need full collapse,” he said, pointing out that even if the bubble just partially collapsed to leave a micro-bubble, it would generate the sound on the necessary timescale. The discovery, the authors add, could explain why small bubbles have be observed in synovial fluid even after knuckle-cracking.

Dr Greg Kawchuk from the University of Alberta, a coauthor of the 2015 study, welcomed the new research. “Their main finding, that theoretical bubble collapse can create sound, is not surprising,” he said. “What makes this paper interesting is that it suggests that other phenomena may occur in between frames of the MRI video published in our prior study and that these phenomena may create sounds that are similar to those produced in knuckle-cracking.”

But, he added, the case was not yet closed, noting that the latest research is a mathematical model that has yet to be verified by experiment.

While there has been some debate about whether knuckle-cracking increases the risk of osteoarthritis, studies .

Among those to study the phenomenon was Dr Donald Unger, who won an IgNobel Prize in 2009 at the age of 83 for cracking only his left knuckles since his teenage years, while leaving his right knuckles uncracked. Unger reported no signs of arthritis in either hand.

Not everyone can produce a knuckle crack. “Some people cannot crack their knuckles because the spacing between their knuckles is too large for this to happen,” said Barakat.

But, for those who can and enjoy the sensation, Barakat has a tip: “The more rapidly you pull on your knuckle, the faster you are changing the pressure and therefore the more likely you are to generate a knuckle crack.”

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *