What is Knuckle Pain and Swelling?

Pain and swelling in the metacarpophalangeal joint or the finger joints is known as knuckle pain and swelling. This could occur as a result of different causes. Pain and swelling in the knuckles can develop due to different conditions, which affect the structures in the knuckles, including nerves, skin, muscles, tendons, joints, bones, blood vessels, ligaments and connective tissue. Some of the common causes of knuckle pain and swelling include trauma or injury and osteoarthritis.

What is Knuckle Pain and Swelling?

Characteristics of Knuckle Pain & Swelling

Knuckle pain can be stabbing, sharp, dull or throbbing. The knuckle pain can be mild to severe in intensity and can occur only at a specific time of the day or when the patient performs certain activities. Depending on the cause of the knuckle pain, it can increase or decrease with movement. It can be very difficult to move the knuckle if there is severe knuckle pain and swelling occurring as a result of traumatic injuries. Sometimes, knuckle pain and swelling occurring as a result of injury can be localized to only a single knuckle. In some cases, many knuckles can be affected. Inflammation in the knuckles can also cause knuckle pain and swelling. Medical conditions, such as rheumatoid arthritis, which is a chronic autoimmune disease, and is characterized by joint inflammation, will also cause knuckle pain and swelling.

There may be acute knuckle pain, which is recent in origin or chronic knuckle pain which develops slowly. Knuckle pain and swelling can also occur from chronic medical conditions which affect the entire body, such as vascular disease, arthritis, cardiac problems, kidney disease and diabetes. Cancer of the bones or soft tissues is a rare and potentially fatal cause of knuckle pain and swelling.

Causes of Knuckle Pain & Swelling

Given below are some medical conditions and other causes which are responsible for knuckle pain and swelling.

  • Soft tissue injury.
  • Lymphedema.
  • Venous insufficiency.
  • Cellulitis.
  • Blunt trauma/injury to the knuckle(s).
  • Infection.
  • Heart failure.
  • Renal failure.
  • Allergic reaction.
  • Lymphadenopathy.
  • Insect bites.
  • Venous thrombosis.
  • Knuckle pain and swelling can be caused as a result of side effect to some medications.
  • Bone cyst.
  • Dermoid cyst.
  • Ganglion.
  • Finger/Hand injury often lead to knuckle pain and swelling.
  • Rheumatoid arthritis.
  • Septic arthritis.

Given above were some of the causes for knuckle pain and swelling. Let's discuss some of the causes in detail.

  • Certain medications can also cause knuckle pain and swelling, such as antibiotics, antihypertensives, medications which are prescribed to treat cardiac dysrhythmias. There are various medications, which can cause fluid retention resulting in knuckle swelling. Certain antihypertensive medications or heart medications can cause weight gain and generalized edema, including swelling in the knuckles, as this causes changes in the heart rhythm and vascular circulation.
  • Blunt trauma or force to the hand can also cause knuckle pain and swelling.
  • Some medical conditions of a patient add to the adverse reactions and effects of the medications. Other than the side effects, medicines can put undue stress on organs in patients suffering from liver or kidney disease, which leads to accumulation of excess body fluid preventing the body from processing or eliminating the medications, which in turn aggravates the symptoms.
  • Knuckle pain and swelling can occur as a symptom of various medical conditions. Rheumatoid arthritis is an autoimmune disorder where the body's own immune system harms and attacks its own healthy tissue. In this condition, knuckle pain and swelling occurs when there is inflammation of the synovial fluid present between the joints. Patient has painful joints and bone deformity in this condition.
  • Gout is another medical condition where there are abnormally increased levels of uric acid in the blood. The collected uric acid develops into crystals, which travel to connective tissue and the joint spaces causing inflammation, pain and swelling including the knuckles.
  • Pseudogout is another medical condition where high levels of calcium pyrophosphate lead to formation of crystals resulting in pain and swelling of the joints, including the knuckles.
  • Systemic or localized infections generate an immune system response. When fighting the infection, there is pain and swelling of the tissues, including the knuckles.
  • Obstruction in the blood or lymphatic vessels from severe injury or infection also causes knuckle pain and swelling. Any severe injury or trauma causes damage to the vessels leading to swelling of the surrounding tissues, which in turn hinders the circulation.

When to Seek Medical Care for Knuckle Pain & Swelling

Immediate medical attention should be sought in the following conditions:

  • If there is persistent or recurrent knuckle pain and swelling.
  • If there are injuries, which involve severe bleeding and damage to the tissues.
  • If the knuckle pain and swelling occurs as a result of bone infections (osteomyelitis) or infection of soft tissues and skin (cellulitis) of the knuckle, which can spread to the entire body and can result in shock and organ failure.

Treatment for Knuckle Pain & Swelling

Treatment depends on the underlying cause of the knuckle pain and swelling. Once the cause is identified and treated, there is relief of the knuckle pain and swelling. In case of persistent knuckle pain and swelling, patient should not delay medical attention.

Home Remedies for Knuckle Pain & Swelling

  • Take a bowl of warm salt water and soak your hands in this solution. This will help in relieving the knuckle pain and swelling along with stiffness of the knuckles and fingers. Salt is an ancient home remedy, which helps in absorbing the pain.
  • Application of cold compresses to the knuckles will help in bringing down the pain and swelling.
  • Application of aloe vera to the affected knuckles helps in soothing the knuckle pain and swelling.
  • Over-the-counter pain killers and NSAIDs also help with bringing down the pain and swelling of the knuckles.
  • When there is knuckle pain and swelling, patient should avoid eating red meat, eggs, processed foods, as they tend to aggravate the symptoms, especially in case of gout and rheumatoid arthritis.
  • Gentle massage to the affected knuckles helps in bringing down the knuckle pain and swelling along with any stiffness.
  • Magnet therapy and physiotherapy also helps in relieving knuckle pain and swelling.

Knuckle Cracking

Knuckle cracking is a common habit, which many people have. There is a misconception that it causes pain and swelling in the knuckles, whereas it is quite a harmless habit. The lubricating synovial fluid contains nitrogen gas. There is formation of negative pressure between the joints and when the space increases, this results in formation of a gas bubble. When this gas bubble ruptures, there is a popping sound heard when a person cracks his/her knuckles. This habit is not responsible for knuckle pain and swelling; however, constantly cracking the knuckles is not advisable as this habit can damage the bony cartilage.

Written, Edited or Reviewed By:


Last Modified On: July 12, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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