Causes and Treatment of Swollen Finger Joints

Swollen finger joints are frequently the result of inflammation caused by an infection, injury, or disease. The swelling may be acute (sudden and short-lasting), caused by a fracture, infected cut, or a "jammed finger." Or, it may be due to a chronic (persistent or recurrent) condition like osteoarthritis, rheumatoid arthritis, gout, and others.

This article lists some of the more common causes of swollen finger joints and explains how they are diagnosed and treated.

Causes of Swollen Finger Joints

A number of conditions can cause swollen fingers. Most are inflammatory but some are not.

A Word From Verywell

A swollen finger can be caused by a number of things and can be debilitating. Evaluation by your healthcare provider is crucial to determine the underlying cause, as treatment varies significantly if the swelling is secondary to trauma versus infection versus autoimmune disease.

— ANITA C. CHANDRASEKARAN, MD, MEDICAL EXPERT BOARD

Injury

Injury to your fingers includes "jamming" your finger, crushing injuries, or direct trauma to your hand or fingers. Injuries like these can cause:

• Hematoma (a pooling of blood under the skin)
• Bone fracture
• Sprained or strained muscle
• Joint subluxation (dislocated joint)
• Ruptured (torn) tendon

After an injury, the body responds with inflammation in which blood circulation is increased to the affected area to aid with healing and eradicate infection. This, in turn, causes swelling, redness, heat, and pain.

Infection

An infection can also cause swollen finger joints. The bacteria Staphylococcus aureus is the most common cause of this. With a soft tissue injury, the ensuing inflammation can cause the skin and underlying tissues to swell.

In certain people, the infection can progress and affect the joint itself, leading to a condition called septic arthritis. Along with joint swelling, septic arthritis can cause a high fever, chills, and body aches. If left untreated, severe joint damage can occur.

Risk factors for septic arthritis include:

• Older age (typically 80 and over)
• Diabetes
• Rheumatoid arthritis
• Recent joint surgery
• Hip or knee replacement
• Injecting drug use
• Immunosuppressant medications
• Being immunocompromised
  

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis, often referred to as "wear-and-tear arthritis." It is an aging-related condition in which long-term stress on a joint causes the deterioration of cartilage.

OA is non-inflammatory but can become inflammatory as cartilage is lost and bone starts to rub against bone. This can lead to abnormal bone remodeling, resulting in bone spurs, joint deformity, pain, and the loss of joint mobility. The joints of the hand are commonly affected, often non-symmetrically but sometimes symmetrically.

Risk factors for hand OA include:

• Older age
• Female sex
• A family history of OA
• Occupations that involve repetitive fine hand motions (such as hairdressing or baking)

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease in which the immune system attacks the joints (typically the same joint on both sides of the body). This immune assault occurs in episodes ("flares"), causing joint pain, stiffness, and, in advanced cases, joint deformity. The joints of the hands and fingers are commonly affected.

The cause of RA is unknown but risk factors include:

• Being over 60
• Female sex
• A family history of RA
• Smoking
• Never being pregnant
• Obesity

Psoriatic Arthritis

Psoriatic arthritis (PsA) is another autoimmune, inflammatory arthritis that causes joint pain and stiffness. About 30% of people with psoriasis develop PsA. People who have psoriasis and PsA are usually (but not always) diagnosed with psoriasis first.

The distal interphalangeal joints of the fingers—the joints closest to your fingertips—are commonly affected by PsA. PsA is also characterized by dactylitis in which your fingers or toes swell and become sausage-like.

PsA is often accompanied by fatigue, nail pitting, nail loss, abdominal pain, bloating, constipation, diarrhea, and uveitis (inflammation of the middle layer of the eye).

Risk factors for PsA include:

• Having psoriasis
• Being between 30 and 50
• A family history of PsA
• Smoking
• Obesity
  

Gout

Gout is another type of arthritis that is not autoimmune, caused by the accumulation of uric acid in the blood. The uric acid crystallizes, causing hardened clusters of uric acid crystals in a joint known as tophi. The big toe is most commonly affected, but other toes or fingers can be affected as well.

Gout can cause excruciating joint pain along with swelling and stiffness. Left untreated, tophi can lead to infection, skin ulceration (open sores), and neuropathy (numbness or pins-and-needles sensations) due to the entrapment of nerves in joints.

Risk factors for gout include:

• Older age
• Male sex
• Chronic kidney disease
• Taking diuretics ("water pills")
• Obesity
• A diet high in purines

 Lupus

Systemic lupus erythematosus (SLE), also known simply as lupus, is a systemic (whole-body) autoimmune disease that causes pain and inflammation throughout the body. The skin, joints, and internal organs can all be affected.

SLE can produce a wide range of symptoms like extreme fatigue, headaches, low-grade fevers, joint pain and swelling, and a butterfly-shaped rash on the cheeks and nose.

As with RA, lupus typically affects multiple joints on both sides of the body, including the wrists, hands, and fingers. Symptoms are usually less severe than those of RA.

Between 5% and 10% of people with lupus develop finger joint deformities, such as the swan neck deformity (in which the middle joint is bent backward) and the ulnar drift (in which the fingers are angled toward the pinkie).

Risk factors for SLE include:

• Being between 15 and 44
• Female sex
• A family history of lupus
• Smoking
• Taking certain prescription drugs like Pronestyl (procainamide), Apresoline (hydralazine), or Quinaglute (quinidine)

Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a rare form of arthritis caused by long-term inflammation of the spine where it meets the pelvis. The condition is poorly understood and is thought by some to be autoimmune (although the blood tests used to diagnose other autoimmune diseases are often negative). It may also have a genetic cause.

AS can affect other joints, including the shoulders, hips, and fingers. As with psoriatic arthritis, AS can cause dactylitis of the fingers and toes along with joint stiffness, pain, and skin lesions.

Risk factors for AS include:

• Being under 45
• Male sex
• Having a gene called HLA-B27 (found in the majority of people with AS)
• Smoking
• Vitamin D deficiency

Diagnosing Swollen Finger Joints

If you have injured a finger joint, you may want to see your healthcare provider. They will examine your finger to assess the level of injury. If the injury is more severe, they may refer you to an orthopedist specializing in diseases and disorders of the bones.

Septic arthritis is diagnosed with X-rays and the evaluation of the joint fluids taken with a needle and syringe (called joint aspiration). X-rays will show joint swelling without damage to the bone. Joint fluids will reveal high levels of defensive white blood cells as well as the presence of bacteria.

If your finger is not injured or infected, you may have a systemic condition that is causing joint swelling and pain. In such cases, it would be best to see a rheumatologist who specializes in joint diseases, including those that are inflammatory or autoimmune. 

Autoimmune diseases can be diagnosed with blood tests, imaging studies, and the exclusion of other possible causes. Blood tests like rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) can help differentiate RA, PsA, or lupus. X-rays may reveal characteristic changes, including joint erosion, narrowing, or deformity.

X-rays are also useful in diagnosing osteoarthritis, while joint aspiration can reveal uric acid crystals in people with gout.

Ankylosing spondylitis is diagnosed based on a set of criteria, including having inflammatory back pain, a family history of AS, the presence of HLA-B27, and a positive response to nonsteroidal anti-inflammatory drugs (NSAIDs).

Treatment for Swollen Finger Joints

Understanding what's causing swollen finger joints is the basis for getting the right treatment.

Injury

Finger joint swelling from arthritis can be reduced by limiting repetitive overuse of the fingers and applying ice to help calm down the pain and inflammation. Strengthening the muscles of the fingers and hands to better support the joints can also help ease pain and prevent the recurrence of symptoms.

For acute finger injuries, rest, ice, and immobilization in the beginning stages can help protect your injured finger joints and allow them to heal. You may be given a brace or splint to wear to help stabilize your injured finger joint until it has healed enough.

If severe injury is present, such as a severed or ruptured tendon or ligament or a broken bone (fracture), surgery may be necessary to repair the injury. 

Physical or occupational therapy may be necessary afterward, depending on the extent of your injury, to regain finger and hand strength as well as range of motion to complete everyday tasks.

A minor injury will typically start to feel better within a week or two, but it may take up to a month or more for the swelling to completely resolve. If the injury is more severe and involves a ligament or tendon sprain, joint swelling may linger for up to a full year.

Infection

Septic infections like septic arthritis must be treated with antibiotics to eliminate the harmful bacteria causing joint pain and inflammation. For systemic conditions that can cause finger joint swelling, treatment will focus on reducing inflammation and preventing disease progression.

Arthritis

Different types of arthritis, including RA and PsA, can be managed with a variety of treatment options to reduce pain and inflammation and improve joint movement. These include:

• Over-the-counter (OTC) pain medications
• Topical pain-relieving creams
• Applying warm paraffin wax to the hands and fingers to decrease pain and stiffness
• Prescription medications to reduce pain and inflammation, including disease-modifying antirheumatic drugs (DMARDs)
• Cortisone injections into the finger and wrist joints to reduce inflammation
• Physical or occupational therapy to improve hand strength and range of motion
• Hand bracing or splinting for joint protection

Autoimmune forms of arthritis like RA and PsA often require lifelong treatment with medications to decrease inflammation and prevent disease progression.

Gout

Reducing uric acid levels in the blood with medications and diet can help decrease finger swelling and inflammation and reduce the risk of future gout flare-ups. 

Therapy to lower urates is the most common treatment used to decrease uric acid levels in patients with gout. The goal is to decrease serum urate levels to 6 milligrams per deciliter or less to reduce tophi and improve joint functioning. Common medications used to lower uric acid levels include Aloprim (allopurinol), Uloric (febuxostat), Benemid (probenecid), Zurampic (lesinurad), and Krystexxa (pegloticase).

If gout tophi are severe and unresponsive to medical treatment, surgery may be necessary to remove the damaged tissue in the affected joints (debridement) and free up the finger tendons to improve functional hand and finger use. The affected finger joint will also be flushed with a warm saline solution to help remove the tophi and prevent the joint from drying out and forming new uric acid crystals.

Surgery for gout is usually done in severe cases only, including when the following are present:

• Disease progression
• Significant pain and tophi
• Nerve compression, or entrapment
• Recurring infections
• Skin ulcerations
• Joint instability

Pain and tophi formation can also be managed by limiting foods high in purines—such as red meat, shellfish, and alcohol—that lead to increased uric acid levels in the blood.

Lupus

Unlike RA, pain and inflammation within joints of the fingers from lupus most often result from ligament and tendon laxity (looseness) rather than bone damage. Because of this, symptoms tend to be easier to correct with bracing or splinting of the fingers.

Lupus is also commonly managed with anti-inflammatory and immunosuppressive medications to decrease inflammation throughout the body.

When to See Your Healthcare Provider

People typically experience pain and swelling in the finger joints after an injury. If the pain or swelling does not improve after a few days, talk to your healthcare provider. If you have additional symptoms, such as the joint feeling warm or you're experiencing fever, chills, body aches, or extreme fatigue, call your healthcare provider right away.

Summary

Sudden pain and swelling in your finger joints can be a result of an injury, infection, or systemic conditions like RA, PsA, lupus, and gout. The pain and swelling that occur are usually due to the inflammation caused by these conditions.

Minor injuries to your hands or finger joints can be managed with home remedies, but more severe cases and infections like septic arthritis require help from a healthcare provider. Systemic conditions need to be treated by a rheumatologist to alleviate symptoms and prevent or slow disease progression.