Symptoms swelling pain hands and feet
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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From the Arthritis Foundation
Most of the conditions that cause these symptoms fall into the arthritis category. Most... but not all.
Some of the more common causes of swelling and pain involving the hands and feet...
Arthritis means "joint inflammation" and refers to a number of conditions that cause pain, swelling, stiffness, and loss of motion in the joints. Arthritis is one of the more common diseases that causes symptoms of swelling and pain in the hands and feet.
"Arthritis" is often used as a general term to refer to the more than 100 diseases that may affect the joints but can also cause pain, swelling, and stiffness in other supporting structures around joints such as muscles, tendons, ligaments, bones, and internal organs.
The amount of discomfort caused by this disease varies. Some people can have pain to such a degree that it limits their daily activities. Other people have mild to moderate pain that doesn't affect their daily living to such an extent. Sometimes there are periods of time without any pain or discomfort.
Arthritis is a chronic disease. The good news is that many advances have been made in arthritis research. There are medicines and other treatments for the disease that may induce remission.
The most common forms of arthritis are:
Osteoarthritis (OA) is also referred to as degenerative joint disease. This is the most common type of arthritis occurring in older people. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. Osteoarthritis causes joint pain and can limit a person's normal range of motion. Swelling of the fingers and toes occurs in the joints and may lead to bony deformity.
Rheumatoid arthritis (RA) is an autoimmune disease where the body's immune system attacks healthy joints, tissues, and organs. It causes inflammation of the synovium (lining of the joints). It can cause pain, stiffness, swelling, and loss of function in joints. When severe, rheumatoid arthritis can deform a joint.
Rheumatoid arthritis affects mostly joints of the hands and feet and tends to be symmetric. This means the disease affects the same joints on both sides of the body.
Fibromyalgia. This chronic disorder is associated with generalized aches. Pain, stiffness, and localized tender points occur in the muscles and tendons, particularly those of the neck, spine, shoulders, and hips. Fatigue and sleep disturbances may also occur. There is subjective swelling in the hands and feet.
Gout. The body makes uric acid from certain foods. Too much uric acid causes deposits, called uric acid crystals, to form in the joints. The result is an extremely painful attack of arthritis. The most common joint gout affects is the big toe. "Podagra" is the term used to describe the occurrence of gout attacking the big toe. This disease is more common in men than in women.
Infectious arthritis. Arthritis can be caused by an infection, either bacterial or viral, such as Lyme disease. When this disease is caused by bacteria, early treatment with antibiotics may ease symptoms and cure the disease.
Reactive arthritis. This is arthritis that develops after a person has an infection in the urinary tract, bowel, or other organs. People who have this disease often have eye problems (iritis), skin rashes, and mouth sores.
Some people who have psoriasis, a common skin problem that causes scaling and rashes, also have arthritis. This disease often affects the hands and feet. It is usually asymmetric (meaning it will affect one side of the body differently than it affects the other side). It also causes changes in the fingernails and toenails. Sometimes the spine can also be affected.
Systemic lupus erythematosus. This is called lupus or SLE for short and is an autoimmune disease. Lupus can affect many organ systems including the joints, skin, kidneys, lungs, blood vessels, heart, and brain. SLE is a major cause of swelling and pain involving the hands and feet. African American women are three times more likely to get lupus than Caucasian women. It is also more common in Hispanic, and Asian women.
Juvenile rheumatoid arthritis. The most common type of arthritis in children, this disease may cause pain, stiffness, swelling, and loss of function in the joints. A young person can also have rashes and fevers with this disease. Hands and feet are often affected.
Polymyalgia rheumatica. This disease involves joints as well as tendons, muscles, ligaments, and tissues around the joint. Symptoms often include pain, aching, and morning stiffness in the shoulders, hips, neck, and lower back. It is sometimes the first sign of giant cell arteritis, a serious disease of the arteries which is also characterized by inflammation, weakness, weight loss, and fever. Giant cell arteritis may lead to blindness or stroke. While the hands and feet may be affected, this type of involvement is unusual.
Bursitis. This condition involves inflammation of the bursae, small, fluid-filled sacs that help reduce friction between bones and other moving structures in the joints. The inflammation may result from arthritis in the joint or injury or infection of the bursae. Bursitis produces pain and tenderness and may limit the movement of nearby joints.
Tendinitis. Also called tendonopathy, this condition refers to injury of tendons (tough cords of tissue that connect muscle to bone) caused by overuse, injury, or a rheumatic condition. Tendinitis produces pain and tenderness and may restrict movement of nearby joints.
Different types of arthritis have different symptoms. In general, people who have arthritis feel pain and stiffness in the joints. Other common symptoms of arthritis are:
• Swelling in one or more joints
• Stiffness around the joints that lasts for a least one hour in the early morning
• Joint pain or tenderness that is intermittent or constant
• Feeling like it's difficult to use or move a joint
• Warmth or redness in a joint
Diagnosing rheumatic diseases can be difficult because some symptoms are common to many different diseases. Your rheumatologist will first do a complete physical exam, looking for any swelling, redness, warmth, deformity, ease of movement, and tenderness in your joints. Your heart, lungs, eyes, ears, throat and other parts of your body may be examined as well. This is because some types of arthritis can affect your organs. Lab tests may also be ordered and samples of blood, urine, or synovial fluid may be taken.
Other conditions besides arthritis can also cause swelling and pain in the hands and feet.
Polycythemia Vera (PV)is a disorder that is due to an overproduction of red blood cells, white blood cells, and platelets. Some patients with PV will not demonstrate any symptoms at all, but many will experience easy bruising or bleeding with little or no injury. Also, the blood may be thick causing it to clot in small blood vessels. If clotting occurs in the tiny blood vessels of the fingers and toes, a patient may experience numbness or burning. Swelling and pain in the hands and feet may occur.
Some medical conditions cause edema…swelling of the hands, ankles, feet, face, abdomen, or other areas of the body. Swelling is most often seen in the hands, in the feet, or around the eyes.This may occur more at the end of the day. The bloating or swelling can cause muscle aches and pains.
Edema is fluid accumulation in the body. It can be caused by reduced kidney function, chronic kidney disease, congestive heart disease, varicose veins, phlebitis, protein or thiamine deficiency, sodium retention, or cancer.
Other causative factors include pregnancy, standing for long periods of time; premenstrual syndrome; the use of oral contraceptives; an injury, such as a sprain; allergic reactions; or a bee sting.
If the skin indents when the skin of the feet or ankles is pressed by a finger, forming little pits ("pitting edema"), the situation is getting worse and a physician should be contacted.
Fluid retention is sometimes caused by a food allergy. Hypothyroidism, anemia, adrenal malfunction, constipation, and lack of exercise can be causitive factors, along with deficiencies of potassium, vitamin B complex, or vitamins B1, B3, or B6.
As soon as edema is found to exist, it is important to get a precise diagnosis. Once congestive heart disease, kidney disease, or liver disease are ruled out, more unusual causes can be considered.
Insect stings in people who have allergies to these stings can lead to swelling and pain in the hands and feet. The same type of reaction may occur with medications. This is referred to as serum sickness.
Allergic reactions to medications can also cause this symptom complex.
Acromegaly is a disease where a tumor in the pituitary gland causes an oversecretion of growth hormone. This leads to swelling and pain in the limbs, particularly the hands and feet.
Frostbite is another cause of swelling and pain in the hands and feet. The history will provide clues to this diagnosis.
Blood clots in the veins are another cause of swelling and pain in the limbs. This rarely affects the upper extremities (arms). If it does, diseases associated with clotting abnormalities should be suspected.
Reflex sympathetic dystrophy is a peculiar disorder that leads to swelling and pain in an affected limb. Generally it occurs in only an arm or a leg, rarely both at once.
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