The knuckle joints are one of the most important joints of the body. Even though the size of each knuckle is quite small, it is involved with various vital functions like finger movements, gripping of objects, closing of the fist and so on. When knuckle swelling occurs, then the joints become stiff and you cannot flex the fingers properly. Most of the time, the swelling is accompanied by pain, which makes the condition worse. Excessively swollen knuckles can lead to complete or partial loss of functionality of the hands.
Knuckle swelling that develops all of a sudden and subsides after some time is an acute problem. It is triggered by some kind of localized injury. On the other hand, if it persists for a few months, then it is assumed to be a chronic problem and an underlying cause is responsible for it. The key causes of knuckle swelling are as follows -
Traumatic Injury: A knuckle joint is susceptible to many different forms of injury. Since it is a very flexible joint, it often gets twisted abnormally that results in sprain in its ligaments. If this delicate joint is hit by a hard object, then small finger bones in the area may suffer fracture or get dislocated.
Osteoarthritis: Like any other body joint, the finger joint consists of bones, cartilages, ligaments and tendons. In osteoarthritis, the soft tissues of the cartilage wear out. As a result, the adjoining bones present in these joints get rubbed against each other and the bone ends become thick. Elderly people are mostly affected by this form of arthritis. Repetitive use of the fingers for performing activities like typing or playing of a piano can irritate the knuckle joints and cause osteoarthritis in young people as well.
Rheumatoid Arthritis: This is an autoimmune disease. In other words, this disease is triggered by abnormal functioning of the immune system. In this condition, the antibodies produced by the immune system start attacking the healthy tissues of the knuckle joints. As a result, the synovial membrane, which secretes the lubricating fluid called synovial fluid, suffers inflammation. The worst part of this disease is that it may lead to bone deformity.
Gout: Gout is another form of arthritis that can affect the knuckle joint. When the uric acid levels in blood get elevated, then gout becomes difficult to cure. The excess uric acid then forms crystals and gets deposited in the knuckle joint. These crystals then irritate the surrounding tissues of the joint and the knuckles get inflamed.
Fluid Retention: This is also known as edema and is characterized by fluid build up in the cells and tissues of the knuckle. Accumulated fluid in the body tissues is drained out by the small lymphatic vessels. Knuckle swelling due to fluid retention is an indication that the lymphatic system is not working properly. Some serious causes that affect functioning of the lymphatic system are problems in liver, kidney or thyroid gland. Swollen knuckles after pregnancy are usually harmless and is triggered by the hormonal imbalance that takes place during this period. It can be a side effect of some medicines as well.
As swollen knuckles is not a disease in itself, its treatment is based upon its causes. Any injury related swelling can be managed by resting the affected hand. All such activities that cause discomfort should be suspended so that the injury can heal quickly. Ice application can reduce the pain and swelling. A dislocated or fractured knuckle joint needs protection and support, which can be provided by a splint.
Chronic knuckle swelling caused by arthritis is first treated with non surgical methods of treatment. Oral pain relieving medicines or cortisone injections are used to control the excruciating pain in the joint. Soaking the hands in warm saltwater can also provide a lot of relief from the arthritic knuckle pain. Physical therapy is also good to improve the mobility and flexibility of the finger joints. A badly damaged or deformed knuckle joint has to be repaired by surgical means.
Gout patients are treated with medicines that can reduce the level of uric acid in the blood. They also have to follow a gout diet in order to avoid all such foods that can increase the uric acid levels in the body. In case of fluid retention in knuckles, the underlying cause has to be given suitable treatment. Other patients who have this problem for some harmless reason do not require any treatment. They are just asked to increase fluid intake and lower sodium intake.
There is a misconception among many people that swollen knuckles are caused due to excessive knuckle cracking. I would like to make it clear to you that knuckle cracking does not cause any severe harm to the joint such that it would lead to swelling. However, if you are diagnosed with osteoarthritis, then too much of pressure on the knuckles tend to contribute towards faster degeneration of the joint.