Can Swelling In The Hand While Having Arthritis In The Hand Be Managed?

Posted on Mon, 2 Jul 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 2 Jul 2018 Answered on

Fri, 7 Jul 2023 Last reviewed on

Question : I am being awaken, for the last six months and it has become much worse in last month, by my hand (right primarily and slightly in left) feeling as if it is completely swollen and I cannot move it. I then massage it and begin to loosen it so that it moves and goes away during the day. I have been tested for RA and have slight arthritis in hands; but this is now waking me consistently at night.

Answered by Dr. Ivo Ditah (1 hour later)

Brief Answer:
Probably carpel tunnel syndrome!

Detailed Answer:

Hi,

Likely wrong positioning of the hand at night leads to compression of nerves resulting in these symptoms. The common causes are carpal tunnel syndrome. This happens in persons who use the hands for repetitive tasks such as office clerks, typist, cashiers, etc. It is more common with other disease conditions such as low thyroid and diabetes.

My initial plan is to get it evaluated. A night time brace would be helpful. Should symptoms persist, we could inject the nerve with steroids and if all else fails, surgery is the ultimate approach. Your primary care doctor should be able to follow through with this.

Keep me updated about this. I wish you well.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (53 minutes later)

I am extremely familiar with CTS; it is not that. Let me elaborate: this is not a pain or nerve feeling. I literally wake up and feel as if my hand (and sometimes the other hand as well) is swollen completely and it take several attempts to move it to allow the fingers to bend. I have no pain or nerve tingling in the hands. I do have some weakness in my hands; hence being tested for Rheumatoid Arthritis and some other joint dysfunction. If you have any other ideas; I would be interested. AND am also looking for an idea on what specialty I may need to see? I am an executive; so repetitive motion is not the problem as while I do work with a computer; it is not exhaustive enough to cause problems.

Answered by Dr. Ivo Ditah (5 minutes later)

Brief Answer:
I get your point!

Detailed Answer:
Hi,

This is certainly not the case then if you are very familiar with CTS. However, I will maintain that your pain/numbness/feeling of swelling is nerve related. If it were real swelling, it will persist for a few days, at least, before disappearing.

I will recommend two specialists in succession. I will start with rheumatology and if they can't address the issue, get neurologist for further evaluation.

Let me know what you get when you approach these two fields.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (18 minutes later)

Thanks, that is what I was looking for! :-) .

one more question: since my GP ordered the blood tests and xrays to r/o both RA and only found slight arthritis: would it make more sense to go right to a neurologist?

Answered by Dr. Ivo Ditah (0 minute later)

Brief Answer:
A rheumatologist first would be better!

Detailed Answer:
Hi,

I will advise a rheumatologist. Not all arthritis are rheumatoid in nature. Some other possible causes are not always rheumatoid. Because rheumatologist are "joint specialists" and your joint seems primarily involved, lets' clear the way. If there after we find nothing, then we can continue the ride to a neurologist.

I hope this guides and helps.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar