What Causes Swelling In The Hands?

my hands and arms , especially my right, swell up and the muscles in my hands get so tight that they cramp up with just a little bit of squeezing pressure. My hands will go numb if I bend my wrist. I get periodic pain in my elbow, and regular bouts of pain in my shoulders. I was having bad pain in my neck, but that has been rare the past few months. My hands are so weak that I routinely drop things as small as my cell phone, and I cannot play my stringed instruments without my hands cramping up. I do have back pain issues that are much older than this and a right hip replacement that gives me regular bouts of pain. The issue with my hands has been going on for about 10 years now and gets worse every year. I was tested about 2 years ago for carpel tunnel and was told that I did not have carpel tunnel but that I should see a cardiovascular doctor because they thought I may have thoracic outlet syndrome. I am 6 1 , 270 lbs.and 44 yrs. old. I sweat alot and am treated for narcolepsy and high bp which has been very high lately. Any suggestions?