Swollen Hands: 9 Possible Causes (& How to Treat)

Key points
  • Swollen hands with symptoms like chest pain, shortness of breath, or swelling in the legs may signal heart or kidney failure and require urgent medical care.
  • Fever, confusion, reduced urine, or red or purple skin spots along with swollen hands can indicate serious infections or complications and should be evaluated immediately.
  • Severe pain, deformity, numbness, or inability to move the hand after an injury may point to fractures or nerve damage and needs prompt medical attention.

Swollen hands are a common symptom that can occur due to fluid retention, inflammation, or problems with blood circulation. They may develop after physical activity or high salt intake, but can also be linked to conditions like rheumatoid arthritis, carpal tunnel syndrome, heart failure, or kidney disease.

In addition to swelling, symptoms such as pain, stiffness, tingling, or changes in skin color may be present depending on the cause. In more serious cases, swollen hands may occur alongside symptoms like fatigue, reduced urine output, or widespread swelling in the body.

Treatment for swollen hands depends on the underlying cause and may include medications, physical therapy, lifestyle changes, or medical procedures in more advanced cases. Simple measures such as reducing salt intake, managing injuries, or improving circulation can also help relieve symptoms in mild situations.

close up of person's hands

Main causes

The most common causes of swollen hands include:

1. Rheumatoid arthritis

Swollen and red hands can be one of the symptoms of rheumatoid arthritis, a chronic autoimmune disease that causes inflammation in the joints.

This condition can also cause pain, stiffness (especially in the morning), difficulty moving the affected joints, and sometimes fever.

How to treat: Treatment should be guided by a rheumatologist. A doctor may prescribe medications such as methotrexate, hydroxychloroquine, ibuprofen, or naproxen to relieve inflammation and improve quality of life. Physical therapy may also be recommended to keep joints flexible, strengthen muscles, and reduce pain.

2. Carpal tunnel syndrome

Swelling and tingling in the hands can be symptoms of carpal tunnel syndrome, which happens when a nerve that runs through the wrist becomes compressed.

It may also cause a pins-and-needles sensation in the thumb, index, middle, or ring fingers.

How to treat: If carpal tunnel syndrome is suspected, see an orthopedic surgeon or a neurologist. Treatment may include wearing a wrist splint, resting, and attending physical therapy sessions.

A doctor may also recommend over-the-counter pain relievers or anti-inflammatory medications like ibuprofen or acetaminophen to ease pain and swelling.

3. Heart failure

In addition to swelling in the abdomen, legs, and feet, heart failure can sometimes cause swollen hands.

This occurs because the heart cannot pump blood efficiently, leading to fluid buildup throughout the body, including in the hands.

How to treat: Treatment for heart failure typically involves guideline-directed medical therapy (GDMT), which may include an angiotensin receptor–neprilysin inhibitor (ARNI), angiotensin-converting enzyme (ACE) inhibitor, or angiotensin receptor blocker (ARB); a beta-blocker; a mineralocorticoid receptor antagonist (MRA); and an SGLT2 inhibitor. Diuretics may also be prescribed to help relieve fluid buildup.

In more advanced cases, a pacemaker, ventricular assist device, or even a heart transplant may be necessary. It’s also important to maintain a healthy diet, exercise regularly, avoid smoking and alcohol, and get enough sleep.

4. Kidney failure

Kidney failure occurs when the kidneys lose their ability to properly filter the blood. This can lead to symptoms such as fatigue, swelling in the hands, legs, and feet, itchy skin, and foamy urine.

How to treat: Treatment should be managed by a nephrologist and may include adjusting or stopping certain medications, IV fluids when appropriate, or the use of diuretics, blood pressure medications, and glucose-lowering drugs as prescribed by a doctor.

In severe cases, dialysis or a kidney transplant may be needed to remove excess toxins, minerals, and fluids from the blood.

5. Poor circulation

Poor circulation occurs when blood flow, oxygen, and nutrients don’t reach all areas of the body properly, leading to swelling in the hands, legs, feet, or fingers.

It can also cause tingling, cold hands and feet, pale or bluish skin, numbness, and sometimes skin sores.

How to treat: Treatment depends on the underlying cause. For venous insufficiency, elevating the legs, exercising regularly, staying well hydrated, and wearing compression stockings can help improve circulation. However, in cases of peripheral artery disease (PAD), compression stockings are not recommended. 

If poor circulation is caused by underlying conditions like diabetes, atherosclerosis, or high blood pressure, your doctor may prescribe medications such as diuretics (furosemide), statins, antiplatelet agents, or anticoagulants.

Also recommended: Chronic Venous Insufficiency: Symptoms, Causes & Treatment tuasaude.com/en/chronic-venous-insufficiency

6. Injuries

Injuries such as bruises, fractures, or sprains can cause the hand to become very swollen and painful. Other symptoms may include difficulty moving the hand, numbness, or tingling.

How to treat: Depending on the type and severity of the injury, an orthopedic surgeon may recommend immobilization with a cast or splint, surgery, anti-inflammatory medications, and rest.

7. Excess salt intake

Swollen hands can also occur from eating too much salt. Sodium causes the body to retain water, leading to fluid buildup and swelling.

How to treat: To reduce fluid retention, the doctor may prescribe diuretics such as furosemide, hydrochlorothiazide, or spironolactone, depending on the clinical situation.

Simple lifestyle changes can also help, such as reducing salt intake, performing lymphatic drainage massage, exercising regularly, and drinking herbal teas with mild diuretic properties.

Also recommended: 14 Natural Diuretic Teas for Fluid Retention tuasaude.com/en/natural-diuretics

8. Physical activity

Swollen hands during exercise are a temporary and harmless reaction caused by increased blood flow to the heart, lungs, and muscles.

As a result, the blood vessels in the hands expand, which can cause mild swelling.

How to treat: To relieve swollen hands during exercise, remove rings and loosen watch straps before workouts. Move your arms in circular motions during activity, stretch your fingers, clench your fists, and raise your hands above heart level. Drinking electrolyte beverages can also help.

9. Dengue

Severe dengue infection can lead to complications like acute kidney injury or hemolytic uremic syndrome, both of which may cause swollen hands, fever, red or purple skin spots, reduced urine output, nausea, confusion, and blood in the urine.

How to treat: Treatment for hemolytic uremic syndrome must be done in a hospital and may include blood transfusions, blood pressure medications, or dialysis.

Acute kidney injury also requires hospital care, where IV fluids, medications, or dialysis may be needed.