Non-Joint Swelling and Pain in the Index Finger

Swelling of the index finger (non-articular)

Hello, I would like to ask about a situation I experienced.
Last night, I suddenly had swelling and throbbing pain in the tip of my index finger (not related to the joint), which kept me awake.
The next morning, I went to a clinic for an examination, but they couldn't identify any issues.
This condition seems to occur intermittently, approximately every six months to a year.
During my last visit to a major hospital, I underwent X-rays, blood tests, and uric acid tests, all of which showed no problems.
The swelling and throbbing pain usually last for about 2-3 days before gradually subsiding and returning to normal.
The pain can be quite severe, yet there seems to be no clear solution.
If I were to go back to a major hospital for further examination, which department should I consult? Or should I wait for the symptoms to recur before seeking medical attention? I am struggling to find the cause of the pain, and I would appreciate your guidance.
Thank you.

wang, 30~39 year old female. Ask Date: 2016/07/19

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
I believe it would be beneficial to consult with an allergist or rheumatologist to investigate whether it might be recurrent rheumatic disease.
I recommend seeking an appointment at any time, rather than waiting for an episode to occur.
The Changhua Hospital of the Ministry of Health and Welfare has an Allergy, Immunology, and Rheumatology department that can assist you.
Take care.

Reply Date: 2016/07/19

More Info

The symptoms you are experiencing with your index finger, specifically the swelling and pain in the soft tissue (not the joint), can be quite perplexing, especially since previous examinations, including X-rays and blood tests, have not revealed any underlying issues. This type of pain can be attributed to several potential causes, and understanding these can help guide your next steps.

Firstly, it’s important to consider the possibility of soft tissue conditions. Conditions such as tenosynovitis, which is inflammation of the sheath surrounding a tendon, can cause localized pain and swelling. This can occur due to repetitive use or strain, even if you do not recall a specific injury. Another possibility is a condition known as De Quervain's tenosynovitis, which affects the tendons on the thumb side of the wrist but can sometimes cause referred pain in the fingers.

Another potential cause could be a form of neuropathy or nerve entrapment. While you mentioned that the pain is not in the joint, the nerves that innervate the fingers can sometimes become compressed or irritated, leading to pain and swelling in the surrounding soft tissues. This could be related to positions held during sleep or activities that put pressure on the nerves.

In addition, you might want to consider the possibility of a systemic condition, such as an autoimmune disorder. Conditions like rheumatoid arthritis or lupus can sometimes present with symptoms that are not immediately identifiable through standard tests. These conditions can cause inflammation in the soft tissues, leading to pain and swelling.

Given that your symptoms seem to recur every six months to a year, it may be beneficial to keep a detailed diary of your symptoms. Note when the pain occurs, any activities that precede it, and how long it lasts. This information can be invaluable to your healthcare provider.

If you decide to seek further medical evaluation, it would be advisable to consult with a rheumatologist or an orthopedic specialist. A rheumatologist can evaluate for autoimmune conditions, while an orthopedic specialist can assess for any musculoskeletal issues that may not have been identified in previous examinations. Additionally, a neurologist could be consulted if nerve involvement is suspected.

In the meantime, managing your symptoms with rest, ice, and over-the-counter anti-inflammatory medications may provide some relief. If the pain becomes unbearable or if you notice any new symptoms, such as changes in sensation or increased swelling, it would be prudent to seek immediate medical attention.

In conclusion, while the exact cause of your symptoms remains unclear, there are several avenues to explore. Keeping a symptom diary and consulting with specialists can help you find the answers you need. Remember, persistent pain should not be ignored, and seeking further evaluation is a proactive step towards understanding and managing your condition.

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