Intermittent Finger Swelling: Causes and Treatment Options

Intermittent swelling of the fingers?

Subject: Inquiry Regarding Persistent Finger Swelling and Associated Symptoms
Dear Doctor,
I would like to seek your advice regarding a health issue I have been experiencing since February.
Both of my fingers have been intermittently swelling (not limited to specific fingers), and I sometimes experience numbness in my arms upon waking.
I consulted a rheumatologist at a nearby major hospital, where I have been taking medication (quinine) and attending regular follow-up appointments.
Blood tests were conducted, and the results were normal, except for one elevated marker.
The doctor believes this elevated marker indicates inflammation in my fingers.
However, the medication has not been very effective; it only temporarily alleviates pain or reduces swelling.
There are times when, despite taking the medication, my fingers still swell, and then they subside after a period without any apparent warning.
Since mid-May, I have also consulted a rehabilitation specialist.
X-rays revealed that I have 3 to 4 vertebrae on the right side of my spine that have slipped (with reduced spacing), and the doctor suspects this may be contributing to my recurrent swelling issues.
As a result, I have started rehabilitation treatment, which includes electrical therapy, heat application, and neck traction.
I am uncertain about the effectiveness of rehabilitation for these symptoms.
I have also researched the "Pain Management" clinic, which seems to be an option for cases where medication is ineffective but surgery is not yet warranted.
I would appreciate your recommendations regarding this situation.
Thank you.

Yiquan, 20~29 year old female. Ask Date: 2020/05/19

Dr. Shi Guozheng reply Orthopedics

Arthritis of the fingers can generally be managed with conservative treatment.
It is advisable to consult an orthopedic physician for medication management, starting with a specific medication for continuous treatment, followed by adjustments in dosage and type of medication.
Patience is essential in the treatment process, and there is no need to frequently change doctors.

Reply Date: 2020/05/19

More Info

Intermittent finger swelling can be a perplexing and uncomfortable issue, and understanding its causes and treatment options is crucial for effective management. Based on your description, it appears that you have been experiencing swelling in your fingers intermittently since February, along with occasional arm numbness. You have consulted a rheumatologist and have been prescribed medication (quinine) to manage the inflammation, but the results have been less than satisfactory. Additionally, you have undergone imaging studies that revealed some issues with your cervical spine, which your doctor suspects may be contributing to your symptoms.

Possible Causes of Intermittent Finger Swelling
1. Inflammatory Conditions: Conditions such as rheumatoid arthritis, psoriatic arthritis, or other autoimmune disorders can lead to intermittent swelling of the fingers. These conditions often cause inflammation in the joints, leading to pain, swelling, and stiffness.

2. Tendonitis or Tenosynovitis: Inflammation of the tendons or the sheath surrounding them can cause swelling and pain in the fingers. This is often seen in repetitive strain injuries or overuse scenarios.

3. Nerve Compression: Given your mention of arm numbness, it is possible that nerve compression, such as carpal tunnel syndrome or cervical radiculopathy, could be contributing to your symptoms. Nerve issues can lead to swelling and discomfort in the fingers.

4. Cervical Spine Issues: The findings from your X-ray indicating that several cervical vertebrae are misaligned or have reduced spacing could be a significant factor. Cervical spine problems can lead to nerve impingement, which may manifest as swelling and numbness in the arms and fingers.

5. Vascular Issues: Conditions affecting blood flow, such as Raynaud's phenomenon or other vascular disorders, can cause intermittent swelling and color changes in the fingers.

Treatment Options
1. Medication: While you are currently on quinine, it may be beneficial to discuss with your doctor the possibility of trying nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, which can help reduce inflammation more effectively.

2. Physical Therapy: Engaging in a structured rehabilitation program, as you have started, can be beneficial. Physical therapy can help improve mobility, strengthen the muscles around the joints, and alleviate some of the pressure on the nerves. Techniques such as electrical stimulation, heat therapy, and specific exercises can be particularly effective.

3. Pain Management Clinics: Consulting a pain management specialist can provide additional options. These clinics often employ a multidisciplinary approach, including medication management, physical therapy, and interventional procedures like injections, which may help alleviate your symptoms without resorting to surgery.

4. Lifestyle Modifications: Incorporating ergonomic adjustments in your daily activities, such as using supportive devices or modifying your workspace, can help reduce strain on your fingers and wrists. Regular breaks and gentle stretching exercises can also be beneficial.

5. Monitoring and Follow-Up: Since your symptoms are intermittent, keeping a symptom diary may help identify triggers or patterns related to your swelling. Regular follow-ups with your healthcare providers will be essential to adjust your treatment plan as needed.

Conclusion
Intermittent finger swelling can stem from various underlying causes, and a comprehensive approach to diagnosis and treatment is essential. Given your current treatment plan and the involvement of multiple specialists, it is crucial to maintain open communication with your healthcare team. They can provide tailored recommendations based on your specific situation and may consider further diagnostic tests if your symptoms persist or worsen. Engaging in physical therapy and exploring pain management options could significantly improve your quality of life. Always consult your healthcare provider before making any changes to your treatment plan.

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