Hand and Foot Swelling in Adolescents: Causes and Treatments

Q: Hand and Foot Swelling in Adolescents: Causes and Treatments

Hello： In response to your question... <br>The possible causes of edema in the hands and feet, aside from kidney disease leading to proteinuria, include heart disease, liver disease, and metabolic disorders (such as hypothyroidism, etc.). <br>It is recommended to visit a nephrolo

Swelling of the fingers and toes?

Hello Dr.
Yang: My child is currently 14 years old and experienced swelling in the hands and feet (fingers and toes) around the age of 9, which was accompanied by pain.
I forgot what the doctor said at that time.
It occurred occasionally, but for the past one to two years, it had not happened until last week when it recurred, and the symptoms were more severe.
Last week, we consulted a traditional Chinese medicine practitioner who indicated that it was caused by nerve compression in the lumbar spine, which is also related to a cough (ongoing for about a month).
The treatment involved manipulation (to relax the spinal nerves) along with cough treatment, but there has been no improvement so far.

Dr.
Yang, could you please advise what factors usually cause swelling in the hands and feet (fingers and toes)? If we were to see a Western medicine doctor, which specialty should we consult and what kind of examinations should be performed? What should we pay attention to in daily life?

Fan Ren, 10~19 year old female. Ask Date: 2004/10/15

Dr. Yang Jun reply Internal Medicine

Hello: In response to your question...
The possible causes of edema in the hands and feet, aside from kidney disease leading to proteinuria, include heart disease, liver disease, and metabolic disorders (such as hypothyroidism, etc.).
It is recommended to visit a nephrologist for a urine test to determine if there is proteinuria, followed by further differential diagnosis by a physician.
It is also necessary to reduce salt intake in daily meals to prevent worsening of the edema.
Keelung Hospital, Dr.
Yang Jun.

Reply Date: 2004/10/15

More Info

Swelling in the hands and feet, particularly in adolescents, can be a concerning symptom that may arise from various underlying causes. In your child's case, the recurrence of swelling and pain in the fingers and toes, along with the history of previous episodes, warrants a thorough evaluation to determine the root cause and appropriate treatment.

Possible Causes of Hand and Foot Swelling
1. Injury or Trauma: Previous injuries to the hands or feet can lead to localized swelling. If your child has had any recent injuries, this could be a contributing factor.

2. Infections: Infections in the skin, joints, or underlying tissues can cause swelling. Conditions like cellulitis or septic arthritis should be considered, especially if there are accompanying symptoms like redness, warmth, or fever.

3. Allergic Reactions: Allergies to certain foods, medications, or environmental factors can lead to swelling. If your child has had any recent exposure to potential allergens, this could be a factor.

4. Autoimmune Conditions: Conditions such as juvenile idiopathic arthritis (JIA) or lupus can cause swelling in the joints and surrounding tissues. These conditions may also present with other systemic symptoms, such as fatigue or fever.

5. Circulatory Issues: Problems with blood circulation, such as venous insufficiency or deep vein thrombosis (DVT), can lead to swelling in the extremities. This is less common in adolescents but should be considered, especially if there are risk factors present.

6. Kidney or Heart Issues: Swelling can also be a sign of fluid retention due to kidney or heart problems. If there are any signs of systemic illness, these should be evaluated.

7. Nerve Compression: As mentioned by the traditional Chinese medicine practitioner, nerve compression in the spine could potentially lead to swelling in the extremities. Conditions like herniated discs or spinal stenosis could be responsible.

Recommended Medical Evaluation
Given the complexity of the symptoms, it is advisable to consult a healthcare professional who specializes in these areas. Here are the steps you might consider:
1. Pediatrician: Start with a visit to your child's pediatrician. They can perform a thorough physical examination and take a detailed medical history.

2. Referral to Specialists: Depending on the initial findings, your pediatrician may refer you to specialists such as:
- Rheumatologist: If autoimmune conditions are suspected.

- Orthopedist: For musculoskeletal issues or injuries.

- Neurologist: If nerve compression or neurological issues are suspected.

- Nephrologist: If kidney function is a concern.

3. Diagnostic Tests: The following tests may be recommended:
- Blood Tests: To check for signs of inflammation, kidney function, and autoimmune markers.

- Imaging Studies: X-rays, MRIs, or ultrasounds may be necessary to evaluate for structural issues in the joints or spine.

- Urinalysis: To assess kidney function and rule out any underlying kidney issues.

Management and Care
In the meantime, here are some general care tips you can follow:
- Rest and Elevation: Encourage your child to rest the affected limbs and elevate them to reduce swelling.

- Cold Compresses: Applying cold packs can help alleviate swelling and discomfort.

- Hydration: Ensure your child stays well-hydrated, as dehydration can exacerbate swelling.

- Monitor Symptoms: Keep a record of when the swelling occurs, its duration, and any associated symptoms, as this information can be helpful for the healthcare provider.

Conclusion
Swelling in the hands and feet can stem from various causes, and it is essential to approach this symptom with a comprehensive evaluation. By consulting with a pediatrician and possibly specialists, you can work towards identifying the underlying issue and implementing an effective treatment plan. Early intervention is key to managing symptoms and preventing potential complications.

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