Treatment of swelling in the hands and/or wrists depends, in part, on the underlying cause responsible this symptom. Common culprits include injury, inflammation, infection and obstruction of the blood or lymph flow. An injury that causes sudden swelling and deformity, or inability to move the hand, fingers or wrist requires immediate medical attention. Fever or redness, swelling, pus drainage or streaking around a cut or wound of the hand or wrist also requires immediate evaluation. Swelling from less serious injuries or long-term conditions, such as arthritis, can often be treated with home remedies, as approved by your healthcare provider.
Rest and Exercise
Rest can limit swelling related to a hand or wrist injury by preventing further tissue damage and inflammation, and allowing the injury time to heal. In some cases, a splint might prove useful for resting the injured area. Although many types of splints are available over the counter, it's best to check with your doctor about whether a splint is advisable and, if so, the specific type that's best for your condition.
While rest can help reduce swelling with short-term hand and wrist ailments, reduced use of the the affected areas is typically counterproductive and can lead to increased swelling -- particularly if you have a long-term condition. A physical or occupational therapist can advise you about specific stretches and exercises to perform at home to limit or reduce swelling of your hands or wrists.
Cold and Heat Therapy
For hand or wrist swelling associated with an acute injury, application of an ice or cold pack to the area for 15 to 20 minutes several times daily for the first 2 to 3 days can help limit or reduce swelling. After the first few days following an injury, and for longer-term hand or wrist swelling, a combination of heat and cold therapy is usually more effective.
This practice, known as contrast baths, involves placing your hands alternately in warm and cool water. The warm water is typically 100 F to 105 F, and the cool water 55 F to 65 F. A typical protocol involves placing your hand or hands in the warm water for 3 to 4 minutes, then in the cool water for 1 minute. This cycle is repeated 3 or 4 times per session. If you don't have a thermometer to measure the water temperature, you can use a heating pad or hot pack, and an ice or cold pack for the same time intervals. Talk with your doctor about the best contrast bath protocol, especially if you have rheumatoid arthritis.
Elevation and Compression
Swelling of the hands and/or wrists represents excess accumulation of fluid in the soft tissues of these areas. Elevating the affected area above the level of the heart reduces pressure in the blood and lymphatic vessels by decreasing the effects of gravity. This promotes absorption of excess fluid back into the circulation, reducing swelling. This process takes time, so the more time the area is elevated, the greater the response. For many people, prolonged elevation of your hands or wrists during the day isn't feasible, so it's important to optimize elevation during the night by sleeping with your forearms elevated on pillows.
External compression of the hands or wrists also promotes reduced swelling by pushing excess soft tissue fluid back into the circulation -- and preventing further leakage of fluid into these tissues. External compression can be accomplished with elastic bandages, or compression gloves or sleeves. Fingerless compression gloves are available for crafters and others who experience swelling with repetitive hand movements. Compression bandages, gloves and sleeves should be snug but not tight enough to compromise circulation to the fingers.
Retrograde massage, which involves stroking upward from the fingers and hands toward the upper arm, also promotes reabsorption of excess soft tissue fluid. This type of massage is practiced with the hand and wrist elevated. While you can perform retrograde massage yourself, having a friend or loved one do it for you can be helpful if both hands are affected or you have joint pain or stiffness in your hands. Retrograde massage should not be painful. A physical or occupational therapist can instruct you on the proper technique and appropriate amount of pressure.
Diet and Over-The-Counter Medicines
For noninjury-related hand or wrist swelling, changes in your diet may help diminish this troublesome symptom. If the swelling is caused by gout, for example, limiting the amount of alcohol, meat, fish and poultry in your diet might help limit or reduce swelling. Decreasing the amount of sodium in your diet can also be helpful, particularly if you have persistent or recurring hand or wrist swelling.
Over-the-counter nonsteroidal anti-inflammatory medications -- such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve) -- can help reduce hand and wrist swelling causes by inflammatory conditions, such as arthritis. By suppressing inflammation, these medications may help limit related swelling.
Next Steps and Precautions
Occasional, temporary hand swelling occurs commonly, such as during hot weather, after a minor injury or in late pregnancy. Persistent or recurring hand or wrist swelling, however, can indicate a potentially serious underlying health problem that requires medical evaluation. Seek medical care as soon as possible if you experience hand or wrist swelling associated with an injury. Urgent medical evaluation is necessary if you experience hand or wrist swelling associated with any warning signs or symptoms, including fever or chills, or severe or rapidly increasing pain, numbness or tingling.
Reviewed and revised by: Tina M. St. John, M.D.