Joint Swelling

WHEN TO SEE YOUR DOCTOR

* The swelling lasts more than seven days.

* Your joint is red and hot as well as swollen.

* You also have fever or chills.

* You have already been diagnosed with arthritis, but this swelling is new or a different type than you've had before.

* If the joint has been punctured, see your doctor immediately.

What Your Symptom Is Telling You

Have you been pushing yourself lately? Maybe you survived a stint of aerobic housecleaning—only to notice a newly swollen elbow or wrist. Or perhaps you twisted a knee during that heroic lunge to catch a fly ball at the company picnic.

Rather than its usual firm, sturdy feel, the joint now feels puffy and soft. A newly injured joint swells because of a small amount of internal bleeding, which stretches the skin and surrounding tissues.

Other things besides brand-new injuries can cause joint swelling, however. An old injury can flare up with swelling from fluids that have collected in the joint. (In some people, a previously injured joint even acts like a barometer, swelling in response to changes in the weather.)

Arthritis is another common cause of swelling in the joints. When you have a swollen (and sometimes painful) joint anywhere in your body for more than six weeks, it's probably arthritis. (You can also develop arthritis with no visible swelling.)

When a joint is not just swollen but also red or hot to the touch, it is inflamed. Bacteria, a virus or fungus—all of which can enter through a break in the skin—may be attacking the joint, causing infection. Even without infection, however, arthritis or injury can inflame a joint.

Symptom Relief

When you injure a joint, keep this in mind: If pain begins to lessen and you feel strength starting to return to the joint within 24 hours, you're already beginning to mend. In the meantime, here are several ways you can help your swollen joint return to normal size.

Cool it. The first weapon against swelling is ice, says Robin Dore, M.D., a rheumatologist in private practice in Anaheim, California. "Cover the ice with a plastic baggie or towel and apply it 15 to 20 minutes, three times a day," she suggests.

Stabilize it. You can immobilize a swollen finger joint with a taped-on Popsicle stick, Dr. Dore says. "Put one tip of the stick at the tip of the finger, the other in the palm of your hand, and wrap adhesive tape around the finger," she explains.

For a swollen toe, use the adjoining toe as the splint. Simply wrap the tape around the swollen toe and a toe next to it, says Dr. Dore.

One caution about splinting comes from Sidney Block, M.D., a rheumatologist in private practice in Bangor, Maine. "A day or two is as long as you should splint without checking with your doctor," he says. If you splint for too long you could end up with an extremely stiff joint called a flexion contracture.

When Arthritis Causes the Swelling

If you have arthritis, you don't need to report each episode of swelling to your doctor, says Dr. Block. Unless the pain or swelling is unusual or particularly severe or accompanied by fever, just mention it at your next visit. Between visits, here's how to deal with the swelling.

Warm it up. If you have a history of arthritic swelling, hot packs are more effective than cold, Dr. Block says. Reserve ice for injuries.

Reach your range. Gentle range-of-motion exercises help keep your joints functioning. Move the joint gently in every direction as far as it will go. Keep the joint moving but don't overdo it. And be sure to have your doctor's okay before you begin.

Range-of-motion exercises stimulate the muscles to pump the debris produced by inflammation out of the joint and into the body's lymph system, which carries it away, says William Loomis, D.O., an osteopathic physician in Spokane, Washington and president of the American Association of Orthopedic Medicine.

Ask about soundwaves. If swelling is persistent, your doctor may refer you to a physical therapist for a soothing ultrasound treatment, Dr. Loomis says. Ultrasound waves penetrate painlessly into the swollen tissues around the joint, improve the joint's blood supply and promote healing.

Treat Infections Carefully

If an infection is causing the swelling, your doctor will treat you with a course of appropriate antibiotics. Here's what to keep in mind for home treatment.

Avoid ice. Use moist heat instead of an ice pack on an infected joint, says Dr. Dore. Ice will cause blood vessels to contract and actually keep the infection in place. Heat will open up the blood vessels so white blood cells—the body's immune defense against infection—can reach the area. Some infections may even drain through the surface of the skin when moist heat is applied, she says. Wrap the joint for 20 minutes in a towel that has been dipped in hot water and wrung out.

See also Joint Inflammation; Joint Pain; Joint Stiffness