Severe Hand Pain and Swelling: What Could Be Causing It?
The combination shown in the photos—marked swelling of several fingers, redness when bending them, significant pain, and symptoms that have persisted despite more than 10 days of prednisone—deserves medical reassessment rather than assuming it is simply from overuse.
Painting and moving for a month could certainly aggravate muscles, tendons and joints, but swelling, warmth/redness and substantial pain can also occur with inflammatory arthritis, gout or other crystal arthritis, infection, or other joint conditions. (MedlinePlus)
Could It Be From Overuse?
Possibly. Repetitive gripping, squeezing brushes, carrying boxes and other strenuous hand activity can cause tendon or joint irritation.
But overuse doesn’t explain every case of significant swelling. If several finger joints are swollen and painful, especially on both hands, an inflammatory arthritis such as rheumatoid arthritis is another possibility. Rheumatoid arthritis commonly affects the small joints of the hands and can cause swelling, warmth, tenderness and difficulty making a fist. (nhs.uk)
Why Is the Prednisone Not Helping?
This is particularly important.
Prednisone is an anti-inflammatory medicine used for several types of arthritis and other inflammatory conditions. If you have been taking it exactly as prescribed for more than 10 days and there has been no meaningful improvement—or the swelling is worsening—the prescribing clinician should know. The underlying diagnosis or treatment may need to be reconsidered. (MedlinePlus)
Also, do not stop prednisone suddenly on your own. Your doctor may need to taper it depending on the dose and duration. (MedlinePlus)
Redness and Swelling Need Attention
A joint that is swollen, painful, warm or red can be inflamed, but infection can produce similar symptoms. Joint infection is particularly important to rule out because it requires prompt treatment. (MedlinePlus)
Prednisone can also reduce the body’s ability to fight infections and can sometimes mask infection symptoms, which makes unexplained worsening symptoms while taking it especially worth discussing with a clinician. (MedlinePlus)
What You Should Do Now
Because the symptoms are severe and have continued despite treatment, contact the doctor who prescribed the prednisone as soon as possible for an examination. They may consider blood tests, X-rays or ultrasound and, depending on the findings, tests for inflammation, autoimmune arthritis, crystals or infection. (MedlinePlus)
Until you’re assessed:
Stop or substantially reduce repetitive painting and heavy gripping.
Give your hands a break from strenuous activity.
Keep the hands elevated when possible.
Don’t forcefully bend or exercise very painful, swollen fingers.
Don’t increase the prednisone dose yourself.
Don’t stop prednisone abruptly unless your prescriber tells you to.
Get Urgent Medical Help If…
Seek urgent care if the swelling becomes suddenly much worse, a joint becomes very hot/red, you develop fever or chills, you cannot move a finger, you develop numbness or significant color change, or you feel generally very unwell. Severe unexplained hand swelling and redness are reasons for urgent medical assessment. (nhs.uk)
If you develop shortness of breath or chest pain, seek emergency care immediately. (nhs.uk)
Bottom Line
The painting and moving could have triggered or aggravated the problem, but the amount of swelling and pain shown, combined with no improvement after 10+ days of prednisone, shouldn’t simply be written off as overdoing it.
An in-person examination is important to determine whether this is overuse, an inflammatory arthritis flare, a crystal-related problem, infection, or something else. (MedlinePlus)
