Swelling and pain therapy

All hands swell after injury or surgery. Swelling is an accumulation of extra body fluid, and causes many problems even if it is not visible. Most of the pain and stiffness which follows injury or surgery is due to pressure in the wound from swelling. The best treatment is to reduce this pressure by elevating the the hand higher than the heart (which lies behind the breastbone). For several days after surgery, the hand soaks up extra fluid like a sponge. During this time, every minute that the the hand is not elevated, it swells. However, every minute that the hand is kept elevated, veins siphon this fluid out of the hand and back to the heart. For at least three days after surgery every effort should be made to keep the hand elevated higher than the heart - day and night. Swelling may also be aggravated by tight splint straps or bandages such as an ace wrap, and these should be placed loosely on the forearm.


Smoking interferes with wound healing, and increases the chances that skin and bone will not heal properly. It also tends to make wounds more painful, and blocks the action of some pain medications. Smoking may directly aggravate many hand problems, and should be avoided.


Infection should be suspected if there is redness, pain or swelling that gets worse over the course of the day or night, despite elevating the hand. Infection is uncommon less than four days after surgery or more than two weeks after surgery. The physician should be notified if there is any question of infection.

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