Are you experiencing swelling in one of your joints and wondering what’s happening and why? Here’s what you need to know about joint swelling from our physiotherapist team in Hong Kong.
We’ve all experienced swelling and felt frustrated by it, especially when it limits our ability to move and go about our days. Whether it’s a one-off occurrence, your swelling tends to come and go, or you feel like you’re not catching a break, swelling is a clear message from your body. So, what is it telling you?
As physiotherapists, we frequently work with patients experiencing swelling in their joints, muscles and tissues. While swelling may be a normal response to injury and specific health conditions, it can sometimes signal the need for further testing. Either way, understanding why we get swelling means you know what you can do to best manage it and take the right steps to get the proper care early.
What Is Swelling?
Swelling, or oedema, is your body’s natural and healthy response to injury, irritation, or illness. Think of it as your body sending reinforcements to protect and heal an area. During swelling, your body increases blood flow to the affected area, sending extra fluid filled with nutrients, white blood cells, and other immune components to jumpstart healing. While this process is helpful, it also causes the redness, puffiness, and pain you might experience.
Swelling serves several important purposes:
Protection as it acts as a stabiliser, limiting movement in the affected area to prevent further damage.
Inflammatory response - the body releases specific chemicals and immune cells to combat infection and repair tissues.
Nutrient delivery - increased circulation provides vital components for tissue repair, such as growth factors and enzymes.
Waste removal - the accumulation of fluid also assists in clearing away cellular debris and waste, creating an optimal environment for healing.
Acute vs. Chronic Swelling
When we discuss swelling as health professionals, there’s a big distinction that we always make: whether the swelling is acute or chronic.
Acute swelling occurs quickly after an injury or irritation and lasts a few days to a few weeks. It tells us that our body is doing the right thing and facilitating healing.
Chronic swelling is long-lasting swelling that can last months or even years. It’s often linked to underlying conditions like arthritis or poor circulation. As the swelling (inflammation) cycle is not designed to be long-standing, this tells us that there may be more to your problem, injury, or condition than meets the eye. If you’re experiencing persistent swelling and are unsure why, it’s always a good idea to see a health professional.
What Happens During Swelling?
Swelling starts with your blood vessels dilating (widening), which increases blood flow to the area. This brings oxygen, nutrients, and immune cells to help repair the damage. This process also allows fluid to leak into the surrounding tissues, which causes the puffiness you see. This increased fluid can press on nerves in the area, leading to pain and stiffness. In many cases, this pain serves a purpose: it encourages you to avoid using the injured area, giving it a better opportunity to heal.
Common Causes of Swelling
Swelling can happen for a variety of reasons. Here are the most common ones we see in our clinic:
1. Injuries
Injuries such as sprains, strains, or fractures often cause swelling as part of the body’s repair process. Our physiotherapists usually help manage pain and swelling associated with ankle sprains, stress fractures, knee injuries following falls or collisions, and other similar injuries.
2. Overuse and Repetitive Strain
Repetitive movements or overuse can inflame the tissues around a joint, leading to swelling. Examples include runner’s knee pain (patellofemoral pain syndrome), iliotibial band syndrome, plantar fasciitis, Achilles tendonitis, rotator cuff injury and tennis elbow (lateral epicondylitis).
3. Infections
When your body fights an infection, it directs immune cells and fluid to the affected area, causing swelling.
4. Inflammatory Conditions
Swelling is a hallmark of many inflammatory conditions, a common one being arthritis. The three most common types of arthritis that our physios and podiatrists work with include:
- Osteoarthritis is the type of arthritis best known for its “wear-and-tear” damage to joints over time. With the damage often comes swelling, especially in large weight-bearing areas like the knees.
- Rheumatoid arthritis is an autoimmune condition in which the body mistakenly attacks its own joints, leading to persistent swelling. This swelling can last for a very long time and can cause significant joint damage.
- Gout is best known for the intense pain in the big toe. This form of arthritis is where needle-like uric acid crystals form in the joints, often causing sudden, intense swelling and pain. The swelling typically remains until the gout ‘flare’ settles.
5. Systemic Causes
Some causes of swelling are systemic, meaning that it can affect the entire body (or specific body systems). The biggest causes of systemic inflammation tend to be more serious, and you will have likely been diagnosed and set up with a management plan from your GP or specialist. Causes include:
- Heart failure - poor circulation can cause fluid to pool in the lower legs and feet
- Kidney or liver issues - problems with fluid regulation can lead to widespread swelling
- Lymphedema - damage to the lymphatic system can cause fluid to build up in the arms or legs
When Is Swelling a Cause for Concern?
Not all swelling is the same. If your swelling is severe, such as when it comes on suddenly, is extreme, or seems to be worsening, it’s a good idea to see your healthcare provider to rule out any underlying problems. The same goes if your swelling is accompanied by redness, warmth, or fever, as it could indicate an infection.
If your swelling has persisted for an extended period, specifically for more than six weeks, it may indicate a chronic issue that needs further testing to determine the underlying cause. Chronic swelling can result from conditions like arthritis or ongoing irritation and often requires a more targeted treatment plan.
Finally, if you notice widespread swelling in multiple parts of your body, this could signal a systemic issue. In these cases, the sooner you see your doctor, the better.
How Is Swelling Treated?
Acute swelling after a recent injury
If you’re dealing with swelling after a recent injury, a good place to start at home is the R.I.C.E. method, a simple yet effective approach to helping your body heal.
- First, rest the injured area by avoiding any activity that could strain it further. Giving it a break helps prevent additional damage and allows the healing process to begin.
- Next, apply ice packs for 15-20 minutes to reduce swelling and pain. Remember to wrap your ice pack with a cloth or something similar to avoid direct contact with your skin.
- Gentle compression, such as an elastic bandage, can also be helpful—it supports the area and limits fluid buildup, but make sure it’s not so tight that it restricts circulation.
- Finally, elevate the injured area above heart level whenever possible. This helps the fluid drain away, reducing swelling and discomfort.
If you have an injury, whether from trauma (like a fall during exercise) or overuse (repetitive strain), book a consultation with your physiotherapist so you can get back to pain-free movement as quickly as possible. Many injuries can worsen if left untreated (and the area continues to be used), so the earlier you can start your recovery, the better.
Managing persistent swelling
For chronic swelling, the approach is more about long-term management and addressing the root cause of the swelling. This is where working with a physiotherapist can be invaluable. Together, you can create a tailored treatment plan that focuses on improving movement, reducing pain, and tackling what’s causing the swelling in the first place.
Physiotherapist treatment
Here at PhysioCentral, we use various techniques to help manage and reduce swelling. The most suitable one for you will depend on the cause of your swelling.
One of the most fundamental approaches is movement and exercise. Gentle, controlled movements help stimulate blood and lymphatic flow, preventing stagnation that can worsen swelling. Exercises are often tailored to the individual's condition, emphasising active range-of-motion movements, muscle contractions, and gradual weight-bearing activities to encourage fluid reabsorption.
Another method is manual therapy, which may include techniques such as massage, lymphatic drainage, or joint mobilisations. These hands-on approaches can help direct excess fluid away from the swollen area and improve tissue elasticity. Physiotherapists may also incorporate positioning and elevation strategies to encourage fluid drainage, particularly for limb swelling. Simple adjustments, such as elevating an affected limb above heart level when resting, can reduce swelling over time.
A big part of our approach is treating your underlying injury or condition. By addressing the root cause, whether it’s a sprain, post-surgical recovery, or chronic condition, physiotherapists help the body heal more efficiently and reduce swelling over time. This may involve strengthening exercises to restore function, stretching to improve mobility, or hands-on techniques to promote tissue repair.
Education is also a key part of treatment. We take the time to guide patients in managing swelling at home through self-care strategies and activity modifications. By supporting the body’s natural healing process, swelling gradually subsides as recovery progresses.
Book your appointment with our team of physiotherapists by calling us at +852 2801 4801 or book your appointment online here.