My fingers swell-up

[gary c.]

I have not done a lot of backpacking but in the past I noticed that my fingers would swell up just a little. That was while useing treking poles. This past weekend I forgot my poles and on the hike out from Kearsarge Lakes my fingers and hands puffed up pretty bad. Bad enough that it made it difficult to make a fist. Does anyone know what might cause this and is there anything I can do to prevent it from happening? Like when useing the poles, elevating my hands by holding onto my shoulder straps helped.
Gary C.

[copeg]

While this doesn't happen to me, I have heard of many folks whose experience just what you describe. I think its a common problem. Not entirely sure what causes it, but I think its the combo of swinging your arms (centrifugal force) and wearing a pack (tighter shoulder staps make it worse). Here's a post from another backpacking site with a similar discussion:
http://www.backpacking.net/forums/showt ... ber=112129

[KathyW]

It could be caused by an electrolyte imbalance.

[gary c.]

It could be caused by an electrolyte imbalance.

I don't think thatis the case with me. I always carry two bottles. One with water and the other with a sports drink mix and alternate between the two. Also thank you again for the bear cannister. I used it on this trip and by useing the handle on my pocket knife to press the rim it worked out very well.

trailblazer, thanks' for the link Makes me feel a lot better about the whole thing. Two different people(non-hikers) told me they thought it might be high blood pressure. I was sure someone would have heard of the problem hear before.

Thanks' for the reply's
Gary C.

[KathyW]

You're welcome on the canister - I'm glad it's getting used.

I used to use hiking poles a lot, but I don't use them very much anymore. This past winter/spring my fingers would sometimes swell up when I was hiking and I noticed it was worse when I hiked on hot days like out in Palm Springs - one day they got really swollen and I also had cramps in my legs - it was really hot that day, so there were also dehydration/electrolyte problems. With me, it's probably having my hands hanging down below my heart and then the problem gets compounded when my electrolytes are out of balance.

[SSSdave]

I posted the above image on another forum in September 2003 after climbing out of a backpack up Big Pine Creek. People had a good laugh. That was the same trip I briefly met and talked with SnowNymph up at First Lake. Not only does it happen to me but many others especially those hefting heavier loads. It is simply due to shoulder strap constriction much like an arm turniquet. Hands look normal some minutes after the pack is gone. ...David

[Hikerchick]

I also get swollen fingers (to varying degrees) every time I hike, whether I it's at sea level (I live in Vancouver BC) or at 10,000 feet. My husband also gets the same thing and he actually has slightly lower than normal blood pressure (and I have normal blood pressure) - we call it 'sausage finger syndrome'.

Although it can be strange, and sometimes slightly annoying, I don't think it's anything to worry about.

[MountainMinstrel]

I'm not sure that it is totally the shoulder straps because I only get it when I am not using the poles. I'm sure that the pack contributes to it, but I think there are other factors as well.

ken

[streamer]

I agree with MountainMinstrel. My hands will slightly swell every time I walk or jog any kind of distance. Although I'm sure a pack will add to the problem.

[Ranboze]

There are a multitude of factors that could contribute to peripheral edema (swelling of the hands, feet ... but in this case, notably the hands). The movement of fluid between our various body compartments, eg, inside the circulatory system, inside cells, and the space in-between is dependent on factors such as hydrostatic pressure, oncotic pressure (the pressure exerted by the proteins in those compartments, and osmotic pressure (the pressure exerted by electrolytes and other substances in those compartments). Throw in the effects of relative tissue hypoxia at altitude and its effect on the integrity of the "walls" of the compartments, and the effect of lower atmospheric pressure at altitude and you've got a whole host of complex things that could contribute to swellings of the hands.

From what I've read, Im not sure that there is consensus as to the "exact" physiologic mechanism, because there could be many. High altitude researcher Hackett has done some work on this topic. It does seem reasonable to make the following statements:

- A lot of people experience it (I sure do), and it seems to be a "normal" occurance.

- Wearing a pack that puts pressure on the blood vessels that carry blood back to the heart (veins) makes it harder for the blood to get back to the heart, so it "builds up" in the veins causing an increase in hydrostatic pressure in the capillaries which then causes fluid to leak out of the circulatory system to the tissues.

- The mere act of movement facilitates the flow of blood from the veins back to the heart. If the arms are left to just dangle while walking, the effect of gravity and lack of movement also leads to a build up of hydrostatic pressure in the capillaries and fluid seeps out. Using poles keeps the arms moving, which facilitates the movement of blood in the veins back to the heart.

- Electrolyte disturbances such as low sodium (hyponatremia) can also lead to edema because low sodium leads to decreased osmotic pressure (osmotic pressure acts like a magnet for water... if osmotic pressure in one of the fluid compartments is high, water will tend to be pulled to that compartment, if osmotic pressure is low, water will tend to leave that compartment and go the compartment that has a higher osmotic pressure).

- Overhydrating with plain water can also lead to hyponatremia because it "dilutes" the total amount of sodium in the circulatory system. This is a well known cause of death in marathoners.

- At altitude it is "normal" to have less oxygen delivered to the tissues (unless one has fully acclimitized and the body had increased its red blood cell count, which usually takes 3-4 weeks). This can cause the capillaries to get "leaky"... making it even easier for fluid to leak out of the circulatory system and into the tissues (outside the circulatory system and between cells).


Books and scientific papers on high altitude hiking, wilderness medicine, etc... would be the best sources for understanding the complex physiology behind this phenomenom.