Hand Arthritis
Arthritis is a term used to describe joint pain, stiff and swollen joints, and loss of motion resulting from smooth cartilage breakdown on the joint bone surface. Cartilage allows for smooth movement of joint bones, and without it, people with arthritis can experience debilitating symptoms.
There are approximately 100 different types of arthritis that can affect any joint in the body. There are four major arthritis categories:
Arthritis is most noticeable in finger joints and the wrist joint. Osteoarthritis is the most common form of arthritis in hand. Osteoarthritis typically develops with age and normal joint "wear and tear" or after an injury. People with arthritis most often develop painful joints in three areas of the hand (see Figure 1):
at the base of the thumb, where the thumb and wrist come together (the trapezio-metacarpal, or basilar joint)
In hand osteoarthritis, cartilage loss precedes bony lumps, which may develop at the arthritic joint. These bony nodules in the PIP joints are called Bouchard's nodes and Heberden's nodes in the DIP joints. (see Figure 2).
Symptoms of hand arthritis, such as diminished grip and pinch strength, may cause difficulty with daily activities and everyday tasks such as opening jars or turning keys.
Your hand surgeon will conduct a physical examination, assess your range of motion, and inquire about the impact of arthritis on your daily living (morning pain, pain with increased activity level, etc.). Imaging studies may reveal narrowing of the joint space and the formation of bony outgrowths (osteophytes).
There is no cure for arthritis. Arthritis treatment options are aimed to relieve pain and restore range of motion. Nonsteroidal anti-inflammatory drugs or other analgesic medication may alleviate joint pain. People with arthritis benefit from periods of rest with arthritis flare-ups.
Your hand surgeon, physical therapist, or occupational therapist may recommend you to wear finger or wrist splints or a soft sleeve at night and for selected activities. Heat and cold therapy may help with swelling. A steroid injection can often provide temporary relief for arthritis symptoms but does not cure arthritis. Maintaining a healthy weight will reduce your risk factors of developing arthritis in larger joints and joint disease. Enrolling in a weight-loss regimen can help with pain management.
Your hand surgeon may recommend various surgical treatments for hand arthritis when conservative treatments fail, and you have too much pain or too little function. The two most common surgical procedures are joint fusion, in which the arthritic surface is removed, and the joint bones are fused. Or joint reconstruction, in which the degenerated joint surface is removed and replaced with a tendon or a joint implant. The goal of surgery is to restore as much function as possible and eliminate the pain or reduce it to a tolerable level.
There are approximately 100 different types of arthritis that can affect any joint in the body. There are four major arthritis categories:
- Degenerative Arthritis - Osteoarthritis and Post-Traumatic arthritis
- Inflammatory Arthritis - Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis
- Infectious Arthritis - caused by a viral, bacterial, or fungal infection
- Metabolic Arthritis - increased uric acid levels cause gout arthritis
Arthritis is most noticeable in finger joints and the wrist joint. Osteoarthritis is the most common form of arthritis in hand. Osteoarthritis typically develops with age and normal joint "wear and tear" or after an injury. People with arthritis most often develop painful joints in three areas of the hand (see Figure 1):
at the base of the thumb, where the thumb and wrist come together (the trapezio-metacarpal, or basilar joint)
- at the end joint closest to the fingertip (the DIP joint or distal interphalangeal joints)
- at the middle joint of a finger (the PIP joint or proximal interphalangeal joints)
In hand osteoarthritis, cartilage loss precedes bony lumps, which may develop at the arthritic joint. These bony nodules in the PIP joints are called Bouchard's nodes and Heberden's nodes in the DIP joints. (see Figure 2).
Symptoms of hand arthritis, such as diminished grip and pinch strength, may cause difficulty with daily activities and everyday tasks such as opening jars or turning keys.
Your hand surgeon will conduct a physical examination, assess your range of motion, and inquire about the impact of arthritis on your daily living (morning pain, pain with increased activity level, etc.). Imaging studies may reveal narrowing of the joint space and the formation of bony outgrowths (osteophytes).
There is no cure for arthritis. Arthritis treatment options are aimed to relieve pain and restore range of motion. Nonsteroidal anti-inflammatory drugs or other analgesic medication may alleviate joint pain. People with arthritis benefit from periods of rest with arthritis flare-ups.
Your hand surgeon, physical therapist, or occupational therapist may recommend you to wear finger or wrist splints or a soft sleeve at night and for selected activities. Heat and cold therapy may help with swelling. A steroid injection can often provide temporary relief for arthritis symptoms but does not cure arthritis. Maintaining a healthy weight will reduce your risk factors of developing arthritis in larger joints and joint disease. Enrolling in a weight-loss regimen can help with pain management.
Your hand surgeon may recommend various surgical treatments for hand arthritis when conservative treatments fail, and you have too much pain or too little function. The two most common surgical procedures are joint fusion, in which the arthritic surface is removed, and the joint bones are fused. Or joint reconstruction, in which the degenerated joint surface is removed and replaced with a tendon or a joint implant. The goal of surgery is to restore as much function as possible and eliminate the pain or reduce it to a tolerable level.
Figure 1. Hand joints commonly affected by osteoarthritis
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Figure 2. DIP and PIP bony lumps and nodules.
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Reproduced with permission from the American Society for Surgery of the Hand www.handcare.org