Here's information about osteoarthritis of the hand, from what causes it to how it can be treated and how the pain can be managed.
What Is Arthritis?
Arthritis is a general term for inflammation in the joints. Arthritis can occur in numerous forms. The most common is osteoarthritis, a condition in which the cartilage, the protective cushioning between the joints, wears out. When this happens, the bones rub directly against other bones. This causes structural changes that can be seen on X-rays. Bone deposits or bone spurs known as osteophytes may develop on the edges of the joints. The soft tissues that stabilize joints may also show signs of wear.
Arthritis is often painful, but not always. Over time, arthritis can result in joint deformity and can limit the motion and function of joints.
What Is Osteoarthritis?
Osteoarthritis, also known as degenerative arthritis, may affect one or more joints anywhere in the body. The joints most often affected are the hands and the weight-bearing joints of the lower extremities (knees, hips, feet).
In osteoarthritis, there is a steady worsening and decline of joint cartilage. It affects only particular joints and not the rest of the body. The onset of osteoarthritis is usually related to aging, but other factors can be involved:
- Joint instability and misalignment affect both the distribution of forces across the joint and may lead to degeneration.
- Risk factors for osteoarthritis include heavy usage and traumatic injuries that result in joint irregularities.
- Some people may inherit genes that may predispose them to develop osteoarthritis earlier in life or in uncommon joints.
Who Gets Osteoarthritis?
According to the Centers for Disease Control, 27 million American adults have osteoarthritis. Osteoarthritis is more common in older people. But younger people may get the disease through injury or genetic bone or metabolic defects. Because most osteoarthritis results from wear and tear, the chance of developing the disease increases as people age.
Before age 45, more men than women get the disease. After age 45, more women than men are affected. Other risk factors include being overweight and having a job that causes particular stress to joints.
What Are the Symptoms of Osteoarthritis?
Though not everyone who has osteoarthritis has symptoms, many do. Symptoms may include:
- A grinding, grating feeling or a crunchy sound when joints move (this is also called crepitus)
- Less range of motion in affected joints
- Joint pain
- Joint stiffness
- Mucus cysts forming near the ends of fingers (hand osteoarthritis)
What Is Hand Osteoarthritis?
Osteoarthritis of the hand occurs more frequently in certain spots:
- In the joint located at the base of the thumb, where the thumb meets the wrist. You may have bumps or bony knobs located near the site of the arthritis.
- In the joint at the end of the finger closest to the nail. Bumps called Heberden's nodes might show up there.
- In the joint in the middle of the finger. This spot gets bumps called Bouchard's nodes.
With osteoarthritis that is located at the base of the thumb, there is often a deep, aching pain. You may have trouble gripping or pinching things with any kind of strength, or opening lids or turning keys.
How Is Osteoarthritis of the Hand Diagnosed?
To diagnose osteoarthritis, your doctor will conduct a physical exam and take a medical history. Some symptoms of arthritis are noticeable, such as swelling, warmth, deformity, and loss of motion. Tests that may be used to diagnose arthritis include:
- X-rays, which may show changes in bones or the development of bone spurs
- bone scans, which may show arthritis even before the changes show up on X-rays
How Is Hand Osteoarthritis Treated?
The main goals of osteoarthritis treatment involve reducing or eliminating pain and/or restoring function and mobility. The following nonsurgical treatments may be used:
- Medications, including anti-inflammatory or analgesic drugs; this treatment might also include injections of pain reliever/steroid combinations.
- Finger or wrist splints or soft sleeve devices worn during the night or during certain activities
- Resting the joints
- Heat treatments such as paraffin baths or cold treatments
- Topical treatments such as capsaicin cream
- Performing exercises given by your doctor or occupational therapist
- Steroid injections into the affected joints
If the pain is too severe, or if movement becomes too limited, surgery may be needed. Types of surgery for treating hand osteoarthritis include:
- Joint fusion, in which the bones are fused together
- Joint reconstruction, which involves replacing the joint surface that has deteriorated with a joint implant or with tissue such as tendons