Hand and Finger Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a painful inflammatory disease that causes swelling, stiffness, joint destruction, and deformity. This autoimmune disease has an effect on the cells that coat and lubricate joints (synovial tissue).

Although osteoarthritis (the "wear and tear" arthritis") may affect one joint, such as hand arthritis or finger arthritis, rheumatoid arthritis usually happens symmetrically. For instance, RA may affect both wrists, both hands, both knees, and both ankles and feet.

What are the symptoms of hand and finger RA?

The wrist joints and the finger joints closest to the hand are common targets of hand RA. With hand and finger RA, you may feel the following:

• Hand pain, finger pain, swelling, and stiffness.
• Hand joints and finger joints that are warm and tender to the touch.
• The same joints affected symmetrically (both wrists, fingers on both hands).
• Finger joints that "creak" when moved; this is called crepitus.
• Deformities in finger joints, particularly the middle joint.
• Carpal tunnel symptoms such as numbness and tingling of the hands.
• More inflammation, pain, and stiffness that affect other symmetrical joints such as both sides of the jaw, both sides of the neck, shoulders, elbows, hips, knees, ankles, and feet.
• Flu-like feeling.
• Fatigue that is not easily resolved.
• Fever.
• Pain and stiffness that last for more than an hour upon arising.

What causes hand and finger RA?

Scientists are unsure about the causes of hand and finger RA. They do know that RA affects about 1.3 million Americans and occurs in all racial and ethnic groups. About two to three times as many women suffer from rheumatoid arthritis as men. Some rheumatoid arthritis research points to the following factors as possibly influencing rheumatoid arthritis:

• Genetic factors.
• Environmental factors such as a viral or bacterial infection.
• Hormones. RA tends to improve with pregnancy, while breastfeeding and the postpartum period (the time after delivery) may aggravate rheumatoid symptoms.

What is a swan-neck deformity?

Rheumatoid arthritis is a common cause of a swan-neck deformity. It's estimated that about 50% of those with RA have this deformity.

With a swan-neck deformity, the base of the finger and the outermost joint bend, while the middle joint straightens. Over time, this imbalance of the finger joints can result in the crooked swan-neck position. (True swan-neck deformity does not occur in the thumb.)

A swan-neck deformity can make it almost impossible to bend the affected finger normally; it can make it difficult to button shirts, grip a glass, or pinch with the fingers.

By examining the hand and fingers, a rheumatologist can diagnose a swan-neck deformity and determine appropriate treatment, which may include:

• Finger splints or ring splints
• Surgery to realign the joints or fuse the joints for better function