Hand Osteoarthritis

What Is Osteoarthritis of the Hand?

Hand osteoarthritis is inflammation that causes pain and stiffness in your joints. It usually happens in three places:

  • The base of your thumb, where it meets your wrist
  • One of the joints closest to your fingertips
  • The middle joint of a finger

There's no cure, but there are a lot of ways to protect your joints and feel better.

Without treatment, osteoarthritis gets worse over time. It’s important to get a diagnosis and a treatment plan as soon as possible.

Hand Osteoarthritis Causes and Risk Factors

Osteoarthritis (OA) was once thought to happen because of wear and tear on your joints. Doctors now know there’s more to the story.

On the ends of your bones, there's a layer of smooth material called cartilage. It helps cushion your joints and allows them to slide easily. But over time, the cartilage gets worn down. The bones rub against each other, causing the symptoms of OA. The wear and tear can also cause other tissues in the joint to make inflammatory cells, which damage it more.

Certain things can make you more likely to have hand OA:

  • Age. The older you are, the higher your odds.
  • Sex. Compared with men, women are twice as likely to get it.
  • Ethnicity. Rates are lower in African Americans.
  • Weight. Thinner people are less likely to get it than those who have obesity.
  • Injuries. This includes broken and dislocated bones.
  • Changes in your genes. Your parents might have passed down a higher chance of OA.
  • Joint problems. This includes infections, loose ligaments, overuse, and joints that aren’t aligned the way they should be.

What causes flare-ups?

You might notice that your symptoms are worse in the morning. Other triggers may include:

  • Stress
  • Cold weather
  • Changes in barometric pressure
  • Making the same motion over and over
  • Overdoing an activity
  • Infection

 

Hand Osteoarthritis Symptoms

The most common symptoms are pain and stiffness. Over time, they may get worse. The pain might become constant and sharper, and the stiffness could keep you from bending your finger joints all the way.

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Hand osteoarthritis can cause other problems, like:

  • Bumps and lumps. Two types of bony bumps near your finger joints are common. Bouchard's nodes form on the middle joint of a finger, and Heberden's nodes happen on the joint near your fingertip. You're also more likely to get cysts, which are bumps filled with fluid, near your fingertip joints.
  • Clicking and cracking (crepitus). That's the sound of the surfaces of your joints rubbing against each other as the cartilage breaks down.
  • Swelling and redness. This is a sign of inflammation around a joint.
  • Weakness. Pain and joint damage can make it harder to do things like turn doorknobs or lift heavy pots.
  • Other physical changes. Over time, the swelling and breakdown of cartilage and bone can change the shape of your joints and make them bigger.

Hand Osteoarthritis Diagnosis

Your doctor will look at your hands and ask about your symptoms and family history. You'll probably have X-rays, too. They’ll also try to rule out other causes of painful joints, like rheumatoid arthritis.

Hand Osteoarthritis Treatment

Your doctor might recommend one or more of these treatments to ease pain and make it easier to use your hand:

  • Painkiller pills. Acetaminophen and NSAIDs like ibuprofen can ease pain.
  • Immobilizing devices. A splint, brace, or sleeve can hold your hand in a stable position to lessen pain.
  • Hand therapy. An expert called a hand therapist can show you exercises and ways to do everyday tasks. For example, instead of carrying grocery bags with your fingers, you might carry them over your forearm.
  • Cortisone shots. An injection into the joint may help for weeks or months. Your doctor will offer these only a certain number of times because they can have side effects like infection and weakened ligaments.

Surgery

If other treatments haven't worked or symptoms make it hard to use your hand, you and your doctor may consider surgery. One option is joint fusion, in which the surgeon fuses your bones together. You'll have less pain, but you won't be able to move your joint the way you used to. Or you might have surgery that removes and replaces the joint.

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Hand Osteoarthritis Home Remedies

These home treatments can help:

  • Exercises. Your doctor or physical therapist can show you what to do to improve strength and range of motion and to ease pain.
  • Assistive devices. Special pens, kitchen utensils, and other tools with big grips may be easier to use.
  • Ice or heat. Ice may reduce swelling and pain. Heat, like a warm washcloth or a paraffin bath, can loosen stiff joints.
  • Skin treatments. Medicated creams can give relief when you rub them on sore joints. Gels with nonsteroidal anti-inflammatory drugs (NSAIDs) also help.
  • Supplements. Many people take glucosamine and chondroitin supplements for OA. Researchers are still looking into whether they help. Ask your doctor if they're OK to try.

Hand Osteoarthritis Prevention

There’s no one way to prevent osteoarthritis. Some lifestyle changes might lower your odds:

  • Try not to do activities that involve the same motions over and over again. And if you can, skip the ones that might work your joints too much.
  • Keep a healthy weight.
  • Exercise to make your joints and muscles stronger.
WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on March 13, 2020

Sources

SOURCES:

American Society for Surgery of the Hand: "Osteoarthritis."

American Academy of Orthopedic Surgeons' OrthoInfo: "Arthritis of the Hand."

Arthritis Foundation: "Osteoarthritis of the Hands," "Topical NSAIDs Offer Rub-on Relief," “Arthritis Pain Relief and Shoe Inserts: What Triggers an Arthritis Flare?”

Cleveland Clinic: "Arthritis of the Wrist and Hand."

UpToDate: "Management of Hand Osteoarthritis."

American Academy of Family Physicians: “Osteoarthritis.”

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