What Is Hand Osteoarthritis?

Do your fingers hurt when you try to open a jar? Hand osteoarthritis could be to blame. If you have this condition, pain and stiffness in your joints can make some basic tasks a whole lot harder. There's no cure, but there are a lot of ways to protect your joints and ease your pain.

What Causes It?

Osteoarthritis (OA) happens from wear and tear on your joints. On the ends of your bones, there's a layer of smooth material called cartilage. It helps cushion the joints and allows them to slide easily. But over time, the cartilage gets worn down. The bones begin to rub against each other, causing the symptoms of hand OA.

Other things can increase your chances of OA in your hands, too. You're more likely to get it if you're:

  • Older. The older you are, the more likely it is.
  • A woman. Compared to men, women are twice as likely to get it.
  • White. Rates are lower in African-Americans.
  • Overweight. Thinner people are less likely to get it than obese people.

Injuries, like broken bones or dislocations, can also raise the chances of OA, even if you got treatment for them. So can joint infections. And your genes play a role too, since OA can run in families.

What Are the Symptoms?

The most common ones are pain and stiffness, which may be worse in the morning. You could also notice that your joint hurts after you use it a lot but feels better when you rest it.

Over time, the symptoms may get worse. The pain may become constant and sharper, and the stiffness can get bad enough that you can't bend your finger joints all the way.

Hand osteoarthritis can cause other problems, like:

Bumps and lumps. Two types of bony bumps near your finger joints are common. Bouchard's nodes show up on the middle joint of a finger, and Heberden's nodes on the joint near your fingertip. You're also more likely to get cysts, which are bumps filled with fluid, near your fingertip joints, too.

Clicking and cracking. That's the sound of the surfaces of your joints rubbing against each other as the cartilage breaks down.

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Swelling and redness. This is a sign of inflammation around the joint.

Weakness. Pain and joint damage can make it harder to do things like turn doorknobs or lift heavy pots.

Other changes in appearance. Over time, the swelling and breakdown of cartilage and bone can change the shape of your joints and make them bigger.

OA can affect many of the joints in your hands, but it's most common in:

  • The base of your thumb where it comes together with the wrist (trapeziometacarpal or carpometacarpal joint)
  • The joint closest to your fingertip (distal interphalangeal joint or DIP)
  • The joint in the middle of your finger (proximal interphalangeal joint or PIP)

 

How Is It Diagnosed?

Your doctor will look at your hands and ask you questions about your symptoms and family history. You'll probably get X-rays, too.

Your doctor will also rule out other causes of painful joints, like rheumatoid arthritis.

What's the Treatment?

There are several ways that you can get relief from pain and improve your ability to use your hand.

Some home treatments that can help are:

Exercise and steps to protect your joints. An expert called a hand therapist can show you exercises and new strategies for everyday tasks. For example, instead of carrying grocery bags with your fingers, you could carry them over your forearm instead.

Assistive devices. A splint or sleeve can help hold your hand in a stable position to reduce pain. Special pens, kitchen utensils, and other tools with big grips may be easier to use.

Ice or heat. Ice may help reduce swelling and pain, while heat, like a warm washcloth or a paraffin bath, may help your joints loosen up.

Your doctor may also suggest different types of medications, such as:

Skin treatments. Medicated creams with painkillers can give you relief when you rub them on sore joints. Gels with nonsteroidal anti-inflammatory drugs (NSAIDs) can also help.

Painkiller pills. Acetaminophen and NSAIDs like ibuprofen can ease pain.

Cortisone shots. An injection into the joint may help, but the effects may wear off.

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Supplements. Many people take glucosamine and chondroitin supplements for OA, but there's no clear evidence they help. Ask your doctor if they're OK to try.

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, where the surgeon fuses the bones together. There are drawbacks, though. You'll get pain relief, but you won't be able to bend your joint the way you used to.

Surgery that removes and replaces the joint can be an option, too.

While hand osteoarthritis is common, you don't have to accept it. If your symptoms are getting in the way of the things you want to do, talk to your doctor and get treatment.

WebMD Medical Reference Reviewed by David Zelman, MD on March 08, 2018

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."

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

UpToDate: "Management of Hand Osteoarthritis."

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