Arthritis of The Hand
Osteoarthritis is the most common form of arthritis affecting the hand. It is a deterioration of the surfaces that move against one another in the joints, particularly the layer of smooth cartilage that is there to cushion and protect the ends of the bones. Arthritis in the hand causes pain, stiffness and loss of mobility in the fingers.
What is osteoarthritis?
Osteoarthritis is a progressive, degenerative condition that affects a significant proportion of UK adults, particularly with age. It is different to rheumatoid arthritis and some other forms of the disease.
Around 20 per cent of people in their 50s are affected by osteoarthritis. This increases to almost half of people in their 80s. It is a complicated condition as it involves many factors working together. The cartilage may experience accelerated wear and tear; increasing friction in the joint; bone surfaces may be exposed and bone spurs may appear; additional symptoms such as muscle weakness may develop as a result of the pain and stiffness experienced.
Various parts of the body are affected but the hand and fingers are among the most common sites for symptoms to develop. Although it is not known what precisely causes osteoarthritis to develop in some people and not others, the small joints of the fingers are particularly prone to breakdown of the cartilage.
How does osteoarthritis affect the hand?
In the hand, osteoarthritis most commonly affects the small joints of the fingers and the joint at the base of the thumb (see First CMCJ arthritis). Usually the first symptom is a general soreness and stiffness in the joints. It may be noticeably worse in cold and damp weather. Some experience a sharp pain or burning sensation in the muscles or tendons around the joint. In some patients there is a slight clicking sound when the joint moves.
You may sometimes find hard bony enlargements appear at the small joints of the fingers. They may be called Heberden's nodes or Bouchard's nodes, depending on where they appear. These nodes are not necessarily painful but they may limit the movement of the fingers. Some people notice these physical changes before they experience any pain.
Non-surgical treatments for Hand Arthritis
It is possible to ease the symptoms of osteoarthritis of the hand without surgery, and some patients find that controlling symptoms for a period can be sufficient if the arthritis does not worsen. Here are some non-surgical treatments that may reduce discomfort and improve quality of life.
- Warmth: a five-minute soak in warm water, or application of a warm pad around the hands, can improve symptoms in the morning.
- Cold treatment: careful application of an ice pack for five to fifteen minutes at a time may help relieve pain and swelling.
- Over-the-counter non-steroidal anti-inflammatory medication such as aspirin, ibuprofen can help control pain and swelling, although do check with your pharmacist about possible side effects and interactions with any other medication you might be taking.
- A therapist may be able to provide a variety of hand splints to support the thumb and the wrist. They may also be able to provide specially designed adaptive devices to assist with everyday activities that are proving difficult because of hand arthritis.
Surgical treatments for osteoarthritis of the hand
The first step is to confirm that osteoarthritis is definitely the problem. Before resorting to surgery, your doctor may be able to prescribe stronger anti-inflammatory medication or a cortisone injection into the affected area, which may provide relief from symptoms for about two months.
If surgery is required, the main reasons it may be advisable are to relieve pain and prevent progressive weakness and deformity from occurring. Should your hand arthritis be severe enough to prevent you from doing many things with your hands, you may feel that surgery is the preferred option going forward.
The aim of hand surgery for osteoarthritis is to reconstruct or fuse the joints affected. This means there are two main types of surgical procedure we can consider:
- Joint fusion, also known as arthrodesis, is an operation to make the bones of a joint grow together. While it does mean you will lose movement in the joint, it can remedy the pain and awkwardness of a crooked or unstable joint and may also reduce the size of an enlarged joint.
- Joint reconstruction, also known as arthroplasty, involves replacing your own joint surfaces with artificial joints made of pyrolytic carbon. These surgical replacements are a reasonable alternative to joint fusion, and are most often performed on those suffering from thumb basal joint arthritis.
If you opt for either of these treatments, therapy after surgery is very important to ensure the best long term outcome. This may involve having custom splints made and maintained by a hand therapist.
Contact us and make an appointment
To discuss a problem with your hands that you believe may be osteoarthritis, please contact us to make an appointment.