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Do you have persistent pain in your hands or wrists? Is it difficult to complete daily tasks that require putting pressure on your fingertips or use of your thumb? Hand arthritis is a common condition that affects the joints of men and women alike. It can range in severity from mild to disabling, making it harder to carry out normal activities, such as opening doors or tying your shoes.
Fortunately, there are several treatment options that can relieve pain, from medication and physical therapy to surgery. The best treatment for you will depend on the location and severity of your symptoms. In addition, you may need to explore several different options before finding the best treatment for your unique case.
What is hand arthritis?
Within the hand and wrist, there are 27 tiny bones working together to perform day-to-day movement. Joints are where each bone connects to one another, cushioned bycartilage in between. Cartilage helps these joints to glide smoothly during motion, just as a watch with working gears displays the correct time. When something disrupts the cartilage in these joints, it can lead to pain, swelling, and inflammation.
Arthritis most frequently develops in three joints within the hand:
- Base of the thumb: Thumb arthritis can form at the carpometacarpal (CMC) joint, or the base of your thumb.
- Fingertips: The joints of the fingertips closest to your fingernails are called the distal interphalangeal (DIP) joints.
- Mid-finger: The proximal interphalangeal (PIP) joints are the middle points of the finger, commonly known as the middle knuckles.
Many times, hand arthritis is caused by normal wear-and-tear that occurs as we age. As a result, the condition typically begins in adults in their late 40s or early 50s. However, some people may be predisposed to developing early degenerative changes in the hands due to genetics. In other instances, arthritic hands develop as a result of trauma or a systemic inflammatory disorder, such as rheumatoid arthritis (RA).
What are the signs and symptoms of arthritis in the hand?
Most patients with hand arthritis experience pain during motion, such as pinching, grasping, or gripping an object. For example, patients will describe their pain by saying, “It hurts everytime I do [fill-in-the-blank].”
However, it’s possible to have arthritis in the fingers or hand without pain. Other arthritic signs may include:
- Stiffness, swelling, or tenderness in the finger joints or wrist
- General weakness in the hand
- Decreased range of hand motion
- Enlarged knuckles or other finger deformities
Diagnosis and treatment.
At your first appointment, your doctor will conduct a physical examination and ask comprehensive questions about your symptoms to understand how they’re affecting your everyday life. Hand arthritis is generally confirmed using X-ray imaging, which reveals what’s going on under the surface of your skin.
The best treatment for one individual may not be the best treatment for the other, which is why it’s important to meet with a doctor specializing exclusively in treating hand conditions. A hand specialist will be able to recommend the right method for managing your symptoms, including nonsurgical options that may include one or more of the following:
- Medications: There are several options available for managing pain, including topical medications, over-the-counter or prescription pain relievers, and corticosteroid injections.
- Splinting: A supportive brace or splint can stabilize arthritic joints, which may alleviate some pain.
- Physical or occupational therapy: Certain hand exercises may help you regain strength in the fingers and wrist, which might prevent worsening arthritis. In addition, your doctor or therapist may recommend lifestyle or activity modifications that can help limit the strain on your finger joints and minimize pain.
Depending on the severity of your arthritis, conservative treatment options may be enough for managing pain and other symptoms. However, if these treatments don’t provide satisfactory long-term relief, there are several surgical treatments that can help manage symptoms and slow down additional wear-and-tear.
Surgical treatments for hand arthritis.
If pain or limited mobility remains after trying nonsurgical options, your doctor may recommend surgery to manage your condition. The procedure your surgeon will recommend will consider the type of surgery that will be most appropriate given the location and impact of your arthritis. They’ll also thoroughly explain the pros and cons of your surgical options, so you can make the best decision for your goals.
Base of the thumb arthritis surgery.
If thumb base arthritis prevents you from using your thumb, your surgeon may recommend a trapeziectomy. During this procedure, your surgical team will remove one of the joints at the base of the thumb (trapezium), which should eliminate your pain. In certain instances, your surgeon may also replace the joint with a tendon graft, but this is not always necessary. In either case, it’s a safe and effective outpatient procedure that typically involves a two-to-three month recovery.
Motion eliminating surgery.
If you have debilitating arthritis in the DIP joints (near the fingertips), your surgeon may recommend joint fusion surgery. This involves removing the arthritic joint and permanently fusing the remaining bones, which means they will no longer have flexibility to move. Because it eliminates the joint altogether, it’s generally a successful option that gets rid of pain.
Motion preserving surgeries.
For individuals with arthritic pain and mobility limitations in the PIP joint (the middle of the finger), there are different options, each with their own benefits and disadvantages. These may include joint replacement surgery, which involves replacing part or all of the affected joint with an artificial joint.
Advantages of this procedure include correcting any deformity and alleviating pain. However, it will not completely restore your range of motion and the replacement will likely not last for your lifetime.
A different variation of joint replacement may replace the worn out joint with joint material from somewhere else in your body, such as the toe joint. This is a more involved procedure, but it has the potential to be effective for the rest of your life.
Seek a hand specialist if pain is interfering with your life.
The best treatment for your hand arthritis is the one that alleviates your pain and restores your quality of life. And for the most effective results, it’s important to seek care from a hand specialist who focuses exclusively on diagnosing and treating arthritis and other conditions that affect the fingers and wrist. This level of expertise involves additional training and education, giving hand experts the experience necessary to minimize the risk of any potential complications.
Even if you don’t need surgery, a hand specialist will be most well-versed in the full range of treatment options that will best meet your individual needs and goals. While there’s no cure for arthritis, our doctor and surgeons are experts in helping you manage symptoms so you can get back to daily life, work, and recreation without pain.
