Millions of people in the U.S. suffer from some type of hand arthritis, a condition that can affect joints in the fingers and thumbs. The ultimate outcome of arthritis is degradation of the cartilage that lines the joints. This can cause pain, stiffness, and deformity. There are three common types of arthritis:
- Rheumatoid arthritis
- Post-traumatic arthritis
Osteoarthritis, often considered "wear and tear" arthritis, is a degenerative disease that gradually worsens with time. The cartilage that covers the ends of bones and ensures a smooth rotation of the joint eventually wears down.
Rheumatoid arthritis is a painful inflammatory disease that often affects multiple joints, including those in the thumbs and wrists. It occurs when the body's immune system attacks and damages the synovial membrane, which lines the joint and keeps the cartilage healthy. The condition can lead to the wearing down of cartilage and supporting structures and it can result in severe pain and deformities of the hand and wrist.
Post-traumatic hand arthritis occurs when an injury or fracture damages the cartilage of a hand joint and a process of degeneration and inflammation begins.
What are the symptoms of hand arthritis?
All types of arthritis have symptoms of pain, swelling and stiffness. The inflammation associated with arthritis often leaves the joint warm to the touch and may even redden the skin. This is caused by increased fluid accumulation to compensate for poor cartilage lubrication. Some symptoms differ according to the type of arthritis.
- Bony nodules at the middle joint of the finger (Bouchard's nodes)
- Bony nodules at the joint at the end of the finger (Heberden's nodes)
- Deep pain at base of thumb (basilar arthritis)
- Difficulty gripping or pinching objects
Rheumatoid arthritis symptoms:
- Painful body joints, including those in the thumbs, wrists and elbows
- Dramatic deformities of the fingers and wrist
- Tendon ruptures (sudden inability to bend or straighten the fingers)
- Flu-like feeling throughout body
Post-traumatic arthritis can include a combination of many of the rheumatoid or osteoarthritis symptoms. Careful examination from the physicians at Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute can determine the type and extent of arthritic damage.
Who is likely to get hand arthritis?
Hand arthritis can affect people of all ages, yet each type of arthritis has different risk groups. Osteoarthritis is more common in women and may run in families, so there is a genetic predisposition. Rheumatoid arthritis can start in childhood or adulthood and is usually accompanied by pain in many joints and symptoms throughout the whole body. Post-traumatic arthritis can occur in anyone after an injury.
The most common risk factors for arthritis include:
- Gender — more prominent in women
- Active lifestyle
- Advanced age
- Injury to joint
- Repetitive joint motion
If you are experiencing pain, discomfort or immobility in your hands, contact the specialists at the Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute. They are available to discuss the most comprehensive treatments.
What causes arthritis in the hand?
It is not known for sure what causes arthritis, but genetics may play a role. Rheumatoid arthritis may be associated with genetic factors, viral or bacterial infections or even hormones. Post-traumatic arthritis is caused by damage to the cartilage from an accident or injury.
How is arthritis of the hand diagnosed?
Hand arthritis is diagnosed through careful examination of the hand and other joints throughout the body. A physician will consider factors such as extent of pain, joint mobility, swelling, appearance and lifestyle to help determine a diagnosis. An X-ray or other imaging test may be performed to inspect bones for degeneration, reveal nodes and search for thinning of space between bones in the joint. In some cases, rheumatoid arthritis can be diagnosed with blood or joint fluid tests that check for inflammation indicators.
What are the treatments for hand arthritis?
Treatment for hand arthritis is meant to restore function, reduce pain and prevent further damage. The physicians at the MOR Hand, Wrist & Elbow Institute may recommend a variety of treatments.
Non-surgical Treatment Options
Treatment can involve any of the options below:
- Non-steroidal anti-inflammatory drug (NSAID)
- Disease-modifying anti-rheumatic drugs (DMARDs)
- Biologics, which are genetically engineered proteins
- Physical or occupational therapy
- Cortisone injections
- Lubrication injections
- Braces, insoles or assistive devices
Surgical Treatment Options
If a physician determines that surgery is necessary, there are several options depending on the severity of the condition. They are:
- Joint reconstruction is an option for those who do not have severe bone degeneration. Reconstruction can clean and smooth cartilage and remove painful bone spurs. Small incisions are made to remove damaged tissue. This procedure is successful in mild arthritis cases in which the condition is caught in an early stage. It may not be adequate for patients with rheumatoid arthritis or advanced osteoarthritis. Reconstruction for arthritis of the thumb carpometacarpal (basilar) joint is common and is one of the most effective surgical procedures for hands and wrists. The pain from arthritis — where the hand meets the wrist can be virtually eliminated, with predictable maintenance of range of motion and modest improvements in strength.
- Joint fusion is optimal for severe arthritis in the DIP (distal interphalangeal joint, located closest to fingertip) joint, or for younger patients who are very active. During a fusion, the joint is removed and finger bones are attached directly to each other, fusing them into one. Fusion minimally impacts function and can eliminate pain.
- Joint replacement in the finger is most successful in the PIP (proximal interphalangeal) joint, located in the middle of the finger, and is a great option for those who have low-activity lifestyles. The small and ring finger are best suited for this because flexion of those digits is critical for grip and they do not utilize much sideways motion for pinching. The index and middle fingers need sideways stability for twisting things and turning keys, thus joint fusion is favored for those digits. Specialized silicone implants may be successful for patients with arthritis in the index or middle finger.