Arthritis is a common condition that affects millions of people worldwide. It can cause pain, swelling, stiffness, and joint deformity, making everyday tasks difficult. When it comes to arthritis in the hands, early recognition of the signs and symptoms is crucial for effective management. There are quite a few different types of arthritis that can affect the hands, discuss the early signs and symptoms, delve into the diagnosis and treatment options, and provide practical tips for managing hand arthritis at home.
Types of Arthritis in the Hands
Arthritis in the hands can manifest in various forms, with osteoarthritis (OA) and rheumatoid arthritis (RA) being the most common. However, other types of inflammatory arthritis, such as psoriatic arthritis (PsA) and palindromic rheumatism (PR), can also affect the hands.
Osteoarthritis in the Hands (OA)
Osteoarthritis, often referred to as "wear and tear" arthritis, occurs when the cartilage that cushions the joints gradually wears away, causing the bones to rub against each other. This can lead to pain, stiffness, swelling, and loss of movement. Osteoarthritis commonly affects the wrist, the joint at the base of the thumb, and the middle and top joints of the fingers.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis is an autoimmune disease where the body's immune system mistakenly attacks the synovium, the lining of the joints. This causes inflammation, pain, stiffness, and joint deformity. Rheumatoid arthritis can affect the small joints of the wrists, hands, and fingers, usually symmetrically on both sides of the body. It can lead to significant joint damage if left untreated.
Psoriatic Arthritis (PsA)
Psoriatic arthritis is a form of arthritis that often occurs in individuals with psoriasis, a skin condition characterized by red, scaly patches. PsA can cause joint pain, swelling, morning stiffness, and deformity. It commonly affects the fingers, causing swelling and joint pain similar to rheumatoid arthritis.
Palindromic Rheumatism in the Hands (PR)
Palindromic rheumatism is a rare episodic form of inflammatory arthritis. It typically affects multiple joints, including the hands. The symptoms of PR include joint pain, swelling, and stiffness, which come and go in episodes. Although the exact cause of PR is unknown, it is believed to be an autoimmune condition.
Symptoms Early Signs of Arthritis in the Hands
The symptoms of arthritis in the hands can vary depending on the type and severity of the condition. Early symptoms may include dull or burning joint pain, morning stiffness, and swollen joints. As arthritis progresses, the symptoms become more persistent and may include changes in pain intensity, difficulty with hand movements, and the formation of bony nodules on the fingers.
Pain and Stiffness
One of the earliest signs of arthritis in the hands is pain and stiffness. Individuals may experience a dull or burning pain in the joints, which often worsens after periods of increased hand use. Morning stiffness is also common, making it challenging to move the fingers and hands upon waking up.
Swelling and Tenderness
Arthritis in the hands can cause swelling and tenderness in the affected joints. The joints may appear red and feel warm to the touch. Swelling can make the fingers appear puffy and can lead to a decreased range of motion.
Joint Deformity
As arthritis progresses, joint deformity may occur. In osteoarthritis, bony lumps called osteophytes can form in the finger joints, leading to visible deformities. Rheumatoid arthritis can cause the fingers to become large, deformed, and abnormally bent, affecting hand function and making everyday tasks more challenging and increasing joint pain.
Morning Stiffness Duration
The duration of morning stiffness can also provide valuable insights into the type of arthritis affecting the hands. Inflammatory arthritis, such as rheumatoid arthritis and psoriatic arthritis, often presents with prolonged morning stiffness that lasts for an hour or more. In contrast, morning stiffness in osteoarthritis typically eases within five to 15 minutes.
It is important to note that these early signs and symptoms can vary from person to person, and a proper diagnosis from a healthcare professional is essential for accurate identification and treatment.
Diagnosing Arthritis in the Hands
Diagnosing arthritis in the hands involves a combination of medical history evaluation, physical examination, imaging tests, and blood tests. A healthcare provider, typically a rheumatologist, will assess the symptoms, conduct a thorough examination, and order appropriate tests to confirm the diagnosis.
Medical History and Physical Examination
During the medical history evaluation, the healthcare provider will discuss the symptoms, their duration, and any relevant medical conditions or previous injuries. A physical examination will involve assessing the joints for swelling, tenderness, deformities, and range of motion. Differentiating between osteoarthritis and inflammatory arthritis can be done through the examination, as inflammatory arthritis often presents with warmth and redness in the affected joints, which is not typically seen in osteoarthritis.
Imaging Tests
Imaging tests, such as X-rays or magnetic resonance imaging (MRI), can provide valuable information about the joints' condition and help confirm the diagnosis. X-rays can reveal joint erosion and the presence of osteophytes, characteristic of osteoarthritis. MRI scans can provide more detailed images of the joints, showing cartilage loss and other structural changes.
Blood Tests
Blood tests are often used to detect specific antibodies and markers that indicate the presence of inflammatory arthritis, such as rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies. These tests can help differentiate between different types of inflammatory arthritis, such as rheumatoid arthritis and psoriatic arthritis.
Treatment Options for Arthritis in the Hands
The treatment options for arthritis in the hands aim to alleviate pain, reduce inflammation, improve joint function, and slow down the progression of the disease. The chosen treatment approach will depend on various factors, including the type and severity of arthritis, the number of affected joints, the patient's age, activity level, and overall health.
Nonsurgical Treatment
Nonsurgical treatment options are often the first line of management for arthritis in the hands. These options include:
Medications
Medications can help relieve pain and reduce inflammation associated with arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are commonly used to manage symptoms. Acetaminophen may be recommended for pain relief in osteoarthritis. For individuals with rheumatoid arthritis, disease-modifying antirheumatic drugs (DMARDs) and biologic agents may be prescribed to slow down the disease progression and prevent joint damage.
Splinting
Splinting involves using specially designed braces or splints to support and stabilize the affected joints. Splints can help alleviate pain, reduce swelling, and improve joint function. They are typically worn during periods of increased pain or activity to provide support and protection to the joints.
Activity Modification
Modifying daily activities can help reduce stress on the affected joints and minimize pain. Simple changes, such as using assistive devices or ergonomic tools, can make tasks easier and more manageable. Occupational therapists can provide guidance on activity modification and recommend assistive devices tailored to individual needs.
Dietary and Supplements for Arthritis
Several dietary factors can influence arthritis symptoms, for example, omega 3 deficiency, vitamin d deficiency and a few others can also severely exaserbate symptoms. Depending on your needs it may be worth looking at a joint supplement to support arthritis. There are also several natural compounds that have been shown to be effective at reducing inflammation and symptoms in general, most notably curcumin (an extract from turmeric) which has been shown to be as effective as NSAIDs in many trials.
Omega supplements are generally recommended as a base line, but there are also things like glucosamine, ginger, SAMe and as we mentioned curcumin some lesser known compounds like resveratrol that are showing promising results in trials. There are a few more, but we've covered a few of the most popular joint supplements below.
- Glucosamine - Glucosamine and chondroitin are two popular supplements that have gained significant attention for their potential to alleviate arthritis symptoms. Glucosamine is a component of cartilage, the substance that cushions the joints. Research on these supplements has yielded mixed results, partly due to variations in study design and supplement types.
- Omega 3 - Omega-3 fatty acids, commonly found in fish oil and certain foods, possess potent anti-inflammatory properties. These fats are particularly beneficial for individuals with rheumatoid arthritis (RA), a condition driven by inflammation. A systematic review of studies in 2017 found that omega-3 supplements reduced joint pain, stiffness, and swelling in RA and OA.
- S-adenosyl-methionine (SAM-e) - is a naturally occurring compound in the body that possesses anti-inflammatory, cartilage-protecting, and pain-relieving effects. In studies comparing SAM-e to NSAIDs like ibuprofen and celecoxib, it has shown similar efficacy in relieving osteoarthritis (OA) pain without the associated side effects.
- Curcumin - the active compound in the spice turmeric, has gained recognition for its potent anti-inflammatory properties. It acts by blocking the same inflammation-promoting enzyme as the COX-2 inhibitor drug, celecoxib.
- Several vitamins - have been studied for their potential effects on arthritis, including vitamins A, C, D, E, and K. While there is currently no evidence to support the use of antioxidant vitamins in improving arthritis symptoms, it is important to maintain a healthy diet rich in these nutrients for overall well-being.
Injections
In some cases, injections of corticosteroids or hyaluronic acid may be recommended to provide temporary pain relief and reduce inflammation. Corticosteroid injections can be particularly helpful for individuals with limited joint involvement, such as in osteoarthritis or rheumatoid arthritis.
Ice/Heat Therapy
Applying ice packs or using heat therapy can help alleviate pain and reduce inflammation in the hands. Cold therapy is typically used to relieve acute pain and swelling, while heat therapy can help relax muscles and improve joint flexibility. Other topical creams for arthritis are also available over the counter, once again containing ingredients like curcumin in many cases.
Rest
Taking regular rest breaks can help relieve pain and inflammation in the joints. It is important to listen to your body and allow for adequate rest to prevent overuse and excessive strain on the hands.
Pharmacological Treatment Options
Pharmacological treatments may be prescribed to manage pain, reduce inflammation, and slow the progression of certain types of arthritis. The specific medications prescribed will depend on the type and severity of the arthritis. Some common medications used in the treatment of arthritis include:
Acetaminophen
Acetaminophen can provide pain relief and is commonly used for mild to moderate arthritis symptoms.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs, such as ibuprofen, diclofenac, naproxen, and celecoxib, can help reduce pain and inflammation in affected joints. Topical NSAIDs are often recommended as a first-line treatment for osteoarthritis.
Disease-Modifying Antirheumatic Drugs (DMARDs)
DMARDs are used primarily for rheumatoid arthritis to slow the progression of the disease and relieve symptoms. Methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide are examples of DMARDs used in the treatment of rheumatoid arthritis.
Corticosteroids
Corticosteroids, such as prednisolone and prednisone, can be taken orally, injected into the muscle, or given intravenously to reduce inflammation and alleviate symptoms of rheumatoid arthritis.
Immunosuppressive Drugs
Immunosuppressive drugs, such as azathioprine and cyclosporine, are used to slow the progression of rheumatoid arthritis and reduce damage to the bone surrounding the joints.
Biologic Agents
Biologic agents, such as adalimumab, etanercept, infliximab, and tocilizumab, can help slow joint damage in rheumatoid arthritis. These medications are usually prescribed when other treatments have not been effective.
Injections
In some cases, steroid injections may be recommended to reduce inflammation and relieve pain. These injections are typically administered directly into the affected joint. However, due to the potential weakening of tendons and ligaments, injections are usually limited to a few times
Surgical Treatment for Hand Arthritis
If nonsurgical treatments fail to provide relief or if the joint damage is severe, surgical intervention may be considered. The specific surgical options will depend on the type and extent of arthritis, as well as the patient's overall health and preferences.
Joint Fusion (Arthrodesis)
Joint fusion involves permanently fusing the bones of the affected joint together. This procedure eliminates joint movement, reducing pain and stabilizing the joint. While fusion limits joint flexibility, it provides a stable and pain-free joint. Joint fusion is commonly performed in the base of the thumb, knuckles, and top joint of the fingers.
Joint Replacement (Arthroplasty)
Joint replacement surgery involves replacing the damaged joint with an artificial implant. This procedure is typically considered when the joint surfaces are severely damaged, and non-surgical options are ineffective. Joint replacement can alleviate pain, restore joint function, and improve overall quality of life. Finger joint replacements have shown promising results, but long-term outcomes are still being studied.
Tendon Transfer
Tendon transfer surgery may be recommended when arthritis causes tendon rupture or severe joint deformity. In this procedure, a healthy tendon is transferred from another part of the body to restore hand function and improve joint stability.
It is important to consult with a healthcare provider or hand specialist to determine the most appropriate surgical intervention based on individual circumstances.
At-Home Strategies for Managing Arthritis in the Hands
In addition to medical treatments, there are several at-home strategies that can help manage the symptoms of arthritis in the hands and improve overall hand function. These strategies can be incorporated into daily routines to minimize pain and maximize hand mobility.
Heat and Cold Therapy
Using a combination of heat and cold therapy can provide relief for arthritis symptoms. Applying a warm compress or taking a warm shower in the morning can help reduce morning stiffness. Cold packs or ice wrapped in a cloth can be applied to swollen joints after activities to reduce inflammation and numb pain.
Hand Exercises
Engaging in regular hand exercises can help maintain joint flexibility and strengthen the muscles surrounding the affected joints. Simple exercises, such as finger stretches, fist clenching, and thumb opposition movements, can be performed several times a day. A hand therapist or occupational therapist can provide guidance on specific exercises tailored to individual needs.
Assistive Devices
Using assistive devices can make daily activities easier and reduce stress on the joints. There are various assistive devices available, such as jar openers, specialized utensils, and buttonhooks, which can help with gripping and manipulating objects. Occupational therapists can provide recommendations on suitable assistive devices based on individual needs.
Self-Care and Joint Protection
Practicing good self-care and joint protection techniques can help minimize pain and preserve joint function. This includes avoiding repetitive motions and overuse of the hands, maintaining a healthy weight to reduce joint stress, and using proper ergonomics while performing tasks. Taking regular breaks and using adaptive strategies can help prevent further joint damage.
Splinting and Bracing
Wearing splints or braces as recommended by a healthcare professional can provide support and stability to the affected joints. Splints can be worn during activities that exacerbate pain or at night to prevent joint stiffness. It is important to follow the healthcare provider's instructions regarding the type and duration of splint use to prevent muscle atrophy and maximize functional use of the hand.
Anti Inflammatory Diet
Several foods, such as processed goods, foods rich in omega 6 (especially without adequate omega 3 intake) and alcohol can make inflammation worse as such many people find success with following an anti inflammatory diet for arthritis.
Prevention of Arthritis in the Hands
While arthritis cannot be entirely prevented, certain lifestyle measures can help reduce the risk or delay the onset of hand arthritis. These preventive strategies can contribute to overall joint health and well-being.
Maintain a Healthy Weight
Maintaining a healthy weight is crucial for reducing stress on the joints, including those in the hands. Excess weight can accelerate joint degeneration and increase the risk of developing arthritis. Adopting a balanced diet and engaging in regular physical activity can help achieve and maintain a healthy weight.
Regular Exercise
Regular exercise is essential for joint health and overall well-being. Engaging in low-impact exercises, such as swimming, cycling, or walking, can help improve joint flexibility, strengthen muscles, and promote joint stability. It is important to consult with a healthcare professional or physical therapist before starting any exercise program to ensure safety and suitability. We have a list of arthritis excersises here.
Avoid Repetitive Hand Movements
Repetitive hand movements, such as typing or using vibrating tools, can increase the risk of developing hand arthritis. Taking regular breaks, practicing proper ergonomics, and using ergonomic tools can help minimize the strain on the hands and reduce the likelihood of developing arthritis.
Protect Your Hands
Protecting the hands from injuries and trauma is crucial for maintaining joint health. Wearing appropriate protective gear during physical activities or work that involves hand use can help prevent joint damage. It is also important to be cautious when engaging in activities that may put excessive stress on the hands.
Don't Smoke
Smoking has been linked to an increased risk of developing arthritis. Quitting smoking not only benefits overall health but also helps reduce the risk of arthritis and its associated complications.
Regular Health Check-ups
Regular health check-ups, including visits to a primary care physician and rheumatologist, can help detect early signs of arthritis and facilitate prompt treatment. Routine screenings and assessments can help monitor joint health and identify any changes or abnormalities.
While these preventive measures cannot guarantee the prevention of arthritis, they can contribute to overall joint health and reduce the risk or severity of hand arthritis.
Managing Arthritis in Hands
Arthritis in the hands can significantly impact daily life and hinder hand function. Early recognition of the signs and symptoms is crucial for prompt diagnosis and effective management. By understanding the different types of arthritis that can affect the hands, recognizing early signs and symptoms, and exploring various treatment options, individuals can take proactive steps to manage arthritis and improve hand function. Additionally, incorporating at-home strategies, practicing joint protection techniques, and adopting preventive measures can contribute to maintaining joint health and reducing the risk of developing hand arthritis.
