Hand Arthritis

Arthritis is a chronic condition that causes inflammation and pain affecting the joints where two bones meet, such as the elbow, knee or hand. Hand arthritis affects the joints in the hands, leading to pain, stiffness and swelling with movement. Because the hand and wrist have many small joints that work together, hand arthritis can make daily activities painful and difficult. Regular tasks like typing, gripping objects and opening jars become more challenging due to hand arthritis.

Hand arthritis is commonly caused by age, as the cartilage in our joints wears down gradually over time. Overuse, repetitive motions, heavy lifting, obesity and smoking can also contribute to arthritis.

Certain medical conditions, such as gout, rheumatoid arthritis, lupus and psoriatic arthritis, can also lead to hand arthritis.

General risk factors for hand arthritis include age, obesity, previous hand injuries, family history, activities, occupation and overuse of the hand muscles and joints. Individuals with other conditions, such as lupus, gout and psoriatic arthritis, are at higher risk for developing hand arthritis.

Because some forms of hand arthritis are genetic or a result of other health conditions, hand arthritis cannot always be prevented. However, the following steps can reduce risk or help to manage symptoms:

• Using devices, furniture and tools designed to reduce strain on the hand muscles and joints can prevent hand arthritis and manage symptoms. 
• Regular and specific hand-strengthening exercises and stretches can prevent hand arthritis or manage pain and swelling. 
• Maintaining a healthy diet and weight reduces the risk of arthritis. Eating an anti-inflammatory diet with plenty of fresh fruits and vegetables has been shown to reduce risk. 
• Giving your hands plenty of rest from overuse can prevent flare-ups, swelling and pain.

General pain, swelling, weakness and stiffness in the hands and fingers are all symptoms of hand arthritis. Symptoms depend on the type of arthritis and its severity, so work with your doctor to obtain an accurate diagnosis.

Other symptoms include: 

• Crooked, twisted fingers or bumps and nodes on the joints
• Difficulty with fine motor skills
• Visible swelling in the joints, sometimes accompanied by warmth and redness
• Morning stiffness, or stiffness following certain activities
• Weakness in the muscles of the hands leading to difficulty gripping or holding objects
• Grinding or creaking sounds when moving the joints

Hand arthritis is typically diagnosed through a physical examination and medical history review. The experts at the Montefiore Einstein Department of Physical Medicine and Rehabilitation may diagnose your condition using ultrasound, X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) scans to examine the hand’s joint structure, soft tissues, cartilage and tendons.

During the physical exam, your provider will look for signs of pain and tenderness when the hand and fingers are moved in specific ways. They will examine your hands closely, looking for swelling, tenderness, deformities (like bumps or changes in joint shape), reduced range of motion, muscle weakness and creaking or grinding sounds.

Your doctor will create a personalized treatment plan for you based on the type of arthritis and the severity of your symptoms. The most common treatment options include the following: 

• Medications, including over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen
• Prescription or over-the-counter creams that provide pain relief
• Corticosteroid injections that reduce inflammation and pain
• Prescribed medications, like disease-modifying antirheumatic drugs (DMARDs), which can slow the disease’s progression
• Physical therapy that incorporates hand exercises along with splints or braces

In severe cases, your doctor may suggest surgery for joint replacement, tendon or ligament repair or arthrodesis, a procedure that fuses the joint to alleviate pain and enhance stability. 

Though not all forms of hand arthritis can be prevented, symptoms typically improve with treatment and rest. If the condition is exacerbated by overuse, a change in work habits or hobbies may be needed to prevent flare-ups. Many also experience relief by making lifestyle changes, including more exercise and maintaining a healthy anti-inflammatory diet.