Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis, also known as degenerative arthritis, is the most common form of arthritis and it commonly affects the hands because of their frequent use. Patients can also suffer from an autoimmune condition known as rheumatoid arthritis which causes many of the same symptoms as osteoarthritis in the hand, but has other causes and other systemic effects.
Osteoarthritis of the hand develops as the cartilage protecting the bones of the finger joints wears down. Over time, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. Arthritis of the hand may cause the joints to lose their normal shape and limit their movement. Osteoarthritis occurs more frequently in older individuals; rheumatoid arthritis can have its onset at any age, but is more prevalent as patients reach middle age and beyond.
Risk Factors for Hand Arthritis
Apart from aging, there are several factor that predispose individuals to osteoarthritis of the hand. These include:
- Anatomical abnormalities, such as joint instability or misalignment
- Heavy usage of the hand due to occupation or sports activities
- Traumatic injury
- Genetic tendency
Although some individuals develop osteoarthritis at an early age, most patients suffer its effects as they grow older because of increased wear and tear on their joints. Men are more likely to develop osteoarthritis before age 45 and the disease is more prevalent in women between the ages of 40 and 50. By the time men and women reach the ages of 70 to 80, they seem to be affected equally by the disorder. The reasons for these variations are not yet known.
Risk factors for developing rheumatoid arthritis are unknown, although it is believed there may be a genetic component to the illness.
Symptoms of Hand Arthritis
There are a number of symptoms shared by patients with either osteoarthritis or rheumatoid arthritis of the hand. These symptoms, manifested at the joints of the hand, wrist, and fingers, may include:
- Deep, aching pain
- Stiffness and swelling
- Limited range of motion
- Crepitus, a grinding or grating sensation or sound
- Formation of mucus cysts at the fingertips
- Difficulty using the fingers to grip or turn objects
- Weakness in the hand
Common places for arthritic inflammation to affect the hand are: the joint at the base of the thumb, the joint in the middle of a finger, and the joint of a finger closest to its nail. It is fairly common for bumps to become evident on the arthritic hand. When these appear at the joint close to the nail, they are called Heberden's nodes; when they occur in the middle of the finger, they are called Bouchard's nodes.
Diagnosis of Hand Arthritis
In order to diagnose osteoarthritis, the doctor performs a physical exam and takes a medical history. While certain symptoms of arthritis are easily observable, such as swelling, warmth, deformity, and limited range of motion, diagnostic tests are also used, including X-rays and bone scans.
In addition to showing diminished cartilage between bones, these tests may show bone spurs, often a result of arthritis. Sometimes these imaging tests show that arthritis is present even before the patient becomes symptomatic.
Treatment of Hand Arthritis
Treatment of hand arthritis varies according the cause and severity of the symptoms. Some treatments commonly used to alleviate pain and increase mobility include:
- Heat or cold therapies
- Analgesics (pain relievers)
- Anti-inflammatory medications
- Corticosteroid injections
- A splint to support the affected joint
- Physical therapy exercises to increase mobility
Pain relievers and anti-inflammatories used to treat hand arthritis may be topical or oral, over-the-counter or prescribed, depending on the severity of the patient's condition.
In the most severe cases, Arthroscopic surgery may be necessary to treat osteoarthritis of the hand. Such surgery may involve joint reconstruction, in which damaged tissue is replaced, or joint fusion, during which two or more bones are surgically joined. In severe cases, surgery may be required to smooth irregular tissue surfaces, or to reposition or replace joints through arthroscopy.
Where rheumatoid arthritis is the cause of the disorder, medications called biologics may be prescribed, but these can have serious side effects. Alternative treatments for either type of arthritis may also be employed, including, but not limited to, acupuncture.