Hand Arthritis

What is hand arthritis?

Hand arthritis is a condition where the tissue between your joints that lets your hand move smoothy begins to become inflamed and break down. The hands may start to warp or bend at painful angles, which makes it hard for normal function. Arthritis can occur between any joints but is most common in the hands.

What causes hand arthritis?

The most common causes of arthritis in the hand include:

• Osteoarthritis – the gradual wear and tear of the joints and cartilage over time.
• Rheumatoid arthritis – a chronic autoimmune disease that causes the joint lining to swell, producing pain and stiffness of the joint.
• Trauma – fractures and dislocations that occur in the hand are among the most common injuries that lead to posttraumatic arthritis.

What are symptoms of hand arthritis?

The most common symptoms of hand arthritis include:

• Pain – Joint pain that feels dull or burning or pain that occurs after periods of increased joint use, such as heavy gripping.
• Swelling – swelling during or several hours after heavy use of the hands.
• Changes in surrounding joints – Surrounding joints may become more mobile than normal.
• Warmth – The affected joint may feel warm to the touch due to the body’s inflammatory response.
• Crepitus and Looseness – There may be a sensation or sound of grating or grinding in the affected joint caused by damaged cartilage surfaces rubbing against one another.
  • If arthritis is due to damaged ligaments, the support structures may be unstable or loose.
  • The joint may appear larger than normal due to bone changes, loss of cartilage, and joint swelling.

• Cysts – When arthritis affects the ends of the fingers, small cysts may develop. These cysts may cause ridging or dents in the nail plate of the affected finger. Ruptured cysts can become infected.

How is hand arthritis diagnosed and treated?

Your provider will perform a physical examination and review previous medical history. They will also use specialized tests, such as X-ray or MRI to diagnose the severity of arthritis. Your provider may recommend nonsurgical options to treat the arthritis before recommending surgery. Possible treatment options include:

• Medication – can treat symptoms but can’t restore joint cartilage or reverse joint damage.
• Splinting – the affected joint can be splinted to limit motion and reduce pain. The splint supports the affected joint to ease the stress put on it and aid it through frequent use and activity.
• Activity modification 
• Injections
• Ice/heat

If nonsurgical treatment fails to provide relief, your provider may recommend surgical treatment. Your provider will work with you to discuss the different types of surgical treatment. This should be one that has a reasonable chance of providing long-term pain relief and return to function. The recommend surgical treatment options include:

• Joint fusion – joint fusions provide pain relief but stop joint motion. This procedure includes fusing the two joints of the affected finger together to stop the rubbing and irritation caused by the joint. Because there is no longer a joint, motion is no longer possible in that joint.
• Joint replacement – joint replacements help to provide pain relief and maintain function. The replacement is made of materials such as ceramics or long-wearing metal and plastic parts. The goal of these materials is to improve the function and longevity of the replaced joint.

Recovery will vary depending on the severity of arthritis and the type of surgery performed. However, people can usually return to most, if not all their normal activities in about 3 months. You may need a postoperative splint for the duration after surgery to protect the hand while it heals. During this postoperative period, your provider may recommend physical therapy, activity modification, and pain medication to assist you in recovery. It is important to follow your provider’s instructions to ensure proper recovery.

What are risks of hand arthritis surgery?

As with any surgery, there are certain risks associated with treating arthritis of the hand. Risks will vary depending on your course of treatment, but common risks include:

• Bleeding
• Infection
• Blood clotting
• Nerve injury
• Failure of joints to fuse
• Long-term pain