Treating Arthritis of the Hands

If you’ve experienced pain, stiffness, and decreased range of motion in your hands, there’s a good chance arthritis may be to blame. Over 91 million* U.S. adults experience some type of arthritis by the time they reach age 85.

According to Dr. David Veltre of SVMC Orthopedics and Northern Berkshire Orthopedics, “Arthritis of the hands is particularly frustrating as we rely on our hands to help with so many daily tasks. From brushing our teeth and buttoning a shirt to turning a door knob and picking up a ringing phone, our hands are especially key to allowing older adults to maintain their independence.”

Common types of arthritis of the hands

While there are over 100 types of arthritis, the types that most typically affect the hands are osteoarthritis, Rheumatoid arthritis, and trauma-induced arthritis.

“Osteoarthritis (OA) is far and away the most common type we see,” says Veltre. Often referred to as ‘wear and tear’ arthritis, he notes it occurs when, “The smooth layer of cartilage on the end of your bones that cushions your joints and helps them to slide easily against one another, gets worn down. The resulting bone-on-bone contact causes the inflammation that contributes to the pain and stiffness of arthritis.”

Veltre adds that OA of the hand most often happens where the thumb meets the hand at the base of the wrist, in one of the top joints of the fingers, or in the middle joint of the fingers.

“Without treatment,” he says, “OA gets worse over time which is why it’s important to get a diagnosis and a treatment plan as soon as possible.”

Unlike OA which is due to physical changes in the cartilage, Rheumatoid Arthritis (RA) is the result of an autoimmune condition.

“RA occurs when the body’s immune system attacks healthy tissue that protects the joints,” says Veltre. “While the cause of RA is not clear, it is believed to involve a combination of genetic and environmental factors and most often occurs between the ages of 40 and 60 but even children may develop it.”

Veltre also treats patients experiencing post-traumatic arthritis in the hands. “This occurs after a person has damaged their hands, sometimes many years earlier, often through a sport-related injury, a fall, or an accident. Injuries like these can damage the cartilage or the bones of the hand and change the mechanics of how the various joints work. The altered structure often makes joints wear out more quickly than normal.”

The signs and symptoms of arthritis

While the cause of OA, RA, and post-traumatic arthritis are different, the symptoms can be very similar.

They include:

- dull burning pain in joints with movement or at rest

- joint swelling 

- joint stiffness

- joint deformity

- warmth in the joints

- grinding in the joints

- limited range of motion

- reduced strength

“In most cases, once you develop symptoms of arthritis they worsen over time,” says Veltre. “Certain ‘triggers,’ like cold weather, stress, changes in barometric pressure, and repetitive motion can make symptoms worse.” He adds, "There's no cure, but there are a lot of ways to protect your joints and feel better. The first step begins with diagnosis.”

Diagnosing and treating arthritis of the hand

Diagnosing arthritis often involves a combination of patient history, physical examination, X-ray or MRI results, and, if your doctor suspects rheumatoid arthritis, a blood test may be ordered. Understanding when your symptoms started, what makes them worse, and what makes them better will help with the diagnosis.

Veltre notes, “In the earliest stages, patients have a lot of success with over-the-counter medications, non-steroidal anti-inflammatory gels and cream, and splinting during times of overuse or at night if night-pain is an issue.”

He also notes that some patients find relief applying ice or heat to the affected joint. “Hand therapy with a certified hand therapist can also help patients regain strength and mobility.”

Veltre adds, “Again, there is no cure for arthritis. The noted treatments can provide relief but as the condition progresses, they may become less effective.” In those instances, cortisone injections may be prescribed. “For some patients, injections can provide relieve for weeks or even months. But they do have side effects, such as weakened ligaments, so they’re not a long-term solution. As a last resort, surgery to fuse or replace the joint may be considered. It all depends which joint is impacted. Regardless of the treatment prescribed, the goal is always to help patients regain or retain as much use of their hands as possible and maintain their independence.”

To learn more about treatment options offered through SVMC Orthopedics, visit svhealthcare.org/ortho or call 802-442-6314.