Roughly a quarter of American adults have arthritis, an inflammatory condition that progressively degrades the cartilage that protects your bones from rubbing against each other in your joints. Over time, the bones wear away, causing pain, stiffness, and limited mobility in the joints. There are several types of arthritis that can affect the hand, including osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.
Osteoarthritis is the most prevalent type of arthritis in the hand, usually affecting the joints at the base of the thumb, the knuckles, and the joints at the end of the fingers. This form of arthritis occurs when the cartilage that cushions the joints wears down, leading to bone-on-bone contact and the development of bone spurs in the finger joints. Rheumatoid arthritis and psoriatic arthritis are chronic autoimmune diseases that cause the joint lining, or synovium, to swell. Whereas rheumatoid arthritis usually occurs symmetrically in both hands, psoriatic arthritis may only affect a few fingers.
Treatment approaches for hand arthritis depend on the severity of the condition and the patient’s individual needs. Conservative measures such as rest, ice, heat, and physical therapy may be effective for mild cases of hand arthritis. For more severe cases, surgery may be necessary to alleviate pain and restore mobility.
Hand Arthritis Symptoms
Early symptoms of arthritis in the hand can include a dull ache or burning sensation in the joint, swelling, and stiffness, especially in the morning. Over time, arthritis symptoms in the hand tend to progress, leading to sharp pains, loss of hand function, a grating sensation when bending the fingers, and enlarged or deformed joints.
Hand Arthritis Diagnosis
Our hand surgeons diagnose arthritis in the hand with X-rays and blood tests. On an X-ray, your doctor will look for signs of bone cartilage loss and the formation of bone spurs in the hand. Blood tests can help determine if your arthritis is caused by rheumatoid arthritis versus other conditions.
Non-Surgical Treatment Options for Arthritis of the Hand
When you meet with your hand surgeon, you will discuss a variety of treatment options for your hand arthritis. Our goal is to decrease your joint discomfort and improve overall hand function. Your surgeon may recommend a variety of treatment options, ranging from at-home treatments to surgery:
- Splinting and Braces: Wearing a splint or brace helps you protect the joint with added stability. A brace can also keep your hand in a good position for joint alignment, which can alleviate pain and discomfort.
- Over-the-Counter Medication: Acetaminophen can help relieve pain, and Ibuprofen may help relieve pain while reducing swelling in the affected joints. Topical non-steroidal anti-inflammatory drugs are often used to treat osteoarthritis symptoms in the hand.
- Corticosteroids: Oral or injected steroid medications can help reduce inflammation in the affected joints.
- Fat Grafting: Fat injections into the affected joints can help relieve symptoms of osteoarthritis. We perform this procedure in our clinic under a local anesthetic.
- Antirheumatic Drugs: Patients with rheumatoid arthritis may get relief from symptoms after taking an antirheumatic drug, such as methotrexate, hydroxychloroquine, or sulfasalazine.
- Hot and Cold Compresses: Applying hot and cold compresses for 20 minutes at a time can help alleviate pain, swelling, and stiffness in the joints.
- Rest: Resting the affected joints will reduce inflammation and can alleviate pain.
- Hand Therapy: Working with a hand therapist can help you strengthen and stretch muscles in your hand to improve symptoms and overall hand function.
Hand Surgery for Arthritis
If non-surgical approaches aren’t effective, then your hand surgeon may recommend surgery. Based on your symptoms, type of arthritis, affected joints, and anatomy, we have two main surgical approaches to choose from:
Joint Fusion (Arthrodesis): Arthrodesis, or joint fusion surgery, is a common procedure for treating hand arthritis. We use a plate and screws to keep the joint in place, improving joint stability while reducing pain and discomfort. Joint fusion surgery is commonly used to treat arthritis in the base of the thumb, the distal interphalangeal joints, and the proximal interphalangeal joints. Fused joints are stronger and pain-free, but have very little flexibility and a limited range of motion.
Joint Replacement (Arthroplasty): Arthroplasty, or joint replacement surgery, involves removing the damaged joint and implanting a new artificial one in its place. These implants are usually made out of silicone rubber material. Arthroplasty is often used to treat arthritis of the proximal interphalangeal joints and the metacarpophalangeal joints, also called the knuckles.
Arthritis hand surgeries are typically performed on an outpatient basis at our ambulatory surgery center in Flagstaff, AZ. The procedures are usually done under local anesthesia or a nerve block. You can go home on the day of the procedure. After the surgery, we may ask you to follow up with a hand therapist to continue to strengthen the hand and alleviate symptoms. You may need to wear a cast or splint to limit movement in the hand after your procedure to promote healing. Most patients can resume everyday activities within a few months of joint reconstruction surgery.
Medical Review: This procedural information has been medically reviewed by plastic and reconstructive surgeon, Brian A. Cripe, M.D.