Hand Osteoarthritis

Expert Hand Surgeons in Orange County, CA

Osteoarthritis is the “wear and tear” form of arthritis when the protective cartilage cushioning the joints breaks down and wears away. Over time, this causes the bones to rub against each other which can trigger pain, swelling and inflammation of the joint. Osteoarthritis of the hands typically affects the base of the thumb where it meets your wrist, the joints closest to the fingertips, and the middle joint of the fingers. It’s more common in women than men, and about half of women and one-quarter of all men will experience the pain and stiffness of hand osteoarthritis by age 85. Although the condition isn’t curable, there are plenty of ways to protect your joints and stop the progression of osteoarthritis. For that reason, it’s important to see a hand surgeon in order to be properly diagnosed and seek proper treatment as soon as possible.

Hand Osteoarthritis Symptoms

Osteoarthritis of the hand becomes increasingly painful until daily activities become difficult from stiffness and inflammation in the hands. Along with cartilage loss, hand osteoarthritis causes bone spurs to form which can increase joint pain.

The hallmark symptoms of hand osteoarthritis include:

• Pain: Initially, pain caused by osteoarthritis of the hand will be intermittent. It worsens with use and eases with rest. It is typical for pain to be worse in the morning due to more stiffness through the night. As osteoarthritis advances, the pain becomes constant and may worsen from a dull ache to a sharp pain. Some have difficulty sleeping due to the pain.
• Joint deformity: Fingers can swell and the joint becomes large and misshapen from bone changes, cartilage breakdown, and unstable or loose ligaments. Bony lumps can begin to form at the middle joint of the finger or at the joints nearest the fingertips.
• Clicking and cracking (crepitus): You may feel grinding or hear clicking and cracking sensations, due to the damaged joint surfaces rubbing together. This is also referred to as crepitus.
• Swelling and redness: Inflammation around the joint is a natural response to the constant irritation and damage to the tissues surrounding the joint. You body may respond to this constant irritation and tissue damage to the tissues surrounding the joint by becoming swollen, red and tender to the touch.
• Stiffness and weakness: A gradual loss of motion occurs with untreated osteoarthritis, until activities such as lifting heavy objects, starting your car, opening jars, or buttoning a shirt become difficult because the fingers can no longer open and close completely. The combination of loss of motion and joint deformity can leave your hands weak.

Hand Osteoarthritis Diagnosis

You may have hand osteoarthritis if your symptoms flare-up due to changes in weather, such as humidity and barometric pressure. Also, the time of day can play a role, as stiffness tends to be worse in the morning.

Your doctor will take a complete medical history, as osteoarthritis can run in families. During a physical examination, your doctor will look at your hands and observe how they function. X-rays will confirm a diagnosis by showing loss of space in the joints, indicating cartilage loss, and the formation of bone spurs.

Nonsurgical Hand Osteoarthritis Treatment

The following treatments can improve symptoms of hand osteoarthritis:

• Pain Medication: Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can ease pain and swelling. Medicated creams or gels with nonsteroidal anti-inflammatory drugs can give relief when rubbing them on sore joints.
• Cortisone Shots: Cortisone injections into the joints can provide temporary relief for a few weeks or months, but this treatment can only be administered a certain number of times due to negative side effects such as infection and weakened ligaments.
• Immobilizing devices: Your doctor may prescribe a splint, brace, or sleeve so your hand stays in a more stable position, which can decrease pain.
• Hand therapy: Physical therapists who specialize in the hands can help you with exercises that can make your hands more functional and less painful. You can perform these exercises at home to improve strength and range of motion.
• Assistive devices: You can use assistive devices such as special pens, kitchen utensils or other tools with bigger gripping areas.
• Ice or heat: Icing the fingers can reduce swelling or pain, and applying heart can loosen stiff joints.
• Supplements: You may find some relief taking glucosamine and chondroitin. Be sure to consult your doctor before taking these supplements.

Surgical treatment for Hand Osteoarthritis

Surgery may become an option if medication or lifestyle habits fail to give you adequate relief. An orthopedic hand surgeon may recommend hand joint fusion, which involves removing the damaged cartilage and fusing the joints together. While you’ll have less pain, you won’t be able to move the fingers in the same way as before.

Finger or wrist joint replacement is another option involving surgical removal of the damaged cartilage and bony surfaces of the joint and replacing them with artificial protheses typically made of metal and plastic.

Surgery is not a cure for hand osteoarthritis and even with surgery some symptoms may remain or it is possible for new symptoms to occur. Your hand surgeon will discuss the risks and benefits of surgery specific to each individual case.

Do you have hand osteoarthritis?
Call Newport Orthopedic Institute at (949) 722-7038.

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