Arthritis in the hands, most commonly osteoarthritis, feels painful, with stiff and swollen joints. There are many forms of arthritis that can affect the hands, including rheumatoid arthritis and psoriatic arthritis. 

Osteoarthritis is more common in older adults and often is thought of as a result of wear and tear. Osteoarthritis often affects the thumb — down to the first thumb joint near the wrist — and knuckles of the fingers. Arthritis of the thumb is also called basal joint arthritis.

Arthritis pain is caused by inflammation around the joints as the cartilage on the ends of bones wears away. In the hands, this cartilage allows fingers to move smoothly and perform fine motor skills like tying shoelaces.

Some of the first symptoms of arthritis in the hands can include dull or burning joint pain following a period of increased work or other physical activity with the hands. As arthritis worsens in the hands, once-simple daily activities, such as opening a jar or threading a needle, become difficult and painful.

Treating arthritis in the hands tends to focus on relieving symptoms, but emerging treatments include surgery that may provide longer-term pain relief and increased mobility in the hands.

Types of Arthritis in the Hands

Osteoarthritis can develop because of age and wear and tear, including sports that put stress on the joints. Having a family history of osteoarthritis also increases risk for the disease. As the cartilage in your joints wears away, the ends of the bones rub on one another without protection. The result is pain, stiffness and eventually, restricted movement in the affected joint.

In the hands, this means stiff fingers and thumbs, frequently starting at the very base of the thumb, near the wrist.

Rheumatoid arthritis is a chronic autoimmune disease in which your immune system attacks healthy tissue such as the lining of the joints. As the lining swells, the joints become painful and stiff. As the cartilage is destroyed in the joints, the bone itself wears away, and soft tissues in the fingers and hands weaken and stretch causing a deformed appearance. Small joints like those in the hands, wrists and fingers are particularly susceptible to the effects of rheumatoid arthritis.

Psoriatic arthritis affects the skin and joints, and its symptoms are very similar to other forms of arthritis. Severe swelling of the fingers and toes is common with psoriatic arthritis.

Risk Factors for Hand Arthritis

While wear and tear of the finger joints, wrists and other parts of the hand is normal with age, there are some risk factors that may increase your chances of developing arthritis in the hands, including:

• Family history of certain types of arthritis. You may be more likely to develop arthritis if your parents or siblings have the condition.
• Age increases the risk for many types of arthritis, such as osteoarthritis, rheumatoid arthritis and gout.
• Gender, as women are more likely than men to develop rheumatoid arthritis. Other types of arthritis, such as gout, are more common in men. 
• Joint injury from activities, such as playing sports, can make you more likely to develop arthritis in that joint. 
• Repetitive motion from work also can increase joint pain and eventually result in arthritis. Examples of repetitive-motion work are assembly lines or typing.

Treating Arthritis in the Hands

Arthritis treatment focuses on relieving symptoms and improving joint function. You may need to try several different treatments, or combinations of treatments, before you determine what works best for you.

Medications

The medications used to treat arthritis vary, depending on the type and severity of your arthritis. Commonly used arthritis medications include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), which can relieve joint pain and reduce inflammation. Some commonly used NSAIDs are ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). 
• Some varieties of creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy, and may disrupt the pain signals from the joint itself. These are called counterirritants and are rubbed into the skin around the affected joint.
• Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Corticosteroids may be given as a pill or as an injection into the affected joint. 
• Disease-modifying antirheumatic drugs (DMARDs) may slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. 

Therapy

Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. Braces or splints may support the joint and promote proper alignment. Working with your medical provider, you’ll find the right balance of when and how often to wear a brace, and when wearing a brace too much can cause your muscles to atrophy.

Surgery

When nonsurgical approaches don’t provide the pain relief you need, arthritis in the hands can be treated surgically by fusing joints together to reduce pain (with the trade-off being limited mobility). 

Ligament reconstruction and tendon interposition (LRTI) is a surgical procedure used to treat severe arthritis at the base of the thumb, in the basal joint. This long has been considered the gold standard for basal thumb arthritis. The surgeon removes one of the small bones of the hand, the trapezium. A tendon, usually from the forearm, is threaded through the bone, and the excess tendon is rolled into a cushion between the bones. This procedure may have a long recovery, and side effects may include a shortening of the thumb and changes to the overall appearance of the hand, as well as a change in pinch strength.

The BioPro Modular Thumb Implant procedure replaces the entire basal thumb joint. A new socket is formed with the trapezium. This surgery maintains the length and appearance of the thumb and improves pinch and grip strength. Recovery may be up to 10 weeks faster than traditional LRTI. 

Norton Hand & Arm Institute is the only provider in the region to offer the BioPro Modular Thumb procedure.