Osteoarthritis can affect any joint in the body, including the hand. Osteoarthritis of the hand most commonly develops at three sites on the hand -- at the base of the thumb, at the joint closest to the finger tip, and the middle joint of the finger. Early diagnosis and treatment help people with osteoarthritis of the hand manage their symptoms.
Cause of Hand Osteoarthritis
Osteoarthritis is a degenerative joint disease, meaning that the cartilage covering the ends of the bones forming a joint gradually deteriorates. Mechanical wear-and-tear or injury can cause osteoarthritis to develop. When an injury changes the alignment of a joint, it can hasten cartilage damage. The damage is usually visible in hands with enlarged joints and crooked fingers.
Diagnosis of Hand Osteoarthritis
Your doctor will ask questions about your symptoms, including when they began. Your description of pain, stiffness, swelling, and limitations in joint movement will help your doctor assess your condition.
Bony nodules are common visible characteristics with hand osteoarthritis. Small nodules and swellings that develop near the middle joint of the fingers are referred to as Bouchard's nodes. When the nodules are located at the fingertip, they are referred to as Heberden's nodes.
X-ray evidence reveals cartilage loss, bone spurs, and joint damage. What shows up on x-ray might not correlate with the amount of pain and disability you are experiencing. And early osteoarthritis damage may not be detected on x-ray.
Symptoms of Hand Osteoarthritis
Symptoms that are common with hand osteoarthritis include:
- limited range of motion
- bony nodules
- aching at the base of the thumb
It becomes more difficult to grasp objects or make a pinching motion (like picking up a penny). Manual dexterity, fine motor control, and physical function are compromised, making usual daily tasks difficult to perform (such as turning keys, opening doorknobs, writing).
From the physical evidence and x-ray evidence, your doctor will be able to have enough information to detect and diagnose osteoarthritis. There are no blood tests for osteoarthritis. Blood tests would only be ordered to rule out other types of arthritis.
Treatment of Hand Osteoarthritis
Early treatment of hand osteoarthritis is important to prevent irreversible joint damage and progression of the disease. Treatment goals are to relieve pain and improve function. Treatment options for hand osteoarthritis include:
- oral medications (i.e., NSAIDs, analgesics)
- steroid injections
- physical or occupational therapy
Surgery is usually considered a last resort if other conservative treatment options fail. Surgery for hand osteoarthritis includes procedures:
- to remove cysts or excess bony growths
- fuse the joint
- replace the joint
Read more about new treatment guidelines for hand osteoarthritis from EULAR, the European League Against Rheumatism.
Osteoarthritis of the Hand. American Society for Surgery of the Hand. 2006.
Osteoarthritis of the Hand. University of California, San Francisco. Accessed 10/30/2007.