Hand Arthritis

What Is Hand Arthritis?

Arthritis is a condition that affects the hand joints. It primarily targets the tissues of the joints, which are the points where two bones meet, and the cartilage, which is the smooth covering at the ends of bones. The cartilage may degrade over time, causing the bones to rub against each other and lead to symptoms such as joint pain, inflammation, and stiffness.

Types of Hand Arthritis

Osteoarthritis

This is the most common type, often resulting from the wear and tear of cartilage in the joints over time. This condition, affecting about half of all women and a quarter of all men by age 85, leads to symptoms such as joint pain during activities like writing, typing, or grasping, as well as swelling, tenderness, and a grating sensation in the joints​​.

Rheumatoid Arthritis

This chronic autoimmune disease targets the hand and finger joints, leading to inflammation and damage. It arises when the body’s immune system mistakenly attacks the lining of the joints, causing symptoms that include joint pain, stiffness, swelling, and weakened hand muscles, which can impair grip strength and hinder daily activities​​.

Psoriatic Arthritis

Associated with individuals who have psoriasis, psoriatic arthritis is an inflammatory condition. It presents symptoms like joint pain, swelling, stiffness in the fingers or wrists, and changes in nail appearance, such as pitting, yellowing, or separation from the nail bed. This condition arises from an immune response against skin cells, which can also affect the joints.

Causes and Risk Factors

The development of hand arthritis can be attributed to various factors that include:

• Age: The risk increases with age, particularly for osteoarthritis. Cartilage in the hand joints may wear down over time, causing pain, stiffness and reduced hand function.
• Gender: Women are more likely to develop certain types of arthritis.
• Genetics: Inherited genes can increase susceptibility to arthritis, particularly osteoarthritis. Studies suggest that A2BP1 and TBGF1 genes may play a role in causing hand osteoarthritis.
• Previous Hand Injuries: Injuries such as fractures or dislocations can lead to posttraumatic arthritis. This is because misalignment caused by injuries may add extra pressure or stress to the joints.
• Repetitive Movements: Jobs or activities involving repetitive hand movements heighten the risk of osteoarthritis.
• Weight: Being overweight puts additional stress on the joints, potentially leading to arthritis.
• Smoking: Increases the risk of developing arthritis.

Non-Surgical Treatment Options

Non-surgical treatments for hand arthritis aim to relieve symptoms and improve joint function.

• Medications
  Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen are often prescribed to alleviate pain and reduce inflammation. For rheumatoid arthritis, disease-modifying antirheumatic drugs (DMARDs) and biologics are used to slow disease progression by targeting the underlying autoimmune processes.
• Splinting
  Wearing splints can immobilize and support arthritic joints, especially during painful episodes. It helps reduce strain and pain.
• Activity Modification
  Adjust daily activities and hand usage to minimise joint stress. This might include using adaptive tools for tasks like writing or opening jars.
• Injections
  Corticosteroid injections into the joint can provide pain relief and reduce inflammation. The number of injections is often limited due to potential side effects over time.
• Hand Therapy
  Exercises can be conducted to strengthen the muscles around the joints, improve hand function, and reduce pain. These are often tailored to individual needs and conditions.
• Heat and Ice
  Applying heat can help loosen stiff joints, while cold packs can reduce swelling and numb pain.

Surgical Treatment Options

When non-surgical treatments are insufficient, surgical options may be considered. The choice of surgery depends on individual needs, the extent of joint damage, and personal goals.

Joint Fusion (Arthrodesis)

In this procedure, the bones of the affected joint are fused, eliminating the joint to provide pain relief. While it leads to a loss of flexibility, it offers stability and is often used for severely affected joints.

Joint Replacement (Arthroplasty)

This involves replacing the arthritic joint with an artificial one made of materials like metal or plastic. It aims to retain or improve joint function and reduce pain.

Tendon Transfer

If tendons are damaged due to arthritis, a healthy tendon may be redirected to improve hand function. This is especially relevant in cases where tendon function is necessary for hand movements.