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Several types of arthritis can involve the hands, wrists, and fingers, leading to pain, swelling, and a loss of function. Physical therapy, capsaicin cream, and warm and cold compresses are some of the treatment options.
Osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA) are three types of arthritis that can affect the hands.
In time, these conditions can make it difficult for a person to hold items, write, and carry out daily tasks, such as washing and getting dressed.
In this article, we look at how arthritis affects the hands and what people can do if symptoms develop.
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Different types of arthritis can develop in the hands, including OA, RA, and PsA:
- OA, which people sometimes refer to as “wear and tear” arthritis, results from degenerative changes in the cartilage.
- RA stems from an autoimmune condition that causes inflammation in the joints.
- PsA is linked to psoriasis, an autoimmune condition that triggers skin symptoms.
Post-traumatic arthritis is a type of OA. It can result from an injury.
Learn more about some common types of arthritis here.
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Common symptoms of arthritis include:
- pain with movement or when at rest
- joint swelling, stiffness, and deformity
- weakness in the grip and reduced function
- changes in the shape of the fingers, hands, and wrists
Precise symptoms will depend on the type of arthritis.
OA symptoms
Common symptoms of OA include:
- pain that will be dull and intermittent to start with but may become sharp and constant over time
- pain that worsens with use and improves with rest
- stiffness and reduced motion
- cracking or grinding sensations when moving the joints
- swelling and tenderness
- bony lumps, known as nodes or nodules, at the middle finger joint or near the tip of the finger
- joints that feel hard and knobbly
- loosening and reduced stability in the joints
- changes in the shape of the hands and fingers
- difficulty using the hands, for example, when pinching or gripping things
Symptoms of post-traumatic arthritis will be similar but will affect a joint where an injury has previously occurred.
Is it possible to have a flare-up of OA?
RA symptoms
People with RA in the hands
- pain at the wrist and finger joints
- joints that feel soft and doughy
- swelling and inflammation
- stiffness, especially in the morning, that may last over 1 hour
- reduced motion
- thickening and swelling of the tendons
- changes in the shape of the hands, as persistent inflammation leads to long-term damage
- loss of strength that makes it hard to grip things and easy to drop them
- flu-like symptoms, such as fatigue, fever, and a general feeling of being unwell
Symptoms may come and go. During a flare, they may worsen, but then they can disappear for a while during times of remission.
PsA
Symptoms of PsA in the hands include:
- pain
- inflammation
- dactylitis, which is a sausage-like swelling in the fingers
- changes in skin color
- reduced movement in the joints
Many people with PsA also have psoriasis, which can lead to skin and nail changes.
To reach a diagnosis, a doctor will start by asking an individual about their:
- symptoms
- overall health
- personal and family medical history
To learn more, the doctor may ask the following questions:
- When did the symptoms start?
- What makes them worse?
- What makes the symptoms better?
- Have there been any injuries to the hands recently?
- Are there other symptoms, such as fever, unexplained weight loss, rash, unexplained fatigue, dry eyes, or dry mouth?
The doctor will also perform a physical examination of the hands to identify any unusual changes. They will look for deformities in the hands, such as slightly crooked fingers or distinct nodules.
They may also order imaging tests, such as an X-ray or MRI scan, or perform an ultrasound scan.
Additionally, the doctor may order blood tests to check for inflammation and immune markers. If there is swelling and fluid around a joint, the doctor may remove some fluid to analyze it.
The results of these tests may help determine what type of arthritis a person has.
What do blood tests look for?
The blood tests for RA and PsA will measure various markers, including:
- anti-cyclic citrullinated peptide
- rheumatoid factor
- antinuclear antibodies
- C-reactive protein
- erythrocyte sedimentation rate (ESR)
These can also rule out RA and PsA in people with OA.
Learn more about the differences between OA and PsA and between OA and RA.
Various treatments and home remedies can help manage arthritis of the hands.
The most suitable treatment will depend on the type of the condition. A doctor will help a person develop a treatment plan.
Hand exercises
Exercises can help maintain flexibility in the supportive ligaments and tendons in the hands. They may also help reduce pain.
A doctor may recommend physical therapy, where a specialist will work with an individual to make an exercise plan.
The following exercises may help. People should do them gently and slowly so as not to cause new pain.
- Place the hand flat on a surface, spread the fingers out sideways, and then bring them back together.
- Make a loose fist and open the fingers to fully straighten them, repeating this several times on each hand.
- Holding the hand flat, move out the thumb to the side, bring it back across the palm, then return to the starting point.
- Place the wrist on the edge of a table, with the hand free to hang down. Keeping the fingers relaxed, raise the hand until you feel a stretch, then slowly lower it.
- From the same position, turn the hand so that the thumb faces upward. Raise and lower the hand, as if waving.
It is best to do these exercises using gentle motions. Physical therapists who specialize in hands may be able to recommend exercises as well.
Resting the hands from activities that cause pain and overuse can also help alleviate pain.
Hot and cold therapy
Applying hot and cold packs may help, according to the
Cover a cold pack with a cloth and apply to swollen joints. This may help reduce swelling.
Apply a warm pack to stiff or painful joints or place the hands in a tub of water that is warm but not too hot.
Some products for hot and cold therapy are available for purchase online, including hot and cold packs.
Paraffin wax treatments may help ease stiffness and pain. A doctor can advise on safe and appropriate ways to use this treatment.
Splinting
Splinting and other types of support can help manage pain by holding the joint still.
Options include:
- a protective brace on the hand, which may resemble a fingerless glove
- “sleeve” braces that fit individual fingers
- a kinesiology tape, which is a type of dressing that moves with the fingers
The
People can purchase kinesiology tape and hand orthoses online.
Capsaicin creams
Capsaicin uses a compound from cayenne pepper to alleviate pain. Topical preparations containing capsaicin are available from a pharmacy or for purchase online.
Individuals should avoid using this preparation on broken skin or skin with a cut. They should also avoid touching the eyes after applying it, as it can cause pain and a burning sensation. People may also experience tingling after applying the cream.
The
Depending on the type of arthritis and the severity of a person’s symptoms, a doctor may recommend medication.
Examples include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium
- topical NSAIDs to apply directly to the joint
- other pain relief, such as acetaminophen or duloxetine
- disease-modifying antirheumatic drugs or biologics for treating RA and PsA
- oral steroids or steroid shots to reduce inflammation
In some cases, a doctor may recommend surgery, such as joint fusion and joint replacement.
This will depend on various factors, including the type of arthritis, the extent of any damage, and individual needs and preferences.
A person should discuss all of their options with a doctor to ensure they understand the risks the surgery involves.
It is not always possible to prevent arthritis, but avoiding certain risk factors may offer protection in some cases.
The same precautions may also help slow the progression of arthritis and manage its symptoms if a person already has the condition.
Actions that may help prevent arthritis, depending on its type, include:
- staying active
- reaching or maintaining a moderate weight, as complications due to obesity can increase the risk
- avoiding smoking
- eating an anti-inflammatory diet or antioxidant-rich diet, with a lot of plant-based ingredients
- avoiding unhealthy fats and added sugars, which may contribute to overweight and inflammation
- seeking medical help early if symptoms of issues such as respiratory infections and skin changes occur
- protecting the joints from injury, where possible
Learn whether dietary choices can help manage arthritis here.
Learn some more tips on preventing and managing RA and OA in the hands here.
Different kinds of arthritis can affect the hands and wrists. The symptoms may vary, but they can all cause pain, swelling, and a loss of function.
Anyone who notices symptoms in their finger, hand, or wrist joints that could be a sign of arthritis should seek medical attention.
It is not yet possible to cure arthritis, but early treatment may help relieve symptoms and reduce the long-term impact of the condition.