Arthritis in the knuckles may cause pain, swelling, weakness, and stiffness. Nonsurgical treatment options include wrist braces and exercises. Severe cases may require surgical measures such as joint replacement.

This article will review what types of arthritis affect the hands and knuckles and common symptoms. We also look at risk factors for the condition, diagnosis, and treatment options.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Hand arthritis can affect joints in the fingers, particularly the knuckle, as well as the wrist.

Arthritis is more common in older individuals and females. Around half of all females and one-quarter of all females will experience arthritis in their hands by age 85.

Arthritis is a broad term for the disease of different joints throughout the body. In total, there are over 100 different types of arthritis. We discuss some of the more common types below.

Osteoarthritis

The most common type of arthritis is osteoarthritis (OA). This form of arthritis affects over 54 million people across the United States. OA involves the breakdown of cartilage. This rubbery substance protects the ends of bones where they meet in healthy joints.

Alongside the hands, this type of arthritis can occur in the following areas:

  • hips
  • knees
  • lower back and neck

OA often affects three main areas of the hand:

  • the base of the thumb
  • the joints closest to the fingertips
  • the fingers’ middle joints

OA typically occurs in response to wear and tear of particular joints. This could happen from overstressing a joint through a physically demanding job or a sport.

Rheumatoid arthritis

Another type of arthritis that can affect the hands and knuckles is rheumatoid arthritis (RA). In this form of arthritis, joint inflammation degrades cartilage over time.

In the hands, RA can affect the finger joints and wrists and result in swelling. It can cause hand and wrist deformities. For example, RA can cause the fingers to shift toward the pinky finger. It can also reduce both mobility and sensation in the fingers.

People with RA may also exhibit inflammation in tissues throughout the body. They may experience:

People with a family history of RA may be at higher risk of developing this form of arthritis. Other risk factors include:

Other forms of arthritis

Individuals under the age of 16 may develop juvenile arthritis (JA). This form of arthritis can cause stiffness and pain in joints throughout the body. Researchers today consider JA an autoimmune condition.

Children with JA may develop a rash around affected areas. They may also have:

  • decreased appetite
  • eye inflammation
  • fever

Certain genes may cause JA if activated by a virus, bacteria, or other external factors.

Psoriatic arthritis (PsA) can also affect the fingers, but this form of arthritis generally develops after age 30. Like JA, PsA is an autoimmune condition. It can cause swelling in the fingers. In some cases, people with PsA also develop nail deformities.

Psoriatic arthritis can also involve itchy and painful rashes across the body. It can lead to:

The symptoms of arthritis vary according to the individual and the type of arthritis at play. But most people with arthritis in the hands and knuckles will experience a few common symptoms. Let’s review these now.

What does it feel like?

Several common symptoms of arthritis in the knuckles include:

  • pain around the joints
  • limited range of motion
  • stiffness and swelling around the affected joints
  • bone spurs
  • grinding or cracking sensations
  • joint deformity
  • nodules or knots around the finger joints
  • cysts around finger joints or wrists

Frequency and severity of symptoms

The symptoms of OA tend to worsen over time. As cartilage continues to degrade, pain and stiffness become more severe. In advanced cases, people with OA may be unable to work or perform daily activities.

On the other hand, RA symptoms fluctuate over time. During RA flares, symptoms worsen. People with RA also experience remissions where they may have few or no RA symptoms.

This is similar to JA, which also involves flares and remissions. However, JA can cause permanent joint damage. This damage could cause long-term discomfort as well as other symptoms.

PsA symptoms vary widely between individuals. Some may experience mild symptoms, whereas others may experience severe ones that affect many joints. A sudden onset of symptoms, or flare, can last from days to months.

A person should consult a doctor to discuss the characteristics of their symptoms to receive a suitable diagnosis and treatment.

Certain people are more likely to experience arthritis in the hands and knuckles. Some of the most common risk factors include:

People with a family history of arthritis are also at a higher risk of developing it themselves. Certain genes can increase the risk of developing arthritis and worsen symptoms.

Some bacterial and viral infections can also lead to arthritis. Joint injuries or repetitive joint strain likewise increase the chance of developing arthritis.

Individuals experiencing symptoms of hand and knuckle arthritis should visit a medical professional.

During an evaluation, a doctor will review the knuckle symptoms and how long they have been present.

They will take a family history to determine whether an individual is at higher risk of arthritis. Additionally, they will review overall health and daily habits or self-care practices.

During a physical exam, a doctor can determine the range of motion and examine the hand. If the physical exam indicates arthritis, a doctor may prescribe further testing. This can include lab tests, which may help identify markers for certain types of arthritis.

X-rays may also help diagnose arthritis. These scans can help show irregularities around affected joints. Changes in joint shape, or reduction in the space between joints, can indicate arthritis.

Doctors do not routinely use MRI and musculoskeletal ultrasounds to evaluate people with joint pains. However, both tests are more sensitive than regular X-rays in detecting inflammation. A doctor may use these if the diagnosis is uncertain or if standard X-rays show no issues.

There are various options for treating arthritis in the hands and knuckles. Some may include nonsurgical options such as:

Topical pain medications may also help treat hand arthritis. In a 2018 study, researchers analyzed topical capsaicin for reducing osteoarthritis symptoms. They found that topical capsaicin can help reduce OA symptoms with few, if any, side effects.

For individuals with autoimmune disease — for example, RA or PsA — as a cause of arthritis, treatment may involve immunosuppressants, such as disease-modifying antirheumatic drugs (DMARDs).

A person should discuss all possible options before starting any treatments.

Alongside conservative measures, alternative options may also relieve symptoms, including:

In some cases, a doctor may recommend surgery to treat arthritis of the hand. During this procedure, a surgeon can replace joints in the knuckles — through arthroplasty. These plastic or metal artificial joints allow bones around the joint to move with minimal or no pain.

Surgeons usually use arthroplasty to repair the knuckles at the base of the fingers. In most cases, joint replacement relieves pain and restores some mobility.

However, there is a risk of the symptoms returning as surgeons may have difficulty obtaining enough soft tissue to reconstruct around the implant.

A person should discuss the possible benefits and risks of surgical procedures.

Arthritis in the knuckles causes symptoms that range from pain and swelling to changes in finger shape. A person may also have issues bending fingers and a limited range of motion.

There are many different types of arthritis, but OA is the most common type in the hands. Treatments include NSAIDs, steroid injections, and, in some cases, surgical joint replacement.

People may also try home remedies and alternative treatments, such as acupuncture, but they should discuss their options with a doctor first.