What to know about hand osteoarthritis

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According to the Arthritis Foundation (AF), around 50% of women and 25% of men will experience OA in their hands by the age of 85.

While everyone’s joints go through cycles of damage and repair, a person with hand OA often has changes to the joints that make repairs difficult or ineffective. This leads to the eventual breakdown of the joint.

As the joint breaks down, a person may experience pain, stiffness, and swelling. This can affect mobility and limit daily activities.

OA can affect any of the small joints of the hands and fingers. However, it is common in the following joints:

• the base of the thumb
• the middle joint of a finger
• joint closest to the fingertip

Hand OA can cause a breakdown of the cartilage of the joints. Cartilage covers and protects the ends of bones and allows them to glide smoothly across each other. When cartilage breaks down, bones rub together, causing pain and inflammation.

OA can also cause bone spurs, which are bony outgrowths resulting from damage to the bone. Heberden’s nodes develop on the joint closest to the fingertip, and Bouchard’s nodes develop on the knuckle joint. Bony spurs can cause additional stiffness and pain. The fingers may also start to lose their normal shape.

Some common symptoms include:

• pain ranging from dull to sharp, which may start sporadically and become increasingly constant
• crepitus, which is a clicking or snapping sound when the joints move
• stiffness
• reduced range of motion
• weakness
• joint deformity
• swelling
• nodule formation
• joint tenderness, swelling, and warmth to the touch

Hand OA can affect many aspects of daily life. It can make simple tasks seem harder, such as:

• zipping a coat or bag
• using buttons
• opening cans, jars, or bottles
• typing
• using a pen, utensils, or other small objects

People with OA may develop calcium pyrophosphate deposition disease (CPPD) or “pseudogout,” which is more common in older people. This can cause swelling, warmth, and tenderness in the wrists and other joints, such as the knees, elbows, shoulders, and hands. Swelling can last for several months.

A person may also notice their arthritis symptoms worsen when the weather changes, particularly as it gets colder.

Other complications can include:

• deformity
• chronic pain
• reduced joint mobility
• decreased stability in joints
• joint malalignment
• gout and pseudogout flares
• depression

A doctor may prescribe long-term use of analgesic medications to manage complications.

There is not one specific cause of hand OA, but it is more common in later life.

There are several potential risk factors for developing hand OA. They include:

• Older age: The chance of having OA increases with age.
• Gender: Females have a higher risk of OA than males.
• Joint problems: Overuse, infections, poorly aligned joints, and loose ligaments can lead to OA.
• Weight: Having obesity increases inflammation in the body and may increase the risk of OA.
• Genes: Genetics may increase some people’s chances of developing OA early.
• Injuries: Fractures and dislocations can lead to osteoarthritis over time.
• Job: A job that requires repetitive movements may cause more wear-and-tear damage, which may lead to OA.

According to the Centers for Disease Control and Prevention (CDC), doctor-diagnosed OA is more prevalent in white people compared with other ethnic groups.

However, OA-related activity limitations are less prevalent in white people than other ethnic groups.

Learn about the pathophysiology of OA here.

Since OA symptoms worsen over time, it can be difficult to distinguish between a flare and disease progression.

In the early stages of OA, people may notice pain and stiffness when moving, in the evening, and when waking in the morning. They may also notice the symptoms go away or ease with rest.

A person may notice symptoms flare due to the weather. Cold weather is a common cause of worsening symptoms, as is a change in barometric pressure.

Other triggers may include:

• bone spurs
• stress
• repetitive use
• infection
• weight gain

Diagnosis will often start with a physical examination and a review of a person’s medical history. A doctor may also ask about any family history of arthritis.

Doctors will likely check hand function using physical tests and review a person’s symptoms. If they suspect OA, they may order X-rays to check the joints.

X-rays or other imaging tests can often show damage to the cartilage or joints, which can indicate OA.

Learn about tests for thumb arthritis here.

OA treatments can vary based on the severity of the condition and a person’s needs.

Medical treatment often involves medication to treat pain and stiffness. This can include pills, syrups, topical creams, and injections.

Some common medications include:

• pain medication, such as acetaminophen
• counterirritants, such as capsaicin or menthol
• nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or topical NSAID-diclofenac gel
• corticosteroids, which doctors inject directly into the affected joint

In some cases, a doctor may recommend surgical intervention. Surgery can allow a doctor to:

• remove damaged cartilage
• fuse joints together
• replace a joint

Learn about thumb arthritis surgery here.

There are nonmedical ways to help manage hand OA. They include:

• doing exercises to build the muscles around the joints and provide support
• using wrist straps and other supportive devices
• heat therapy, such as a paraffin wax bath
• maintaining a moderate weight
• eating a nutritious and balanced diet
• taking steps to reduce strain on the hands

Learn about exercises for hand arthritis here.

People with hand OA may need to adapt how they use their hands to do daily tasks. Occupational therapists specialize in this kind of advice.

Versus Arthritis offers the following tips:

• use gadgets designed to reduce hand strain, such as an electric tin opener, tube squeezer, and zipper pull
• use a shopping trolley or backpack to avoid carrying shopping bags
• use both hands for tasks normally requiring one
• switch taps and door handles to easier-to-use versions
• alternate between harder and easier jobs to give the hands a chance to rest

A person needs to contact a doctor if they experience pain, tenderness, or loss of motion in their hands that has no explanation

If their symptoms worsen and their treatment regimen seems less effective, a person may wish to consult a doctor. A doctor may recommend a change in medication, complementary therapies, or even surgery.

There is no cure for OA.

For some people, the pain may lessen or even go away over time. However, any nodes that develop will remain and may limit range of motion.

With treatment and management, a person may be able to manage their symptoms and continue to function normally with minimal issues.

Living with OA can lead to additional complications. A person can talk with a healthcare professional if they experience new symptoms, such as signs of depression.

Hand OA can cause pain, stiffness, limited mobility in the hand, and loss of strength. Though pain may improve over time, a person may have long-term limited range of motion in their hands.

Treatments can include medical interventions, such as medications and surgery, and nonmedical interventions, such as braces, heat therapy, and exercise.

With treatment, a person may notice their symptoms improve.