Osteoarthritis of the Hands: Causes, Symptoms, Diagnosis & Treatment

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Osteoarthritis of the hands is characterized by inflammation. When the hand is affected, three sites are most often seen, including the joint nearest to the tip of the finger, the base of the thumb, and the finger’s middle joint. How many Americans have hand osteoarthritis is not known, but it is estimated that arthritis in general affects about one out of every five Americans.

Causes

This condition is degenerative and over time the cartilage covering the bone gradually deteriorates. An injury or mechanical wear and tear may also result in this condition developing. If an injury affects joint alignment, cartilage damage can be hastened. This damage is typically noticeable in the hands with crooked fingers and enlarged joints.

Signs and Symptoms

Range of motion loss, stiffness, and swelling are the most common symptoms of osteoarthritis in the hands. Bony nodules may also form, and these are small swellings or knots. When these are located at the fingertip they are referred to as Heberden’s nodes. They are known as Bouchard’s nodes when they are located at the middle joint. The fingers may become crooked and the joints enlarged. Pain may also occur.

Other signs and symptoms may include the base of the thumb aching, and compromised manual dexterity, physical function, and fine motor control.

Diagnosis

Diagnosis often begins with the doctor asking about the signs and symptoms the patient is experiencing, their severity, and their estimated date of onset. Patients should make sure to accurately and thoroughly describe their pain, swelling, stiffness, and joint movement limitations. The doctor will then often visually examine the hand looking for any bony nodules, enlarged joints, and crooked fingers.

Cartilage loss, if present, can be seen on an x-ray. An x-ray may also reveal joint damage and bone spurs. In the early stages, an x-ray may reveal no abnormalities or a reason for the patient’s symptoms.

While blood testing cannot diagnose this condition, the doctor may order them to help rule out other medical conditions and types of arthritis.

Treatment

Early treatment is focused on preventing the progression of the disease and irreversible joint damage. Doctors will work to help the patient improve function and relieve pain. Treatments may include:

  • Oral medications, such as pain-relieving medications and non-steroidal anti-inflammatory drugs
  • Splinting
  • Surgery
  • Steroid injections
  • Occupational or physical therapy

Surgery is usually reserved as a last resort and not considered until all other treatment options prove ineffective. The different surgical procedures for hand osteoarthritis include:

  • Fuse the joint
  • Removing excess bony growths and cysts
  • Replace the joint

Resources

American Academy of Orthopedic Surgeons. (2011). Arthritis of the Hand. Retrieved on January 10, 2011 from the American Academy of Orthopedic Surgeons: https://orthoinfo.aaos.org/topic.cfm?topic=A00224

University of California San Francisco Medical Center. (2011). Osteoarthritis of the Hand. Retrieved on January 10, 2011 from the University of California San Francisco Medical Center: https://www.ucsfhealth.org/conditions/osteoarthritis_of_the_hand/