Osteoarthritis of the hands and fingers
Osteoarthritis (OA) in the hands and fingers affects the entire joint, including bone, cartilage, ligaments, and muscles.
While it has been traditionally characterized as 'wear and tear,' current understanding suggests that OA may actually be the outcome of a joint's heightened efforts to undergo self-repair. T
he lining of the joint capsule (called the synovium) may thicken and produce more fluid than normal, causing joint swelling, pain and stiffness. Extra bone may form at the edge of the joint. These bony growths are called osteophytes and can sometimes restrict movement or rub against other tissues.
Any joint in your fingers, thumbs, knuckles and wrists can be affected by, and this may cause joint pain, swelling and stiffness. People with hand often find their grip weakens and it becomes harder to do fine movements, such as turning a key or tying shoelaces.
OA is common in women over 50 years old and most likely to cause enlarged nodes in the joint at the base of the thumb, the joints closest to the tip of the fingers (Herberden’s nodes) and the joints underneath those (Bouchard’s nodes).
Osteoarthritis of the wrists
Osteoarthritis (OA) can also impact the wrist joint, and in certain instances, it may be triggered by a prior injury or trauma. The repair process following injury does not always function optimally, and alterations in joint structure can sometimes trigger or contribute to symptoms such as pain, swelling, loss of strength, or difficulties in normal joint movement. Pain from may also occur in the absence of damage as there are many environmental and genetic factors which influence the development of.
What can I do?
Early treatment for osteoarthritis found in the hand and/or wrist may help relieve pain and swelling. The first step in relieving symptoms is to limit or stop those activities that make the pain worse, and even using a splint to support your affected joints may provide some relief. There are other treatments that may help you deal with pain and stiffness:
Movement and exercise. Don’t be afraid to use your hands. Regular exercise is important in reducing stiffness and keeping your joints and muscles working. Try to make sure you move any affected joints in your fingers, thumbs, knuckles and wrists as far as is comfortable several times a day. You could also see an occupational therapist or physiotherapist for specific hand exercises.
Medicines. Many different types of medicines can help the symptoms of hand OA. It’s best to start with simple analgesics and measure their effect before trying others. Your doctor or pharmacist can help you understand which medicines are right for you and how best to use them. Always talk to your doctor or pharmacist about your medicines, as even natural and over-the-counter medicines can have side effects.
Heat and cold. Applying heat, such as a hot pack (microwaveable wheat pack), heating pad or hot water bottle to stiff, painful joints may help relieve these symptoms. If your joints are hot and swollen you may find it useful to apply an ice pack. Try applying heat or cold to the painful area for 15 minutes. Always have a layer (such as a tea towel) between your skin and the heat or ice pack. You can repeat this whenever you need to throughout the day. Make sure the temperature of the skin returns to normal in between applying heat or ice packs to prevent damage to the tissues.
Creams. Applying creams or ointments to the skin in the affected area may help control pain. In particular, creams containing anti-inflammatory medicines may help. Creams containing capsaicin (an ingredient in cayenne and chilli peppers) may be useful for hand arthritis, although this has not been proven by research.1,2Talk to your doctor or pharmacist about these types of creams.
Glucosamine and chondroitin. It is unclear if glucosamine or chondroitin are useful for hands affected by arthritis1. See the Complementary medicines treatment for more information
Fish oils. Fish oils may be useful for some forms of arthritis that affect the hands. See the Nutrition treatment for more information.
Herbal therapies. There is no conclusive proof that herbal medicines are effective in treating arthritis of the hands2. However see the Complementary medicines treatment for more information.
Acknowledge your feelings and seek support. It is natural to feel scared, frustrated, sad and sometimes angry when you have pain. Be aware of these feelings and get help if necessary. You can learn skills to recognise and calm anxiety or strong emotions if you find they start to affect your daily life. See the Awareness of thoughts & emotions treatment information.
Effective ways to protect sore hands
Splints may be helpful in some cases. They are often used to support the joint at the base of the thumb and for affected hands. Splints are usually worn only when the joint is painful or to protect the joint during certain activities. Splints should not stop you from moving or using your hands as thi The first thing to do is to become more aware of how you are using your sore joints. For example, try watching how you make a hot drink. What is happening to your wrist and fingers as you turn on the tap or lift a heavy kettle? Does it cause pain? Try to think of another way of doing this activity to reduce those aches and strains. You might use a tap turner to make it easier to grip the tap. These are examples of ‘joint protection’. It doesn’t mean you should stop using your joints. It just means that you should use them differently to reduce the amount of stress going through your joints.
Here are some ways to protect the joints in your hands:
Take notice of the pain. Rather than giving up an activity altogether, try taking regular rests during the activity. You will usually find you can still do the things you enjoy without discomfort.
Use larger, stronger joints - for example, carry your shopping bags over your shoulder rather than in your hands.
Spread the load over several joints - try carrying things with two hands.
Reduce the effort you have to put in - there is a wide range of labor-saving tools and equipment available. Buy pre-cut vegetables and meat to making cooking easier.
Avoid gripping things tightly - find out about the gadgets that can make gripping and holding objects easier.
See an occupational therapist - learn more ways to make daily tasks easier and take pressure off your joints.
Visit an Independent Living Centre. These centres have a wide range of tools and equipment on display. You can get advice, including where to purchase equipment, in person or over the phone. Occupational therapists are also available at the centres to provide advice about equipment. Although you can drop in at anytime, it is preferred that you call the telephone enquiry service beforehand.
Are splints useful for hand osteoarthritis?
Splints may be helpful in some cases. They are often used to support the joint at the base of the thumb and for affected hands. Splints are usually worn only when the joint is painful or to protect the joint during certain activities. Splints should not stop you from moving or using your hands as this can cause the muscles to weaken and waste. An occupational therapist or physiotherapist can advise whether hand splints will be useful for you.
Other resources
Podcast:
https://www.jointaction.info/podcast/episode/98f21d74/hand-osteoarthritis-with-margreet-kloppenburg
State and Territory Arthritis offices:
Your local Arthritis Office can provide further information to assist you and will have a range of education and support activities. Click here to find your local office.
Independent Living Centres (ILCs): These centres provide information about products and services to help people remain independent and improve their quality of life. They are located in each capital city. See www.ilcaustralia.org.au or call the National ILC Infoline on 1300 885 886 to find your closest centre and more information. (In Queensland, the Independent Living Centre is called LifeTec).
The below references have been used to develop this fact sheet with the most up-to-date evidence available.
References
- Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020;72(2):149-162.
- Terpstra SES, van de Stadt LA, Kloppenburg M. The management of hand osteoarthritis: The rheumatologist's perspective. Journal of hand therapy. 2022;35(3):322-331.
Learn more
This website has been independently developed by Arthritis Australia for Australian users. We thank our sponsors for their support for an unrestricted, educational grant to fund its creation.
