How To Treat Osteoarthritis
The goals in treating osteoarthritis are to relieve pain and restore function. Brief rest either by changing activities or wearing a splint can help. Soft, snug sleeves can help support a joint when rigid splints are too restrictive. Heat can soothe the joints and help keep them mobile. It is important to keep as much finger motion and function as possible. Hand therapists can teach joint protection exercises and activity modification to help protect joints. Anti-inflammatory medication or a steroid injection into the joint can decrease pain, but neither cures osteoarthritis.
Surgery is considered when the non-surgical options above have not helped. In most cases, you will tell your doctor when you are ready for surgery. The goal is to restore as much function as possible and to minimize your pain. One type of surgery is joint fusion. The worn cartilage is removed and the bones on each side of the joint are fused together, which means that the joint will not move but it will not hurt. Another choice is joint reconstruction, where the rough joint surface is removed and either replaced with your own soft tissue or with an implant. The type of surgery depends on the joint involved, your anatomy, and your activities. Your hand surgeon can help you decide which type of surgery is the best for you.
This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.Find a hand surgeon near you.
About Rheumatoid Arthritis Of The Hand
Rheumatoid arthritis affects the cells that line and normally lubricate the joints . This is a systemic condition , which means that it may affect multiple joints, usually on both sides of the body. The joint lining becomes inflamed and swollen and erodes the cartilage and bone. The swollen tissue may also stretch the surrounding ligaments, which are the connective tissues that hold the bones together, resulting in deformity and instability. The inflammation may also spread to the tendons, which are the rope-like structures that link muscles to bones. This can result in stretching out of and ruptures of the tendons. Rheumatoid arthritis of the hand is most common in the wrist and the finger knuckles .
Rheumatoid Arthritis And Hands
Rheumatoid arthritis often starts in smaller joints such as in the hand or wrist. One of the early signs of RA in the hands is aninability to form a complete fist.
It usually occurs in a symmetrical pattern, affecting both hands including the knuckle joints, middle finger joints and wrists. People withlong-standing RA or those diagnosed later in life may notice a deviation of their fingers to the side, away from the thumb.
Surrounding tendons can also become inflamed, affecting the ability to straighten fingers. People with RA are also more susceptible todeveloping carpal tunnel syndrome, a condition caused by pressure on nerves that run through the wrist, with symptoms of numbness, pins andneedles, and pain.
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Knowing If You Have Arthritis Of The Knee
What Are The First Signs Of Arthritis In Your Hands
If you are having pain in your hands and it is frequent, you may have arthritis. Having persistent pains in your hands is one of the signs of arthritis, and another possible cause of pain could be carpal tunnel.
Arthritis can cause joint destruction if it is severe. Knowing the signs of arthritis will help you get your hands treated quickly. The faster you get it treated, the better.
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Weight Management And Diet
Although the link between your weight and osteoarthritis of the hands may be less clear than for weight-bearing joints such as the knees, some research shows that being overweight increases inflammation and therefore pain. Therefore, if you have osteoarthritis of the hand or wrist, it still makes sense to try to maintain, or achieve, a healthy weight.
What Are The Signs Of Arthritis In Your Hands
Posted on 25 May 2021
If you are experiencing symptoms that are making you wonder if you have arthritis in your hands, this article will be a good guide. It covers the types of arthritis that affect the hands and the symptoms associated with them, so that you can seek medical help and advice from your GP if needed.
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Osteoarthritis Of The Knee
If you have osteoarthritis in your knees, both your knees will usually be affected over time, unless it occurred as the result of an injury or another condition affecting only 1 knee.
Your knees may be most painful when you walk, particularly when walking up or down hills or stairs.
Sometimes, your knees may “give way” beneath you or make it difficult to straighten your legs. You may also hear a soft, grating sound when you move the affected joint.
Other Possible Causes Of Hand Pain
Hand pain is also a sign of Dupuytrens contracture, a condition in which the tissue of the palm and fingers becomes thickened and tight, causing the fingers to curl inward. Its not clear why Dupuytrens contracture develops, though those who smoke, drink a lot of alcohol, and have seizures or diabetes are more vulnerable to developing it.
Your doctor will also consider whether your hand pain could be due to carpal tunnel syndrome, says Dr. Byram. RA can be a cause of carpal tunnel syndrome, so if we see someone who has carpal tunnel, well want to make sure they dont have RA. Carpal tunnel is a condition that occurs when one of the major nerves to the hand the median nerve is squeezed or compressed as it travels through the wrist, according to the American Academy of Orthopaedic Surgeons.
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Inflammatory Arthritis Vs Osteoarthritis
Arthritis actually describes over 100 different conditions that affect joints and the surrounding tissue. They fall into two main categories: inflammatory arthritis and osteoarthritis .
Inflammatory arthritis is a systemic disease in which the mechanisms that normally protect your body attack your own joints and tissues instead. The most well-known example is rheumatoid arthritis , which tends to be symmetrical, meaning you’ll have problems in the same joints on both sides of your body, like both wrists or both knees.
The second type of arthritis and the most common form is osteoarthritis. A degenerative disorder, it’s caused by trauma or age-related wear and tear on your joints over time. OA is most likely to affect weight-bearing joints such as the knees, hip, lower spine or big toe, but it can also cause pain and stiffness in your thumb or finger joints.
What Are Hand Psoriasis Treatments
You probably already know that psoriasis on the hands can be challenging to treat. While that can feel a little disheartening, know that there are still lots of options to try.
There are some treatments, such as certain topical creams or ointments, that can help with both psoriasis and eczema, Dr. Rosmarin says. The immune system is too active in the skin, so we have medicines that can tell the immune system to calm down.
Typically, the first-line treatment for psoriasis plaques on the hands is topical corticosteroids, which come in the form of anti-inflammatory creams, ointments, or gels. Sometimes, a doctor may recommend applying this with occlusionthis means wearing gloves or wrapping the hands, ideally to allow the medication to better penetrate. Other times, your dermatologist will recommend combining this medication with calcipotriene, an ointment that helps to slow skin cell growth.
Another topical application is acitretin. Its a form of vitamin A that can take three to six months of steady application to see results.
Unfortunately, psoriasis plaques can sometimes be so thick that its difficult for the topical medications to fully penetrate the skin. When this is the case, you may need to turn to the second-line treatments. These usually involve systemic treatments or light therapy.
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Treatment For Hand Arthritis
Treating hand arthritis usually starts with conservative methods of taking anti-inflammatory medications, ice and heat therapy, splinting, and manipulation therapies. If pain persists, doctors may recommend steroid injections for immediate pain relief. However, this treatment method only offers temporary relief. When arthritis pain in the hand progresses and conservative treatments fail to bring relief, there may be damage to the hands joints, in which case, surgery may be necessary.
Injections For Shoulder Arthritis
There are currently two types of injections that can provide pain relief for shoulder arthritis. The first type is cortisone shots. Typically, cortisone is mixed with a numbing agent that provides immediate pain relief and helps your doctor know if the injection is in the right place. Once the numbing medicine wears off, the joint may be sore until the cortisone kicks in. Its important to ice the shoulder for a day or so after the shot.
Cortisone shots dont damage the shoulder, but most surgeons limit them to no more than a few a year in most cases of arthritis. Cortisone shots may increase the risk of infection if you undergo a total shoulder replacement soon after the shot. If you are considering the surgery, consider avoiding cortisone shots a few months prior.
The other medicine that can help with shoulder arthritis is synthetically manufactured hyaluronic acid. Its a naturally occurring lubricant in the human body. This liquid substance has been injected into arthritic knees for many years. This injection sometimes helps with the pain for up to two years, but it is unusual for it to take all the pain away for an extended period of time.
The current recommendation is not to have shoulder replacement surgery within three months of having a cortisone shot in the shoulder. If you are considering surgery, it is best to avoid cortisone shots until you have discussed it with your doctor.
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How Will It Affect Me
The symptoms of hand osteoarthritis can vary between different people and over time. Youll probably have good days and bad days. You may find this depends on what youre doing, but sometimes there may not be any obvious reason.
If the joints are inflamed then theyre likely to look swollen and red and to feel warm and tender to the touch. Youre likely to have pain, especially when using your hands but sometimes even while resting. Swelling can also cause the soft tissues around a joint to stretch, which can make your hands feel weak or unstable.
As we use our hands such a lot in daily life, pain, stiffness or poor grip strength can cause problems with a wide variety of tasks and activities including:
- opening jars and cans
- holding a pen or cutlery
- doing up buttons or zips
- handling money
- shaving, brushing your teeth, or drying yourself after a bath or shower.
Hand osteoarthritis often tends to burn out after a time. It may be painful for a few years and then the pain may improve, especially if only the small finger joints are affected. Any firm, knobbly swellings or nodes that have developed will remain though. And the range of movement in the joints doesnt always improve even when the pain does.
Sometimes the weather, especially cold weather, can make your symptoms worse. However, the weather wont affect the long-term outlook or how the condition progresses.
Is Heat Or Ice Better For Arthritis
For an acute injury, such as a pulled muscle or injured tendon, the usual recommendation is to start by applying ice to reduce inflammation and dull pain. Once inflammation has gone down, heat can be used to ease stiffness. For a chronic pain condition, such as osteoarthritis, heat seems to work best.
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Healing Arthritis In Hands And Getting Back To Normal
Once you know what is causing your hand arthritis symptoms, you can start moving on getting rid of that arthritis in hands and fingers.
The arthritis hand pain mechanism is 100% reversible.
Having said that, if a certain amount of damage has been done, even with the arthritis mechanism removed, some or all of that damage may be irreversible .
And, mostly in the case of RA, once the bony structures of the joints change shape as the auto-immune process causes them to become deformed, there is no UN-deforming the bone.Bone shape changes are permanent.
So ideally you completely reverse your arthritis issue BEFORE you develop too much joint damage and/or your finger joints deform and change shape.
Can I Prevent Arthritis
While genetics is a factor in many arthritis diagnoses, there are some ways we can hold off or diminish the impact of arthritis:
Stay active: exercise helps keep your bones and joints healthy.
Eat a healthy diet: vitamins and minerals promote bone health, and great nutrition keeps weight down.
Maintain a healthy weight: obesity is a significant risk factor for arthritis. Maintaining a healthy weight through diet and exercise helps keep joints healthy.
Avoid repetitive motions that can cause injury or wear and tear. This includes both work and recreational activities. Physical activity is an excellent way to promote joint health, but be sure to do it safely.
If you have a joint injury, include a high-quality physical therapy program in your healing process. This helps build strength, boosts mobility, and can help prevent arthritis down the road.
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When To See A Healthcare Provider
Arthritis that interferes with your quality of life in any waywhether from pain or loss of range of motion or bothshould, and can, be treated. See your healthcare provider or an orthopedic specialist if you:
- Experience symptoms for three days or more in a row
- Have several episodes of symptoms within a month
- Find yourself avoiding normal activities
- Do not get relief with rest, OTC pain medication, and other conservative measures
- Notice changes in symptoms that are unusualfor example, a stiff joint that normally improves after 15 minutes of exercise becomes swollen and red-hot
Staying Physically Active Despite Hand Arthritis
Your doctor will tell you and probably has already that staying physically active is an important part of managing arthritis. In fact, according to a study of 5,715 adults with arthritis over age 65, a lack of regular, vigorous physical activity doubled the risk of functional decline. In other words, the less physically active the participants were, the more likely they were to become disabled.
Of course, despite data showing that physical activity helps people with arthritis become stronger and more flexible, anyone with arthritis will tell you that sometimes pain or stiffness makes it hard to get going, let alone lift weights at the gym. People with arthritis often give up activities they think of as optional, such as exercising or gardening, in order to have enough energy for the activities they feel obligated to do, such as cleaning the house. One study found that only 13 percent of men and 8 percent of women with arthritis met federal guidelines of at least 150 minutes of moderate-intensity activity per week.
If symptoms of arthritis in your hands or elsewhere are preventing you from participating in the physical activities you used to enjoy and that are good for you it may be time to find new ways to be active. For example, you may want to experiment with water activities such as swimming, or try tai chi, dance, or walking .
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Which Joints In The Hand Are Affected
The index and middle fingers and the thumb are the parts of the hand most commonly affected. Many people find that the hand they use most is affected more than the other.
When the fingers are affected, it may be in the joints closest to the fingernails or the ones in the middle of the fingers. It’s less common to have osteoarthritis in the large knuckle joints, where the fingers meet the hand.
The joint at the base of the thumb can also be affected by osteoarthritis. And occasionally the wrist joint may be affected.
What Are The Symptoms Of Arthritis In The Hands
Early symptoms include:
- Dull or burning joint pain, appearing hours or a day after increased use of your hands.
- Morning pain and stiffness in your hand.
- Swollen joints in your hand.
If you’ve had arthritis in your hand for some time:
- Symptoms are present more often.
- Pain may change from dull ache to sharp pain.
- Pain may wake you up at night.
- Pain may cause you to change the way you use your hand.
- Tissue surrounding your affected joint may become red and tender to the touch.
- Youll feel grating, grinding, cracking or clicking when bending your fingers.
- Your fingers cant fully open and close.
- Small bony nodules form on the middle joint of your fingers or at the top joints of your fingers .
- Your finger joints become large and deformed and abnormally bent, leaving your hands weak and less able to accomplish everyday tasks.
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