Friday, January 27, 2023

What Are The Signs Of Rheumatoid Arthritis In Your Hands

Subtle Signs Of Rheumatoid Arthritis

Rheumatoid arthritis of the hands

What were your first symptoms?

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Rheumatoid Arthritis is a common form of arthritis which affects 1.5 million Americans, with about three times as many women as men affected. There are some early and subtle signs of this painful condition to look out for. Many symptoms may appear to indicate another condition altogether. Preparation and early treatment may be key to reducing the painful symptoms of full-blown RA. Luckily, weve compiled a list of subtle signs to look out for!

  • Redness on hand joints. If you start to notice abnormal redness on or near some of your hand joints, this may be a sign of Rheumatoid Arthritis development. There may be extra heat around the joints which causes the surface of the skin to appear red. If you can rule out skin conditions and other ailments, it may be best to consult a rheumatologist for more information and a possible diagnosis of RA.
  • Fatigue. Fatigue is a common symptom in all stages of RA but may seem a bit out of place if you have not gotten an official diagnosis. Sleep can sometimes be disrupted in those with Rheumatoid Arthritis, and this can cause fatigue during waking hours. In addition, the body is focused on healing the affected joints and therefore diverts its resources to that task, instead of on the external things you need to get done.

How Is Arthritis In The Hand Treated

Treatment options depend on the type of arthritis, stage of arthritis, how many joints are affected, your age, activity level, the hand affected and other existing medical conditions.

Goals of treatment are to:

  • Improve mobility and function.
  • Increase your quality of life.
  • In the case of rheumatoid or psoriatic arthritis, to slow the progression of the disease.

Treatment options include splinting/bracing, medications, injections, non-drug approaches and surgery.

Splinting/braces

Splits or braces support and protect the affected joint, reduce deformity, provide joint stability, lessen strain, and promote proper joint alignment. Your healthcare provider, occupational therapist or hand therapist will discuss splinting/bracing options, how and when to wear them and how long to wear them .

Medications

Steroid injections

Steroids reduce inflammation and relieve pain. Steroids are usually used if medications dont control inflammation or if the inflammation is limited to a few joints. Injections are administered directly into the affected joint. Because steroids can weaken tendons and ligaments, injections are repeated only a few times.

Other management strategies

A complete treatment plan for arthritis of the hand includes these additional approaches:

Surgery

If nonsurgical treatments no longer provide relief and the cartilage at the ends of your bones has worn away, surgery may be an option. There are several approaches:

What Are The Risk Factors For Ra

Researchers have studied a number of genetic and environmental factors to determine if they change persons risk of developing RA.

Characteristics that increase risk

  • Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
  • Sex. New cases of RA are typically two-to-three times higher in women than men.
  • Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
  • Smoking. Multiple studies show that cigarette smoking increases a persons risk of developing RA and can make the disease worse.
  • History of live births. Women who have never given birth may be at greater risk of developing RA.
  • Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
  • Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.

Characteristics that can decrease risk

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What Are The Signs Of Arthritis In The Hands

May 19, 2021

Achy, swollen hands? Stiffness in your wrists? Its common to assume these are symptoms of arthritis. While 40 million Americans suffer from arthritis, its far less frequent in the hands than people expect. Instead, what many mistake for arthritis is actually tendonitis. Let’s look at the difference between arthritis and other conditions, risk factors and treatments.

When Rheumatoid Arthritis In The Hand Is Serious

Hands With Rheumatoid Arthritis Photograph by James ...

Experts estimate 90% of people who have RA have symptoms in at least one hand joint.6,7 While prompt and aggressive treatment can typically prevent the worst outcomes, RA in the hand can be a serious cause for concern if:

  • Damage to joint tissues causes bones to become malaligned. This malalignment can result in hand deformities and prevent the hand from functioning normally.
  • It prevents a person from being able to care for themselves, particularly if they live alone.
  • It leads to severe carpal tunnel syndrome. Advanced carpal tunnel causes numbness and/or tingling and weakness in the thumb and associated fingers, and can result in permanent nerve damage if left untreated.

In any of these cases, consultation with a medical professional is advised.

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How Is Rheumatoid Arthritis Diagnosed

A careful history and thorough physical exam along with laboratory examinations are the cornerstones of diagnosis in Rheumatoid Arthritis. The latest guidelines for diagnosis take into account the number and size of joints affected, the duration of the symptoms, and the results of key blood tests. Blood levels of Rheumatoid Factor, Anti-Citrullinated Protein Antibodies, C-Reactive Protein, and Erythrocyte Sedimentation Rate are noted. Based on this constellation of findings, the diagnosis can be made. X rays and MRI are often utilized to stage the disease once diagnosis has been made.

Malalignment Of One Or More Finger Joints

Over time, the destruction of bone and joint tissue may cause fingers and thumbs to become deformed. While the risk of hand deformities is significant, they are not inevitable.

A diagnosing physician will examine a patients hands, feet, and any other jointslarge or smallthat the patient reports as painful.

Read Are My Painful Joints Caused By Rheumatoid Arthritis or Something Else?

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What Are The Early Signs Of Arthritis In The Hands

The early symptoms of arthritis may vary depending on several factors such as the type of arthritis, age of the individual and which joint is involved.

Some of the early signs and symptoms of hand arthritis include

  • Stiffness in the joints, especially in the morning
  • Pain or ache in the affected area
  • Swelling at the affected site
  • The skin over the affected joint that may appear red and inflamed
  • Loss of function of the involved joint or muscle
  • A grating sensation or popping sound when the joint moves
  • Loss of muscle mass at the affected site
  • Presence of small, bony bump-like swellings on the hand
  • The skin over the affected joint may be warm to the touch
  • Psoriatic arthritis
  • Deformities in the affected hands and fingers
  • Fever, if the arthritis is due to an infection

Jak Inhibitors And Ra

Don’t Ignore Your Joints – The Angry Hand (Rheumatoid Arthritis)
  • Tofacitinib is the first in a new class of “small molecule” medications used to treat rheumatoid arthritis called JAK inhibitors. Tofacitinib is a treatment for adults with moderate to severe active RA in which methotrexate was not very effective. Patients can take tofacitinib with or without methotrexate, and this prescription drug is taken by mouth two times a day. Tofacitinib is a “targeted” drug that only blocks Janus kinase, special enzymes of inflammation, within cells. This is why it is referred to as a JAK inhibitor. JAK inhibitors are not used with biologic medications.

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What Are The Complications Of Ra

Rheumatoid arthritis has many physical and social consequences and can lower quality of life. It can cause pain, disability, and premature death.

  • Premature heart disease. People with RA are also at a higher risk for developing other chronic diseases such as heart disease and diabetes. To prevent people with RA from developing heart disease, treatment of RA also focuses on reducing heart disease risk factors. For example, doctors will advise patients with RA to stop smoking and lose weight.
  • Obesity. People with RA who are obese have an increased risk of developing heart disease risk factors such as high blood pressure and high cholesterol. Being obese also increases risk of developing chronic conditions such as heart disease and diabetes. Finally, people with RA who are obese experience fewer benefits from their medical treatment compared with those with RA who are not obese.
  • Employment. RA can make work difficult. Adults with RA are less likely to be employed than those who do not have RA. As the disease gets worse, many people with RA find they cannot do as much as they used to. Work loss among people with RA is highest among people whose jobs are physically demanding. Work loss is lower among those in jobs with few physical demands, or in jobs where they have influence over the job pace and activities.

Symptoms Of Progressive Rheumatoid Arthritis

Here are some general warning signs and symptoms that you may have developed progressive rheumatoid arthritis:

The active state of the disease is becoming more frequent Flare-ups are occurring regularly and lasting for longer periods of time Your pain and swelling are becoming more intense, spreading throughout other areas of your body Your diagnosis occurred early on, and so the disease has had a long time to develop You are beginning to develop rheumatoid nodules that you didnt have before Your blood tests show high levels of Rheumatoid Factor or anti-CCP

If you suspect that your rheumatoid arthritis has become progressive, consult your rheumatologist to determine the changes in your condition and discuss potential adjustments to your treatment plan.

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Both Sides Of The Body Affected

Typically, the distribution of the joints involved in a person with rheumatoid arthritis is similar on both sides of the body. This symmetric joint involvement is a feature of classic rheumatoid arthritis. This does not mean that joint involvement is always symmetric, but it is common.

Rheumatoid arthritis usually involves many joints on both sides of the body. It is, therefore, sometimes referred to as an asymmetric polyarticular form of arthritis. Accordingly, the small joints of the hands, wrists, and feet are commonly affected. The knees, ankles, shoulders, hips, and elbows can also be involved in early disease. Rheumatoid arthritis is characterized by inflammation in these joints. Early manifestations of this inflammation can be gradual or rapidly intense. The joint inflammation causes stiffness, usually worse in the morning or after being sedentary. It also causes warmth, swelling, redness, and pain in varying degrees. The joint can be very subtly affected with slight swelling or markedly affected with substantial loss of range of motion. The pain level can be completely disabling and does not always correlate with the degree of apparent inflammation.

Other Conditions That Can Cause Hand Pain Include:

Signs Of Rheumatoid Arthritis In Your Hands

Carpal tunnel syndrome

Rheumatoid arthritis can raise your risk of this condition, but many other factors can contribute as well, including anatomy of your wrist, nerve-damaging diseases and possibly repetitive hand motions. Its tricky because you could have carpal tunnel syndrome that is related to RA or not at all related to RA.

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Signs And Symptoms Of Rheumatoid Arthritis Of The Hand

Stiffness, swelling, and pain are symptoms common to all forms of arthritis in the hand. In rheumatoid arthritis, some joints may be more swollen than others. There is often a sausage-shaped swelling of the finger. Other symptoms of rheumatoid arthritis of the hand include:

  • A soft lump over the back of the hand that moves with the tendons that straighten the fingers
  • A creaking sound during movement
  • A shift in the position of the fingers as they drift away from the direction of the thumb
  • Swelling and inflammation of the tendons that bend the fingers, resulting in clicking or triggering of the finger as it bends, and sometimes causing numbness and tingling in the fingers
  • Rupture of tendons with loss of ability to straighten or bend certain fingers or the thumb
  • Unstable joints in the wrist, fingers, and thumb
  • Deformity in which the middle joint of the finger becomes bent and the end joint hyperextended
  • Hyperextension at the middle joint of the finger associated with a bent fingertip

You Have Numbness Or Tingling In Your Hands

One symptom of rheumatoid arthritis is carpal tunnel syndrome, which is marked by tingling in the wrist and hands. Dr. Mandl says the sensation is similar to the feeling you get when you hit your funny bone.

What happens is that the swelling in the arm compresses the nerves going into the hands. The sensation is often worse at night.

If you go to a doctor with these symptoms and dont have other RA symptoms, you may be diagnosed only with carpal tunnel syndrome.

One area in which people often have RA-related pain or inflammation is the forefootwomen often stop wearing heels and head to a podiatrist due to the pain.

Some people with RA may also develop pain in the heel because of plantar fasciitis, a common foot disorder caused by swelling of the tissue at the bottom of the foot, near the heel.

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Cold Or Discolored Fingers

People with RA are at a higher risk of developing another condition called Raynauds syndrome, which causes color and temperature changes in the fingers.

This issue occurs when the blood vessels in the fingers narrow and decrease even further in size. As a result of this, less blood flow is able to get through to your hands and fingers. Typically the effects of the syndrome are more severe in people whose Raynauds is the result of another condition like RA.

Individuals with Raynauds become extremely sensitive to cold temperatures and may notice their fingers turning a white or blueish color as the blood flow diminishes. Numbness, tingling, or sensitivity in the hands may also accompany these changes. In severe cases, ulceration of the skin or even gangrene can develop if your Raynauds is not properly treated by a healthcare provider.

How Is Rheumatoid Arthritis Treated

5 Warning Signs of Rheumatoid Arthritis

Your healthcare provider will figure out the best treatment for you based on:

  • How old you are
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • Your opinion or preference

There is no cure for RA. The goal of treatment is often to limit pain and inflammation, and help ensure function. You may have 1 or more types of treatments. Treatment may include:

  • Medicines. Some medicines may be used for pain relief. Some are used to treat inflammation. Others can help to slow the disease from getting worse. Medicines should be managed by a rheumatologist. This is a doctor who specializes in arthritis and rheumatic diseases. You may need regular blood tests to check how the medicines affect your blood cells, liver, and kidneys.
  • Splints. Splints may be used to help protect the joints and strengthen weak joints.
  • Physical therapy. Physical therapy may be used to help increase the strength and movement of the affected areas.

In some cases, surgery may be an option if other treatments dont work. Surgery does not cure RA. It helps correct the deformities caused by the disease. After surgery, RA can still cause problems. You may even need more surgery. Joint repair or reconstruction can be done in many ways, including:

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How Do Doctors Diagnose Hand Arthritis

Diagnosis of hand arthritis by a doctor may involve:

  • Detailed medical history: The doctor may ask questions about the patients symptoms including their onset and severity, any underlying health conditions, any history of injury or surgery and family history of any related health conditions. The doctor may also ask the patient if they are on any medications or supplements.
  • Physical examination: A thorough physical examination will be done to look for
  • Signs of arthritis in any other part of the body
  • Weakness of the affected joint and muscles
  • Tenderness
  • Any signs of injuries or trauma
  • Imaging studies: They are crucial because they help the doctor to see the condition of the involved bones, joint spaces and muscles. Imaging studies such as X-ray, computed tomography scan and magnetic resonance imaging may be done.
  • Blood tests: They may be done especially in the case of rheumatoid arthritis. Blood tests may also help the doctor know about the presence of infections or nutrient deficiencies that may contribute to the disease. Associated health conditions such as high serum uric acid levels and increased blood sugar levels may also be explored through blood tests.
  • Synovial fluid examination: This involves withdrawing a small amount of synovial fluid and examining it in the lab. This may reveal the presence of joint space infection or the presence of uric acid crystals .
  • Living With Rheumatoid Arthritis

    There is no cure for RA. But it is important to help keep your joints working well by reducing pain and inflammation. Work on a treatment plan with your healthcare provider that includes medicine and physical therapy. Work on lifestyle changes that can improve your quality of life. Lifestyle changes include:

    • Activity and rest. To reduce stress on your joints, switch between activity and rest. This can help protect your joints and lessen your symptoms.
    • Using assistive devices. Canes, crutches, and walkers can help to keep stress off certain joints and to improve balance.
    • Using adaptive equipment. Reachers and grabbers let you extend your reach and reduce straining. Dressing aids help you get dressed more easily.
    • Managing the use of medicines. Medicines for this condition have some risks. Work with your healthcare provider to create a plan to reduce this risk.
    • Seeking support. Find a support group that can help you deal with the effects of RA.

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