What Happens In A Joint Affected By Rheumatoid Arthritis
If you have rheumatoid arthritis, your immune system can cause inflammation inside a joint or a number of joints. Inflammation is normally an important part of how your immune system works. It allows the body to send extra fluid and blood to a part of the body under attack from an infection. For example, if you have a cut that gets infected, the skin around it can become swollen and a different colour.
However, in the case of rheumatoid arthritis, this inflammation in the joint is unnecessary and causes problems.
When the inflammation goes down, the capsule around the synovium remains stretched and cant hold the joint in its proper position. This can cause the joint to become unstable and move into unusual positions.
The following can play a part in why someone has rheumatoid arthritis:
What Is A Swan
This happens when the base of the finger and the outermost joint bend, while the middle joint straightens. Over time, this imbalance of the finger joints can result in the crooked âswan-neckâ position. Rheumatoid arthritis can cause it.
A swan-neck deformity can make it almost impossible to bend the affected finger normally. It can make it hard to button shirts, grip a glass, or pinch with the fingers.
Treatment may include:
- Finger splints or ring splints
- Surgery to realign the joints or fuse the joints so they work better
Hand Deformities From Rheumatoid Arthritis
Evidence suggests that hand deformities commonly occur in the first year of rheumatoid arthritis if it goes untreated.2 Moreover, people who experience hand deformities in the first year tend to have more severe cases of the disease. 3
In some cases, hand deformities can be treated. In addition, new rheumatoid arthritis medications have reduced the likelihood that rheumatoid arthritis will cause permanent deformities.
The most common finger and wrist deformities are described below.
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What Are The Genetic Markers That Are Connected To Rheumatoid Arthritis
Generally, rheumatoid arthritis attacks many body joints at once. In a joint where RA IS affected, the lining becomes inflamed, causing damage to joint tissues. This tissue damage can lead to chronic pain, unsteadiness, and distortion.
Another arthritis that has similar symptoms and signs of RA is osteoarthritis . OA usually affects fewer joints and only one joint at once whereas RA can cause more widespread inflammation and severe damage to the body.
Preventing Hand Deformities Due To Ra
The best way to prevent hand deformities is to get early, aggressive, and targeted treatment for your RA. This strategy has helped make joint deformities less common and less severe than they used to be.
Early, aggressive treatment and a targeted approach are also tied to better overall outcomes and a lower risk of death from RA-related complications. Research shows that, with proper treatment, the average person with RA has only a 15% increased chance of premature death.
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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.
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 .
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:
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:
Hallmark Symptoms Of Ra In The Fingers Thumbs And Wrists
Recognizing the signs and symptoms of RA in the hands can help distinguish rheumatoid arthritis from other types of arthritis that affect the hand, such as osteoarthritis and psoriatic arthritis. Keep in mind that these symptoms may be accompanied by pain in other joints as well as fever, fatigue, and a general feeling of being unwell.
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How Does A Normal Joint Work
A joint is where two bones meet. Most of our joints are designed to allow the bones to move in certain directions and within certain limits.
For example, the knee is the largest joint in the body and one of the most complicated. It must be strong enough to take our weight and must lock into position, so we can stand upright.
It also has to act as a hinge, so we can walk, and needs to twist and turn when we run or play sports.
The end of each bone is covered with cartilage that has a very smooth, slippery surface. The cartilage allows the ends of the bones to move against each other, almost without rubbing.
The joint is held in place by the synovium, which contains thick fluid to protect the bones and joint.
The synovium has a tough outer layer that holds the joint in place and stops the bones moving too far.
Strong cords called tendons anchor the muscles to the bones.
Are Glucosamine And Chondroitin Supplements Helpful For Treating Osteoarthritis Of The Hand
Supplements are not reviewed or approved by the Food and Drug Administration . They are not required to undergo the same rigorous clinical trial methods that medications must undergo in the U.S. Some clinical trials show benefits with pain relief however, there is no proof that these supplements slow the progression of osteoarthritis. If you plan to try these, always check with your healthcare provider before using supplements. These products may interfere with medications you currently take.
A note from Cleveland Clinic
Dull or burning joint pain, morning stiffness, swollen joints in your hand are all symptoms of arthritis. Many types of arthritis could affect your hands. Many treatment options are available depending on your exact arthritis type. Medications can reduce joint pain and swelling. Researchers are still working on ways to slow the progression of osteoarthritis. See your healthcare provider if you think you have arthritis in your hands. They will perform a complete exam and offer you a complete treatment plan, which includes hand exercises, use of hot and cold packs, other lifestyle tips and traditional treatments including medications, braces/splints, steroid injections and surgery.
Last reviewed by a Cleveland Clinic medical professional on 07/06/2021.
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What Causes Rheumatoid Arthritis
Several joints have a coating called synovium that lubricates the joint and allows it to move more readily. The synovium thickens, gets inflamed, and creates an excess of joint fluid in rheumatoid arthritis.
Synovitis is the medical term for this condition. Swelling, cartilage degeneration, and bone softening occur as a result of the additional fluid and inflammatory chemicals generated by the immune system.
The swelling tissue may sprain the ligaments that surround it, causing deformity and instability. Tendons may be weakened and damaged as a result of the inflammation. Ligaments and tendons are connective structures that link two bones tendons connect muscle to bone.
Ra Symptoms In Your Joints
RA almost always affects your joints. It may take a few weeks or months for the first signs to show. The inflammation it causes often leads to these three hallmark symptoms:
- Pain.Inflammation inside a joint makes it hurt whether youâre moving it or not. Over time, it causes damage and pain.
- Swelling. Fluid in the joint makes it puffy and tender.
- Tenderness. It hurts when you move or push on a joint.
Other RA symptoms include:
- Stiffness. The joint is harder to use and doesn’t move as well as it should. Itâs especially common in the morning. Although many people with other forms of arthritis have stiff joints in the morning, it takes people with rheumatoid arthritis more than an hour before their joints feel loose.
- Redness and warmth. The joints may be warmer and have color changes related to the inflammation.
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How Is Rheumatoid Arthritis Managed
Most people with RA can lead full and active lives. Taking control of RA will help you cope with its impact on your lifestyle. As there is no known cure, early diagnosis and treatment can control its symptoms and help prevent disability.
People with RA are usually looked after by several health professionals. This might include a general practitioner, a rheumatologist, physiotherapist and occupational therapist.
Treatment will be tailored to your symptoms. Options include:
- medicines to relieve symptoms or slow progress of the condition
- heat and cold treatments, such as warm baths, and hot or cold packs
- TENS electrical device, which is thought to reduce pain by stimulating the nerves
- surgery to correct joint problems
- supportive treatments such as physiotherapy
- exercise to keep your joints flexible and muscles strong
- complementary therapies such as relaxation techniques, massage, hypnosis or acupuncture
It is possible to use more than 1 of these approaches at the same time . The experience of pain is also unique to everybody, so what works for you may not work for someone else.
Tenosynovitis In The Hands
In addition to encapsulating joints, synovial tissue also surrounds most tendons. Tendons connect muscles to bones. Rheumatoid arthritis can cause a tendonâs synovial sheath to become inflamed, a condition called tenosynovitis. The inflammation is not always painful but can lead to tendon damage.
In the hand, flexor tendons allow a person to bend their fingers. When a fingerâs flexor tendon is inflamed it can cause the middle knuckle to get stuck in a bent position. This condition is called trigger finger.
At least one study suggests that tenosynovitis of flexor tendons is a strong predictor of rheumatoid arthritis.5
Inflammation of the flexor tendon or tendon sheath in the hand can lead to trigger finger and may be an early indicator of rheumatoid arthritis. Read Trigger Finger
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How Arthritis Of The Hand Is Diagnosed
Your doctor will examine you and determine whether you have similar symptoms in other joints and assess the impact of the arthritis on your life and activities. The clinical appearance of the hands and fingers helps to diagnose the type of arthritis. X-rays will also show certain characteristics of rheumatoid arthritis, such as narrowing of the joint space, swelling and diminished bone density near the joints, and erosions of the bone. If your doctor suspects rheumatoid arthritis, he or she may request blood or other lab tests to confirm the diagnosis.
What Is Arthritis Of The Hand
Arthritis is a disease that attacks the tissues of your joints. A joint is where two bones meet. Arthritis can attack the lining of your joint or the cartilage, the smooth covering at the ends of bones. Eventually the cartilage breaks down, the ends of your bones become exposed, rub against each other and wear away. You have many joints in your hand, therefore its a common site for arthritis to happen.
Arthritis of the hand causes pain and swelling, stiffness and deformity. As arthritis progresses, you cant use your hands to manage everyday tasks as you once could.
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How Does Osteoarthritis Affect The Hand
Osteoarthritis strikes the bigger joints first. The index and middle fingers, as well as the thumb, are the most usually affected areas of the hand. Hand osteoarthritis symptoms vary with people and time. Many people discover that their dominant hand is more impacted than their other hand.
The joints closest to the fingernails or those in the center of the fingers may be compromised when the fingers are afflicted. Osteoarthritis at the major knuckle joints, where the fingers meet the hand, is less prevalent.
Osteoarthritis can affect the joint near the base of the thumb. In certain cases, the wrist joint is impacted.
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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.
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.
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Changes In Surrounding Joints
In patients with advanced thumb base arthritis, the neighboring joints may become more mobile than normal.
Thumb extension deformity. This patient has lost mobility at the base of the thumb due to arthritis. The next joint closer to the tip of the thumb has become more mobile than normal to make up for the arthritic joint. Normally, the thumb does not come to a right angle with the rest of the hand.
How Can I Ease Hand And Finger Joint Pain
Regular exercise is very important to make your hands and fingers more flexible. You also need to rest painful joints. It helps to use hand or finger splints to ease pressure if your RA flares up.
To exercise your hands and fingers, you can use a soft foam ball like a Nerf ball . Squeeze it and then relax your hand muscles.
Ask an occupational therapist about gadgets and devices that may help make everyday activities easier, at home or on the job. For instance:
- Use hook and loop fasteners to replace buttons on clothing.
- Add accessories to doorknobs for easier turning.
- Use lamp switches that require just a touch to the lamp base rather than twisting a small knob switch.
- Try a long-handled shoehorn to put on your shoes so you donÃ¢t have to bend over and stretch your hands.
- Use lightweight household utensils, pots, pans, cups, and dishes.
- Put foam padding around your pen or pencil. These are available at most office supply stores.
Learn about more hand and finger exercises you can do for RA
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Can Moist Heat Or Ice Help Ra Pain
Both of these simple methods can ease RA pain and stiffness.
Use a warm, moist compress on your fingers and hands for 15 minutes before you exercise.
To reduce swelling, use ice packs. Put an ice pack on the painful joint for 10 to 15 minutes at a time.
You may want to switch between moist heat and ice packs. Experiment to find out what works best for you, and then make it part of your routine before and after exercise. Read more about heat and cold therapy for arthritis pain.
How Ra Affects The Wrist
Rheumatoid arthritis is one type of arthritis, and is an autoimmune and chronic condition. An autoimmune disease causes the body’s immune system to attack its own tissue. This means in RA in the wrist, the condition will cause damage to the nearby tissue and soften the bone in the wrist.
Everyone’s experience with RA and wrist arthritis varies. Some won’t have symptoms right away, while others may experience extreme pain. People with wrist arthritis may have overlapping symptoms between RA and another condition like carpal tunnel syndrome or gout.
RA joint damage and deformity cannot be reversed, so it’s best to catch the problem and start the treatment early.
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