Osteoarthritis is a common degenerative joint disease from the gradual breakdown of protective cartilage cushioning the ends of bones. This process can affect any joint but frequently occurs in the hands, leading to discomfort and changes in function. This progressive condition alters the entire joint structure, including the cartilage, bone, and connective tissues.
Identifying Hand Osteoarthritis Symptoms
The primary symptoms of hand osteoarthritis often develop slowly and can include a deep, aching pain that worsens after using your hands and improves with rest. Morning stiffness is also a common complaint, though it typically subsides within about 30 minutes of waking. You might notice a diminished ability to move your fingers through their full range of motion or experience weakness in your grip, making tasks like turning a key or opening a jar difficult. A grating sensation, known as crepitus, can sometimes be felt or heard when moving the finger joints.
This form of arthritis most commonly targets specific joints in the hand. These include the joint at the base of the thumb, called the carpometacarpal (CMC) joint, the middle joint of the fingers (proximal interphalangeal or PIP joint), and the joint nearest the fingertip (distal interphalangeal or DIP joint). Swelling and tenderness around these joints are frequent signs.
A distinct feature of hand osteoarthritis is the formation of bony enlargements around the affected joints. When these hard lumps appear on the DIP joints closest to the fingertip, they are called Heberden’s nodes. Similar bony growths on the PIP joints in the middle of the fingers are known as Bouchard’s nodes. These nodes contribute to the visible changes and stiffness associated with the condition.
Underlying Causes and Risk Factors
Hand osteoarthritis is influenced by several factors, with the natural aging process being a primary contributor. Cumulative stress from using hand joints over decades can lead to the gradual erosion of cartilage. This explains why the condition is more prevalent in individuals over the age of 45.
Genetics also play a part, as the tendency to develop osteoarthritis can be inherited, elevating your risk if close family members have the condition. Osteoarthritis of the hand is also more common in women than in men.
Previous trauma to the hand is another risk factor. A history of joint injuries, such as fractures or dislocations, can damage the cartilage surface. This damage can accelerate the degenerative process, leading to what is known as post-traumatic arthritis in the specific joint that was injured years earlier.
How Hand Osteoarthritis Is Diagnosed
Diagnosing hand osteoarthritis begins with a physical examination by a doctor. The physician will check your hands for indicators like swelling and the presence of bony Heberden’s or Bouchard’s nodes. They will also press on the joints to identify areas of tenderness and assess your hand’s range of motion.
To confirm the initial findings and understand the extent of joint damage, an X-ray is the most common imaging tool used. X-rays can clearly show characteristic changes associated with osteoarthritis, such as the narrowing of the space between bones, which indicates cartilage loss. The images may also reveal the presence of bone spurs, which are small, bony projections that form around the affected joint.
While blood tests are not used to diagnose osteoarthritis itself, a doctor might order them in some cases. This is primarily done to rule out other types of arthritis, such as rheumatoid arthritis, which is an inflammatory autoimmune disease.
Managing Pain and Maintaining Function
Managing hand osteoarthritis focuses on relieving pain and preserving your ability to perform daily activities. Applying a heating pad or soaking hands in warm water can help soothe stiff joints, particularly in the morning. Conversely, using cold packs can help reduce swelling and numb sharp pain after activities that have stressed the hands.
Specific hand exercises are beneficial for maintaining joint flexibility and strengthening the muscles that support the hand and thumb. A hand therapist can teach joint protection techniques and recommend gentle range-of-motion stretches to keep the fingers as mobile as possible.
Over-the-counter medical options can provide additional relief. Topical creams or gels containing anti-inflammatory ingredients can be applied directly to the painful joints. Oral pain relievers are also an option for managing more persistent pain. For more targeted support, wearing a splint, especially for the thumb joint, can help stabilize the area and reduce pain during certain activities.
Using adaptive aids can make a significant difference. Tools like specialized jar openers, ergonomic pens with wider grips, and key turners are designed to reduce the strain on your hand joints.