Arthritis in the hands is a common condition leading to joint inflammation, causing pain, stiffness, and swelling. This joint damage can severely reduce a person’s range of motion and interfere with daily activities. Finding the right medical professionals to manage this complex problem is the first step toward effective treatment and improved quality of life.
Initial Consultation and Referral Process
The journey to an arthritis diagnosis and treatment typically begins with a Primary Care Physician (PCP) or general practitioner. The PCP serves as the initial point of contact for evaluating joint pain and determining the appropriate path forward. The doctor conducts a physical examination, reviews the patient’s medical history, and looks for signs like joint tenderness or limited movement.
The initial assessment involves ruling out other conditions that can mimic arthritis, such as tendonitis or acute injury. The PCP may order basic laboratory tests, including acute phase reactants like C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), to check for systemic inflammation. If the PCP suspects an inflammatory condition, or if symptoms persist for more than six weeks, a referral to a specialist is warranted for a timely and accurate diagnosis.
Key Medical Specialists for Hand Arthritis
The type of arthritis suspected determines whether a patient is referred to a rheumatologist or an orthopedic surgeon specializing in the hand. These two specialists have distinct roles and treatment philosophies, though they often collaborate in complex cases.
A rheumatologist is an internal medicine doctor specializing in diagnosing and treating inflammatory and autoimmune conditions affecting the joints and connective tissues. They treat inflammatory types of arthritis, such as Rheumatoid Arthritis (RA) or Psoriatic Arthritis. Rheumatologists use advanced blood tests to look for specific markers, like the rheumatoid factor or anti-citrullinated protein antibodies (ACPA), to confirm an autoimmune diagnosis. Their treatment focuses on managing the systemic disease through non-surgical methods, primarily using medications such as Disease-Modifying Antirheumatic Drugs (DMARDs) and biologics to suppress the overactive immune response and slow joint damage.
An orthopedic surgeon, particularly one with fellowship training in hand surgery, specializes in the structural and mechanical issues of the musculoskeletal system. This specialist treats patients with severe joint damage or the most common form of the disease, Osteoarthritis (OA), a degenerative “wear and tear” condition. Orthopedic specialists rely on advanced imaging, such as X-rays and MRI, to assess cartilage loss and bone spurs. Their treatment centers on preserving or restoring joint function, which may involve non-surgical interventions like steroid injections. They also perform surgical procedures, ranging from joint fusion (arthrodesis) to complete joint replacement (arthroplasty) for severely damaged joints.
Functional Management and Rehabilitation
Functional management and rehabilitation are fundamental for maintaining independence and hand function beyond medical and surgical treatment. This aspect of care involves non-physician specialists who focus on the practical, day-to-day impact of arthritis.
Occupational Therapy (OT) is a key component of rehabilitation, focusing on helping patients adapt to their environment and perform daily tasks. The goal of an Occupational Therapist is to improve a person’s ability to participate in activities such as dressing, cooking, or writing. They teach techniques for joint protection, which involves using stronger joints and larger muscle groups to reduce stress on the small joints of the hand. OTs often fabricate custom splints and recommend assistive devices that help maintain joint alignment and reduce pain.
Physical Therapy (PT) plays a supportive role, concentrating on improving range of motion, muscle strength, and pain relief. A Physical Therapist designs an exercise program tailored to the patient’s needs, incorporating gentle stretches and strengthening exercises for the hands and wrists. This targeted approach helps combat stiffness that results from avoiding movement due to pain. In some cases, a Certified Hand Therapist (CHT), who is an occupational or physical therapist with specialized training, may provide an integrated approach to functional adaptation and physical recovery.