Hand Osteoarthritis

What is hand osteoarthritis?

Hand osteoarthritis is a degenerative joint disease that occurs over time as joint cartilage undergoes wear and tear. It is characterised by joint swelling and inflammation, loss of joint cartilage and narrowing of joint spaces resulting in pain and stiffness over joints, as well as loss of finger movements. Bone spurs may also develop within the joint, resulting in pain over the finger joints upon movement and difficulties in the management of daily tasks.

Osteoarthritis most commonly affects 3 parts of the hand:

• The joint at the base of the thumb, where the thumb and wrist bones meet.
• The end joint of the finger (closest to the fingertip).
• The middle joint of the finger.

Osteoarthritis usually occurs later in life, with no specific cause. But several factors can play a role, including:

• Age – the older you are, the more likely you are to have hand osteoarthritis.
• Sex – women are more likely to be affected than men.
• Weight – obese people are more likely to have hand osteoarthritis than thinner people.
• Genes – some individuals inherit the tendency to develop osteoarthritis, usually at a younger age.
• Injuries – even when properly treated, an injured joint is more likely to develop osteoarthritis over time. Fractures and dislocations are among the most common injuries that lead to arthritis.
• Joint issues – joint infections, overuse, loose ligaments, and poorly aligned joints can also lead to hand or wrist arthritis.

How do I know if I have osteoarthritis?

Signs and symptoms of hand osteoarthritis may include:

• Pain – At first, pain will come and go. It worsens with use and eases with rest. Morning pain and stiffness are typical. As the osteoarthritis advances, the pain becomes more constant and may change from a dull ache to a sharp pain. It may start waking you up at night.
• Stiffness and loss of motion – As arthritis progresses, you may lose the ability to open and close your fingers completely.
• Crepitus – When damaged joint surfaces rub together, you may feel grinding, clicking or cracking sensations.
• Swelling – Your body may respond to constant irritation and damage to the tissues surrounding the joint by swelling and becoming red and tender to the touch.
• Nodules – Bony lumps may form on the middle or end joints of the finger.
• Joint deformity – Bone changes, loss of cartilage, unstable or loose ligaments and swelling can result in your finger joints becoming large and misshapen.
• Weakness – The combination of joint pain, loss of motion and joint deformity can leave your hands weak. Activities that once were easy, such as opening a jar or starting the car, become difficult.

How is hand osteoarthritis diagnosed?

Your specialist Doctor will obtain your health history and perform a physical examination to check your joints for signs of arthritis. Your Doctor may also order medical diagnostic tests (e.g. X-rays) to check for loss of space in your joints (indicating cartilage loss) and formation of bone spurs.

How is hand osteoarthritis treated?

Osteoarthritis is a chronic disease. There is no cure, but healthy lifestyle habits and treatments can help manage your symptoms and keep you active.

Hand Therapy

Your specialist Doctor may refer you to our Hand Therapist, who will be able to provide the following services:

• Wax therapy
• Ultrasound therapy
• Advice on joint protection strategies, activity pacing, as well as lifestyle and activity modifications so as to eliminate or minimise daily activities or movements which may further aggravate your joints
• If necessary, provide a customised splint to be worn over the affected joint/s when you are using your hands to perform daily activities so as to provide support and reduce strain on the joint/s
• Soft tissue mobilisation and release
• Appropriate and gentle exercises to improve joint and muscle movements
• Gentle strengthening exercises if appropriate
• Pain relief/management
• Personalised home exercise program

Non-surgical Treatment

Your Doctor may suggest other non-surgical interventions such as pain relief and anti-inflammatory medications, or corticosteroid injections to help ease osteoarthritis symptoms.

Surgical Treatment

If non-surgical treatment fails to provide relief, surgery may be an option. Your specialist Doctor may recommend surgery that involves removing the damaged cartilage and fusing bones together, or replacing the damaged joint with an implant.