Skip to content
Osteoarthritis of the Hand

Osteoarthritis of the Hand

Hand Osteoarthritis: Causes, Symptoms, Diagnosis, and Treatment

Osteoarthritis is a degenerative joint disease that causes the cartilage covering the bones at the joints to wear out. While it can result from simple “wear and tear” on the joints, it may also develop after an injury.

Common Areas of Hand Osteoarthritis

In the hand, osteoarthritis typically develops in three key areas:

  • Base of the Thumb: Where the thumb and wrist come together (trapezio-metacarpal or basilar joint).
  • End of the Finger: The distal interphalangeal (DIP) joint, closest to the fingertip.
  • Middle Joint of the Finger: The proximal interphalangeal (PIP) joint.

Osteoarthritis may also affect the wrist.

Signs and Symptoms of Hand Osteoarthritis

Common symptoms of osteoarthritis in the hand include:

  • Stiffness, Pain, and Swelling
  • Bony Nodules: Found at the middle joint (Bouchard’s nodes), end joints (Heberden’s nodes), or the DIP joint.
  • Deep, Aching Pain: Typically at the base of the thumb.
  • Swelling and a Bump: Noticed at the base of the thumb.
  • Diminished Grip and Pinch Strength
  • Wrist Pain: Swelling, stiffness, and reduced strength.
Diagnosing Hand Osteoarthritis

Your doctor will evaluate your hand to check for similar symptoms in other joints and determine the impact of arthritis on your daily activities. The diagnosis is based on:

  • Appearance: The visual examination of your hands and fingers.
  • X-rays: These can reveal joint space narrowing, bony outgrowths (osteophytes), and hard bone areas along joint margins, which are characteristic of osteoarthritis.
Treatment of Hand Osteoarthritis

The treatment of hand osteoarthritis focuses on relieving pain and maintaining joint function. Options include:

  • Anti-inflammatory Medications: To help relieve pain and inflammation.
  • Wrist Splints: Worn at night or during specific activities. Soft sleeves may be an alternative if rigid splints are too restrictive, particularly for arthritis at the base of the thumb.
  • Heat Therapy: Warm wax or paraffin baths may help reduce swelling.
  • Hand Therapy: Engaging in therapy helps maintain finger motion and function.
  • Cortisone Injections: These can provide temporary relief from pain but do not cure the condition.
Hand Surgery for Osteoarthritis

Surgery is typically recommended only when conservative treatments fail or when pain is unmanageable. Surgical options may include:

  • Joint Fusion: Involves removing the arthritic surface and fusing the bones on either side of the joint, eliminating motion and pain, but reducing joint flexibility.
  • Joint Reconstruction: The damaged joint surface is removed to eliminate rough bone contact, and may be replaced with soft tissue (like tendon) or a joint replacement implant.

The choice of surgery depends on the specific joint(s) affected, your activity levels, and personal needs. Your hand surgeon will guide you in selecting the best surgical approach for your condition.

Related Conditions