Osteoarthritis of the hand involves the degeneration of joint cartilage, leading to pain and stiffness.
Osteoarthritis of the hand is wear of the cartilage lining the small joints of the hand and fingers, most commonly affecting the base of the thumb (the carpometacarpal joint) and the joints of the fingers closest to and furthest from the palm. As the protective cartilage thins, the joint becomes painful, stiff and, over time, can develop the characteristic bony enlargement often seen at the finger joints.
Osteoarthritis of the hand develops from age-related wear of the joint cartilage, and is more common with increasing age, in women, and in people with a family history of the condition. A previous injury to a joint, and heavy repetitive hand use over many years, can also contribute to earlier or more localised wear.
Common symptoms of hand osteoarthritis include:
Symptoms typically develop gradually over years, though periods of increased pain and swelling can occur.
Assessment includes examination of the affected joints and X-rays to confirm the degree of wear and rule out other causes of joint pain.
Non-surgical treatment is the mainstay for most patients: activity modification, splinting, particularly for thumb base arthritis, anti-inflammatory medication, and a corticosteroid injection into a specific painful joint.
For joints that remain significantly painful despite these measures, surgical options depend on which joint is affected. Thumb base arthritis is often treated with trapeziectomy, removing the affected small bone at the base of the thumb. Finger joints may be treated with joint fusion, sacrificing movement at that joint for reliable pain relief and stability, or in selected cases joint replacement, which aims to preserve some movement.
Hand osteoarthritis is a progressive condition, but symptoms are often manageable with non-surgical treatment for a considerable period, sometimes many years. For joints that become persistently painful and limiting despite these measures, surgery generally provides good, reliable pain relief, though the specific procedure and its effect on joint movement vary depending on which joint is involved.
Osteoarthritis of the hand and fingers is a common, progressive condition, most often affecting the base of the thumb and the finger joints. Non-surgical measures manage symptoms well for many people over years, and effective surgical options exist for joints that remain significantly painful. Persistent hand joint pain, stiffness or swelling is worth having assessed.
