The Arthritic Hand
By Heather Lopez, OTR/CHT
The Arthritic Hand
An arthritic hand is inflamed, stiff, and painful. The joints can be a reddish hue and even feel warm to touch. Arthritis can be rheumatoid in nature or osteoarthritic.
A Rheumatoid Arthritic hand is visually characterized by drifting the digits toward the hand’s small finger side. The fingers are no longer able to maintain proper alignment with the hand. In more severe cases, the extensor tendons that run along the back of the hand and into the digits slip off the large knuckles (MP joints), causing the fingers to drift even further. This positioning of the fingers makes grasping activities, in-hand manipulation, and fine motor tasks virtually impossible.
Rheumatoid arthritis is a progressive autoimmune disease. This means that the body’s own immune system attacks its healthy cells. A panel of blood tests diagnoses rheumatoid arthritis. In the early stages of the arthritic process, pain, inflammation, and stiffness can be alleviated by:
- warm compresses
- paraffin treatments
- gentle hand exercises with little to no resistance
Joint protective techniques are a crucial part of the education process to help preserve the joint surfaces as much as possible. Medications may also help; from over the counter NSAIDs to prescribed disease-modifying anti-rheumatic drugs. When the conservative treatments are no longer a benefit, surgery may be necessary to realign the digits and replace the MP joints.
The second type of arthritic hand is the osteoarthritic hand. Osteoarthritis is a degenerative joint disease that results from everyday usage, or it may be a result of a particular injury. The cartilage or cushion between the joint surfaces deteriorates over time, causing a bone on bone joint that is painful, stiff, and full of crepitus. The extra calcification creates nodules on the hand’s interphalangeal joints (IP joints), giving the fingers a “knobby” appearance. The thumb is a common digit that is affected by osteoarthritis. The thumb is characterized by a loss of web space between the thumb and the index finger.
A simple x-ray can diagnose osteoarthritis. It can be conservatively managed in the early stages of the disease process, similar to rheumatoid arthritis. Again joint protection techniques are a crucial part of joint preservation. Prolonged gripping and pinching activities need to be avoided. Osteoarthritis can become so painful and debilitating that joint replacement or joint fusion is necessary to alleviate the pain and improve function.
The arthritic hand can be very debilitating, and there is not a cure. Becoming aware of early arthritis signs and symptoms can help one preserve their function and independence.