Arthritis of the Hand
By Anita Ballmick MOTR/L
What is Arthritis?
Arthritis is inflammation of one or more of your joints. The hand and wrist have multiple small joints that work together to produce motion, including the fine motion needed to tie a shoelace or to fasten buttons. When the joints are affected by arthritis, activities of daily living can be difficult to complete independently.
Symptoms of Arthritis
- Pain in hands after gripping or grasping tasks
- Morning stiffness
- Swelling of the joints
- Joints may feel warm to touch
- Grating or grinding sensation to affected joint
- Cyst formation
Types of arthritis
Osteoarthritis is much more common and generally affects the older population. Also known as “wear and tear” arthritis, which causes the cartilage to wear away. Osteoarthritis affects the large weight-bearing joints such as the shoulders, knees, hips, and spine, and the small joints of the hands, most commonly the thumbs.
Rheumatoid arthritis is a chronic disease that can affect many parts of your body. It causes the joint lining (synovium) to swell, which causes pain and stiffness in the joint. It usually affects the same joints on both sides of the body.
A doctor can diagnose arthritis of the hand by examining the hand and by taking x-rays. Medications can treat symptoms but cannot restore joint cartilage or reverse joint damage. The most common medications for arthritis are anti-inflammatories, which stop the body from producing chemicals that cause joint swelling and pain.
Treatment options for arthritis of the hand and wrist include, splinting, injections, and surgery, and are determined based on:
- Progression of arthritis
- Type and number of joints are involved
- Age and level of activity
- If the dominant or non-dominant hand is affected
- Compliance with exercises and postsurgery protocol
If anti-inflammatory medication is not suitable, steroid injections may be used. These typically contain a long-lasting anesthetic that can provide pain relief for weeks to months. This can vary based on a number of factors. The injections can be repeated, but most surgeons limit the number of times due to possible side effects.
Injections are usually combined with splinting of the affected joint. The splint helps support the affected joint to ease the stress placed on it from frequent use and activities. Splints are typically worn when the affected joints are in pain. They allow functional use of the hand when they are worn and do not restrict functional motion. A hand therapist can assist you in the proper splint and application.
There are many surgical options. It should be customized to your individual needs. Talk with your surgeon to find out if surgery is right for you.
After any type of joint reconstruction surgery, there is a phase of recovery. Often, you will be referred to a trained hand therapist, who can help you maximize your recovery. Therapy can assist with education, modalities, splinting and any questions you may have. The use of a splint or cast for a while after surgery to protect the repair is common after surgery. A hand therapist can suggest modifications of activities to allow the joint reconstruction to heal properly. Length of recovery time varies widely and depends on the extent of the surgery performed and personal factors.