October 03, 2022
Arthritis is not just one single disease, as the term arthritis simply means a painful inflammation of the joints. In fact there are over 100 different types of arthritis as well as related conditions, affecting all races, ages and sexes. It is a leading cause of disability.
The most common type of arthritis is osteoarthritis (OA) and although it can damage any joint, OA is most common in the hands, spine, hips and knees. OA used to be thought of as the “wear and tear” arthritis in which the protective cartilage in the joints wore out as a result of years of use. The current thinking has changed on this and now the disease is seen as one involving the entire joint, not just the cartilage.
Another type of arthritis is inflammatory autoimmune arthritis, in which the immune system becomes overactive, fails to recognize the body as “self” and begins to attack the joints as if they were invaders. This type of arthritis most commonly attacks the hands, spine and feet but in some people can become systemic and affect the eyes, heart, skin and other organs. The most common form of inflammatory autoimmune arthritis is rheumatoid arthritis known as RA. Juvenile rheumatoid arthritis (JRA), psoriatic arthritis and ankylosing spondylitis are also types of inflammatory autoimmune arthritis.
Arthritis of the hands, regardless of the type, is particularly bothersome, because in addition to pain, people with hand arthritis have difficulty with or even lose the ability to perform necessary day to day tasks at home or at work. People who suffer from hand arthritis commonly have pain, swelling, stiffness and may even have deformity of the joints.
In osteoarthritis of the hands, the most commonly affected areas are the wrist, the joint at the base of the thumb and the middle and distal (nearest the fingernails) joints of the fingers. Over time, OA can cause unsightly painful bony lumps to form in the finger joints. When rheumatoid arthritis affects the hands, it causes the lining of the joints (the synovium) to swell, resulting in pain, stiffness and a loss of function. As the disease progresses, the joints become deformed due to the destructive nature of the inflammation. RA typically affects the small joints of the wrists, hands and fingers and usually affects the same joints on both sides of the body.
You are more at risk for developing hand arthritis if you are older (OA is usually seen after age 50 and RA between 35 and 50), you are female, you are white, overweight, had previous injuries to your hands (such as dislocations or fractures) or if you are genetically predisposed.
Early symptoms can include joint pain which comes on hours after you have had increased use of your hands, morning stiffness and pain in your hands, and swollen hand joints. Arthritis which has been present for some time may cause sharp pain which may wake you up at night, the skin over the joint may become red and tender, your joints may click or crack when bending them or you can’t fully open or close your hands.
OA is diagnosed by history, physical exam and xrays of the hands which will show a loss of bone cartilage as well as bony spurs. Blood tests are usually done when inflammatory autoimmune arthritis is suspected.
Treatment of hand arthritis has to be individualized and will depend on the type of arthritis, what stage it’s at, and how many of your joints are affected. Other considerations are your age and activity level as well as other pre-existing medical conditions. Treatments range from splinting and bracing, to medications, steroid injections and sometimes even surgery. Additional strategies may include special exercises, hot/cold packs and rest. Of course healthy eating, stopping smoking, managing diabetes and/or obesity. Marine collagen has also been shown to reduce joint pain and improve the strength and flexibility of joints, including joints in the hands. If you are experiencing symptoms talk to your doctor or health care provider about the best options for your specific case.
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