Arthrosis of the hands: symptoms, causes and treatment

By Cristiano Antonino On Feb 1, 2023

Arthrosis of the hands is a chronic inflammatory disease that consists of a slow but inexorable wear and tear of the cartilage that surrounds the joints of the fingers and/or wrist, protecting them and helping them to move

Wear and tear can also cause other tissues in the joint to produce inflammatory cells, which further damage it.

Due to the loss of cartilage, the joint bones rub against each other, causing pain and the formation of bone beaks or osteophytes.

In general, arthrosis of the hands most frequently affects

the trapeziometacarpal joint, which is located at the base of the thumb, where the finger meets the wrist. Wear and tear of the thumb joint is known as rhizarthrosis (trapeziometacarpal arthrosis) and occurs when the tension of the stabilising ligaments decreases. After all, this is an area that is highly stressed by everyday activities, for example when using keyboards or gripping a bottle;
the joints closest to the fingertips;
the middle finger joints.

More rarely, joints at the base of the fingers are affected.

Causes of arthrosis in the hands

There are certain factors that increase the risk of suffering from arthrosis of the hands:

age: the older the years, the greater the likelihood of developing this disease;
gender: compared to men, women are twice as likely to suffer from osteoarthritis of the hands;
weight: thinner people are less at risk than obese people;
previous injuries, e.g. bone fractures and dislocations. In many cases, the trigger for cartilage damage is a previous injury, such as a broken bone or torn ligament between the carpal bones. It can happen that this problem goes undiagnosed for a long time and thus, over the years, arthrosis of the hands can develop;
genetic predisposition: those who have other cases of hand arthrosis in their family are more vulnerable;
previous joint problems, such as infections, loose ligaments, overuse and misalignment of joints;
presence of rheumatism.

Other triggers may include: stress; changes in barometric pressure; doing the same movement over and over again; infections; strain.

Arthrosis of the hands, symptoms

The most common symptoms of osteoarthritis in the hands are pain, stiffness and poor mobility, which vary in intensity depending on the case and may worsen over time.

The pain may become constant and more acute and the stiffness may prevent the person from fully bending the joints of the fingers.

Sufferers of this condition may have difficulty carrying a shopping bag, as well as opening a bottle and/or gardening.

Not infrequently, symptoms worsen in cold and wet weather and improve in warm weather.

It may also happen that symptoms worsen in the morning.

Arthrosis of the hands and lumps

Arthrosis in the hands can cause other problems, such as:

the appearance of bony protuberances near the joints of the fingers, so-called ‘knots’. Bouchard’s knots form on the middle joint of a finger and Heberden’s knots occur on the joint near the tip of the finger;
the formation of cysts, i.e. fluid-filled protuberances, near the fingertip joints;
the ‘cricks’: those who suffer from arthrosis in their hands may experience strange crackling noises. This is the sound of the surfaces of the joints rubbing against each other;
swelling and redness, signs of inflammation around a joint;
weakness: joint pain and damage can make it more difficult to do things like turning door handles or lifting heavy pots and pans;
other physical changes: over time, swelling and breakdown of cartilage and bone can change the shape of joints and make them larger and more deformed.

The doctor who diagnoses and treats arthrosis of the hands

If there are suspicious symptoms, it is important not to pretend nothing is wrong, but to contact your doctor, who may then refer you to an orthopaedist and/or rheumatologist.

Without treatment, in fact, arthrosis is bound to worsen over time.

It is important, therefore, to get a diagnosis and treatment plan as soon as possible.

In some cases, specialists can diagnose arthrosis of the hand simply by observing the joint and taking a careful anamnesis, which consists of a thorough interview with the patient to learn about the symptoms experienced and the personal and family medical history.

To confirm the diagnosis and exclude the presence of other diseases, such as rheumatoid arthritis, they can then make use of imaging techniques such as:

-radiography, which allows imaging on various planes, detecting cartilage loss and other damage;

-magnetic resonance imaging (CT/MRT), which allows a closer examination of the bones and soft tissues.

The doctor may also prescribe blood tests, especially to rule out other types of arthritis such as rheumatoid arthritis.

He or she will also examine the person to assess the joints and their mobility, any swellings and deformities.

How to treat arthrosis in the hands

There is no definitive cure for osteoarthritis in the hands, but there are many strategies to protect the joints and feel better.

Your doctor may recommend one or more of these treatments to relieve pain and facilitate hand movement:

use of pain-relieving drugs, such as paracetamol and NSAIDs, which help alleviate pain;
use of immobilising devices: in some cases, the use of immobilising devices, such as splints or braces, is indicated to keep the hand in a stable position in order to reduce pain;
Occupational hand therapy: this involves exercises and strategies for performing daily activities that are taught to the patient by an expert called a hand therapist. For example, the professional might teach the patient to carry shopping bags over the forearm instead of with the fingers;
specific exercises, to improve strength and range of motion and to relieve pain;
assistive devices, such as special pens, cooking utensils and other tools with large handles, which are easier to use;
application of ice or heat: ice can reduce swelling and pain, while heat can loosen stiff joints;
medicated creams, which can provide relief when applied to painful joints;
cortisone injections into the joint, to reduce discomfort.

Many people take glucosamine and chondroitin supplements for osteoarthritis in the hands, but it has not yet been proven whether or not they are effective.

If conservative treatments have not worked or if the symptoms are such that they hinder hand movement, the doctor may recommend surgery.

One option is joint fusion, in which the surgeon fuses the bones together: this operation reduces pain, but decreases the movements that can be performed with the joint.

One could also opt for surgery that removes and replaces the joint.

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