Arthritis of the Hand: Let's talk about causes, symptoms, and treatment in simple terms!

Do you also feel a little stiff in your fingers when you wake up in the morning, and it's hard to bend or straighten them? Or do you feel a little pain or burning in your joints and wrists in the evening after doing small tasks throughout the day? You may think that this is just something that happens due to fatigue. However, these can also be the early signs of arthritis of the hand . Since many people are not exactly aware of this, today we will talk about it in detail and very simply.

What is arthritis of the hand? Let's understand it very simply!

Simply put, arthritis is a disease that attacks the tissues in your joints. What is a joint? It’s where two bones meet. It’s like the hinges on a door. Arthritis can damage the lining of a joint or the soft, cushiony cartilage that covers the ends of bones. Think of it like the sound your car makes when the engine parts of your car make contact with each other. When this cartilage wears down, the ends of the bones become exposed and start rubbing against each other. That’s when pain, swelling, and stiffness occur. Since our hands have so many tiny joints, arthritis is more likely to occur in the hands. Over time, this can make it difficult for you to do your daily tasks.

What types of arthritis affect the hands?

Yes, there are several types of arthritis, but let's talk about the three main types that most commonly affect the hands.

1. Osteoarthritis - degenerative joint disease

This is the most common type of arthritis. Some people also call it "joint wear." In osteoarthritis, the cartilage I mentioned earlier gradually wears down and breaks down. Then the ends of the bones rub against each other without protection. This is why things like pain, stiffness, and difficulty moving occur over time.

Think about it, it's like the parts of a frequently used machine that wear out over time.

Osteoarthritis most often affects your wrist, the base of your thumb, and the joints between your middle and fingernails. Over time, you may develop small bone spurs in your finger joints.

2. Rheumatoid Arthritis - Inflammation that comes from within the body

Rheumatoid arthritis is a slightly different, chronic inflammatory disease. It involves inflammation of the lining of the joints, called the synovium . It is an autoimmune disease.. That is, your body's own immune system mistakenly attacks your own healthy tissues. The synovium inside our joints produces a lubricant that helps them move easily. In rheumatoid arthritis, when this synovium becomes inflamed, pain, stiffness, and difficulty moving occur. Over time, this inflammation destroys the cartilage and the bone itself begins to wear away. The tendons and ligaments around the joints become weak and stretched, which can cause the shape and position of the joints to change. Rheumatoid arthritis usually affects the small joints in the wrists, hands, and fingers. What's special is that it often affects the same joints on both sides of the body. For example, if you have arthritis in the fingers of one hand, it's more likely to affect the fingers of the other hand as well.

3. Psoriatic Arthritis - Joint problems that come with skin disease

You may have heard of the skin disease psoriasis . Psoriatic arthritis is a type of arthritis that occurs in some people along with psoriasis. It causes swelling of the fingers, joint pain, and stiffness in the morning. In many cases, the symptoms are similar to rheumatoid arthritis. However, sometimes it can affect only a few fingers.

Which part of the hand is most affected by this arthritis?

There are four main areas of the hand that are affected by arthritis:

• The base of the thumb: This is where the thumb connects to the wrist.
• Knuckles: The joints that come up when the hand is clenched.
• The middle joints of the fingers.
• The top joints of the fingers: That is, the joints closest to the nails.

Who is more likely to develop arthritis in the hands?

Some people are more likely to develop arthritis than others. See if these facts apply to you:

• Increasing age: Osteoarthritis usually becomes more common after the age of 50. Rheumatoid arthritis can first appear between the ages of 35 and 50.
• Being a woman: Women are more likely to develop arthritis than men.
• Being white: (This is a fact mentioned according to foreign data.)
• Obesity or weight gain : As body weight increases, more pressure is placed on the joints.
• Previous hand injuries: Broken, twisted, or injured joints in your hand or fingersIf you have, you are more likely to develop arthritis later on. For example, if you hit your hand hard while playing sports or working, that can also affect it.
• Genetic influence : If certain types of arthritis run in your family, you may have a genetic predisposition to developing it too.

What are the symptoms of hand arthritis?

It's good to be a little careful about these characteristics.

Symptoms that may be seen in the early stages:

• A dull or burning pain in the joints: This pain can come on within a few hours or the next day, especially after a day of heavy manual labor. You might feel this way after a day of heavy kitchen work or cleaning around the house.
• Morning arm/hand pain and stiffness: When you wake up in the morning, your arm may feel stiff for a while, making it difficult to bend.
• Swelling of the joints in the hand/arms.

These symptoms may become more severe as arthritis progresses:

• Symptoms are becoming more and more frequent .
• The pain can range from a dull ache to a sharp, stabbing pain .
• You may even wake up at night because of the pain .
• Pain can cause you to change the way you use your hand . For example, you might use a different way to lift a weight or grip a handle.
• The tissue around the affected joint may become red and painful to the touch .
• You may hear or feel a "clicking" or cracking sound ( crepitus ) when you bend your fingers.
• You may not be able to fully extend your fingers.
• Small bony lumps called Bouchard's nodes and Heberden's nodes may appear on the middle joints of the fingers.
• The joints of the fingers can become enlarged, deformed, and stretched . This can weaken the hands and make it very difficult to perform daily tasks .

How do you find a doctor for arthritis in the hand?

If you have these symptoms, it's best to see a doctor. The doctor will examine your hand and ask you about your symptoms. In addition:

• X-rays: An X-ray can be used to see if the cartilage in the bones has worn away and if there are new bone growths at the ends of the bones (bone spurs).
• Blood tests: Blood tests are done to check for certain substances in the blood, such as rheumatoid factor , especially if rheumatoid arthritis is suspected.

What are the treatments for hand arthritis?

Treatment options depend on the type of arthritis you have, the stage of the disease, how many joints are affected, your age, how active you are, whether your dominant hand is affected, and any other medical conditions you have.

The main goals of treatment are:

• Reducing joint pain and stiffness.
• Improving joint mobility and function.
• Improving your quality of life.
• In conditions like rheumatoid arthritis or psoriatic arthritis, controlling the further progression of the disease.

Treatment options include splinting/bracing , medications , injections , non-drug approaches , and surgery .

1. Wearing splints or braces

These provide support and protection to the affected joint. They also help to reduce joint deformity, stabilize the joint, reduce stress on the joint, and keep the joint in the correct position. Your doctor, occupational therapist, or hand therapist can advise you on the right splint for you, how to wear it, and how long to wear it. Wearing these for too long can cause muscle weakness.

2. Medications

Your doctor may prescribe medication to reduce joint pain and swelling, and to prevent further damage to your joints in conditions like rheumatoid or psoriatic arthritis. You may try different medications depending on the type and severity of your arthritis.

• Acetaminophen: This is a pain reliever.
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): These reduce pain and swelling. Examples include ibuprofen , diclofenac , naproxen , and celecoxib . Topical NSAID creams are usually recommended first for osteoarthritis.
• Disease-modifying Antirheumatic Drugs (DMARDs): These control the progression of rheumatoid arthritis and reduce symptoms. Examples: Methotrexate , Hydroxychloroquine .
• Corticosteroids: These are used as oral pills, as injections into a muscle, or as injections into a vein. They reduce inflammation and other symptoms of rheumatoid arthritis.
• Immunosuppressive drugs:These control the progression of rheumatoid arthritis and reduce damage to the bones around the joints.
• Biologic Agents: These help control joint damage in rheumatoid arthritis. Examples: Adalimumab (Humira®) , Etanercept (Enbrel®) .

Important: Even over-the-counter medications should not be used without consulting a doctor, as they may interact with other medications you may be taking or other health conditions you may have.

3. Steroid Injections

Steroids are a type of medication that reduces inflammation and relieves pain. These injections are usually used when the inflammation cannot be controlled with medication, or when the inflammation is limited to a few joints. These injections are injected directly into the affected joint. However, because steroids can weaken tendons and ligaments, these injections are not used continuously, only a few times.

4. Other Management Strategies

A complete treatment plan also includes:

• Exercise: Joint strengthening and stretching exercises can help reduce symptoms and improve function. A physical therapist can help you determine which exercises are right for you.
• Hot and cold packs: Cold packs can reduce pain and swelling. Hot packs can reduce congestion. Do not apply for more than 20 minutes at a time.
• Rest: Taking regular breaks can help reduce joint pain and inflammation.
• A healthy diet and controlling diabetes and cholesterol.
• Lose weight if you are obese.
• Avoid smoking: Smoking increases the risk of developing arthritis.
• Occupational therapy: You can learn how to use self-help devices to help you with everyday tasks, such as getting dressed or doing chores in the kitchen.

5. Surgery - as a last resort

If medication and other treatments do not provide relief, and the cartilage at the end of the bone has completely worn away, surgery may be considered. There are several main types of surgery:

• Joint fusion (Arthrodesis): This surgery uses a plate and pins to fuse the bones in your joint together. This gives you a more stable, pain-free joint, but limits your ability to move the joint flexibly.
• Joint replacement (Arthroplasty):Just like joints like knees and hips can be replaced, joints in the hand can also be replaced. An artificial joint made of plastic, ceramic, silicon, or metal is used to replace the damaged joint. But remember, artificial joints placed in fingers do not fully mimic normal finger movement.
• Tendon transfer: Tendons are the tissues that connect muscles to bones. Long-term inflammation from arthritis can cause tendons to rupture. If this happens, a section of healthy tendon can be used to restore function in your hand.

You and your surgeon will discuss and decide which surgical procedure is best for you, taking into account factors such as your age, activity level, affected joints, and the amount of pain and deformity you have.

What to expect after hand surgery?

After surgery, you will need to wear a cast or splint to protect your hand while it heals. Your doctor may also refer you to a hand therapist. They may also prescribe painkillers for a limited period of time to help reduce pain.

Are there any complications with hand surgery?

Like any surgery, hand surgery can have some complications. For example:

• Mobility not improving as expected.
• Having to replace the implant due to breakage or wear.
• Bones not joining together or joining together incorrectly during fusion surgery.

How long does it take to recover from surgery?

The recovery time depends on many factors, including the severity of your condition, the type of surgery performed, the skill of the surgeon, and how well you comply with treatment. You can usually return to normal activities about three months after joint reconstruction surgery. Your medical team will give you the best idea of ​​the recovery time that is right for you.

Are you looking for new treatments?

Yes, there are several clinical trials underway in the US, especially for osteoarthritis, on things like stem cell treatment. The early results are encouraging. Also, in the last decade, many new drugs have been discovered for psoriatic arthritis and rheumatoid arthritis, and more research is underway.

Are Glucosamine and Chondroitin pills good?

These supplements are not reviewed and approved by agencies like the U.S. Food and Drug Administration (FDA). This means they are not subject to the same rigorous clinical trials as regular medications. While some clinical trials have shown that they may be helpful in reducing pain, they have not been proven to slow the progression of osteoarthritis. If you are considering using something like this, be sure to ask your doctor. They may interact with other medications you are taking.

Can arthritis in the hands be prevented?

Unfortunately, arthritis cannot be completely prevented. However, you can pay attention to the symptoms of arthritis as you age. If you notice any changes in your joints, see a doctor right away. You can also take steps to control some risk factors:

• Eat nutritious foods: Provide your body with the nutrients it needs and maintain a healthy weight. Being overweight (BMI greater than 25) puts more pressure on your joints.
• Don't smoke: Smoking increases the risk of developing arthritis.

So, what should we remember from this? (Take-Home Message)

If you have a dull or burning pain in your hand joints, morning stiffness, or swelling in your joints, these could be symptoms of arthritis. As we've discussed, several types of arthritis can affect the hands.

The best thing to do is to seek medical advice immediately if you have these symptoms. The doctor will examine you thoroughly and provide you with a treatment plan that is right for you.

That treatment plan may include things like hand exercises, hot and cold packs, and lifestyle changes, along with medications, splints/braces, steroid injections, and even surgery as a last resort. Remember, although there is no cure for arthritis, you can still manage your symptoms and live a good life. So don't panic, and follow your doctor's advice.

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