Managing Symptoms of Arthritis in Your Hands
Osteoarthritis and inflammatory forms of arthritis, like rheumatoid arthritis, often cause joint pain and other symptoms in hands and fingers. But there are treatments to help.
You may not think about how much you use your hands until symptoms of arthritis start to affect them, making the activities you once enjoyed challenging or even impossible. Hand arthritis poses considerable limitations to those who have it. Over 53 million Americans have arthritis, and according to the Centers for Disease Control and Prevention (CDC), many of them find grasping small objects or lifting or carrying anything weighing 10 pounds or more “very difficult,” if not impossible.
Stiffness, swelling, and pain are common symptoms of arthritis in the hands, but different forms of arthritis affect the hands in different ways.
With osteoarthritis (OA), the most common form of arthritis, cartilage can wear down in all the joints in the fingers and thumb. The Arthritis Foundation notes that half of all women and 25 percent of men will experience OA of the hands by age 85. OA most commonly affects three parts of the hand:
Bony bumps may appear in the middle joint of the finger or at the joint near the fingertip, per the Arthritis Foundation, and joint deformity can occur.
Rheumatoid arthritis (RA), an inflammatory, autoimmune condition, can also happen in your hands. RA affects the synovium, the lining of the joints, throughout your body. The Cleveland Clinic notes that RA commonly affects the small joints of the hand, wrists, and fingers, typically on both sides of the body. Growth of rheumatoid nodules — inflammatory lumps under the skin — can occur in the hands.
According to CreakyJoints, RA tends to affect the small joints of the hands early in the course of the disease.
Joints may be swollen and feel warm to the touch, and RA is more likely to cause morning stiffness that can last at least a half an hour. It’s possible that numbness in the hand could be due to carpal tunnel syndrome, a complication of RA.
Psoriatic arthritis, a type of arthritis related to the skin condition psoriasis, is most likely to cause pain in the joints closest to the fingernails (called the distal joints) and cause swelling that makes fingers look sausage-like (dactylitis), notes the Cleveland Clinic.
The progression of arthritis in the hands can actually be measured. People with rheumatoid arthritis (RA) and psoriatic arthritis lose bone density, which can be measured with bone-density scanning, while the joint damage of osteoarthritis can usually be seen on X-rays.
“Physical therapy can help to alleviate arthritis hand pain by improving joint mobility and strength,” says Theresa Marko, DPT, a spokesperson for the American Physical Therapy Association (APTA) and the founder and owner of Marko Physical Therapy, a private practice in New York City, specializing in orthopedics. “Improving mobility will reduce stiffness and improve movement in the knuckles and finger joints, helping to reduce pain,” she adds.
Dr. Marko notes that physical therapists (PTs) can do this through manual techniques, including gentle joint mobilizations, in which a passive force is applied in a specific direction to help the biomechanical glide of the joint. “When hands become stiff, the joints can benefit greatly from this technique,” she says.
It’s also important to improve the strength of your wrist, elbow, shoulder and shoulder blade in order to reduce demand on the small joints in the hands. “You want assistance from your larger joints to help support the work of the hands so that your force when performing activities is not all generated by your hands,” explains Marko. “Think of something like scrubbing the bathtub — a strong shoulder will mean the strength and stability is coming from the shoulder instead of straining the hands.”
Physical therapy can also help improve and maintain movement that might be limited by pain, to preserve a person’s quality of life, notes Marko. “This can include exercises for enhancing joint flexibility, general physical conditioning, muscle strength, and pain management.”
While it varies depending on the person and their symptoms, exercises typically include squeezing or closing the hand, opening the fingers with something like a gentle elastic, and some stretches with range of motion incorporated, says Marko.
Additional exercises to help the larger joints supporting the hands could include:
Marko adds that if arthritis is making it too painful to hold a weight in the hand, she might opt for light ankle weights placed around the wrists when performing these exercises.
A benefit of PT is that it’s tailored to the individual. The signs and symptoms of OA and RA can vary, so the approach to care also will vary, says Marko, and what works for some may not work for others. But typically, low impact and more gentle exercises may be advised for both.
“People with RA may have more fatigue than usual, so energy-saving physical activity should be kept in mind,” she adds.
Treatment options depend on how severe your arthritis symptoms are, but in addition to physical or occupational therapy, they include using splints or braces to support the affected joint and prevent further damage, medications, and surgery.
Certain over-the-counter medications as well as prescription drugs are used to treat arthritis, depending on which type of arthritis you have. Acetaminophen can help reduce pain and nonsteroidal anti-inflammatories (NSAIDs) can relieve pain and swelling.
For inflammatory arthritis such as rheumatoid arthritis or psoriatic arthritis, systemic treatments like disease-modifying antirheumatic drugs (DMARDs) and biologics can slow the progression of the disease and relieve symptoms, notes the Cleveland Clinic. Corticosteroids can reduce inflammation.
There are currently no medications approved to slow the progression of osteoarthritis, but methotrexate, a DMARD, may offer new help for OA in the hand where inflammation is a factor. In a recent study, people with hand OA and inflammation took either a weekly methotrexate pill or a placebo for six months. Pain improved initially for both groups but was more significantly reduced for the methotrexate group at the end of the study. More research will likely be needed before this becomes part of regular treatment regimens.
Surgery may be an option, when more conservative treatments aren’t working. For OA, joint fusion and joint reconstruction are types of surgery to relieve pain and improve function, according to the Massachusetts General Hospital. With RA, surgery could involve removing inflamed joint linings, repairing tendons, fusing joints, or joint replacement, according to CreakyJoints.
Your doctor will tell you — and probably has already — that staying physically active is an important part of managing arthritis. In fact, a study of 2252 adults over 60 found that higher levels of physical activity were associated with higher functional measures, both self-reported and objectively measured.
“Exercise is helpful for those with both OA and RA in helping with weight loss (extra weight puts pressure and stress on joints), muscle strength, and a reduction in joint pain,” says Marko.
Of course, despite data showing that physical activity helps people with arthritis become stronger and more flexible, arthritis pain or stiffness can make it hard to get going, let alone lift weights at the gym. People with arthritis often give up activities they think of as optional, such as exercising or gardening, in order to have enough energy for the activities they feel obligated to do, such as cleaning the house.
If symptoms of arthritis in your hands or elsewhere are preventing you from participating in physical activities it may be time to find new ways to be active. For example, you may want to experiment with water activities (which are easier on the joints) such as swimming, or try tai chi, dance, or walking (which has the added benefit of being low-cost).
When your hands are in pain, assistive devices and gadgets can help you take care of everyday tasks more easily and can preserve joint health by reducing stress on the joints, notes the Hospital for Special Surgery.
A number of items can make work in the kitchen less challenging. Consider a grip wrench, to aid in opening bottles and jars with twisting lids, an electric can opener, and kitchen tools and utensils with larger grips.
If your fingers are aching and stiff, try zipper pulls and buttoning aids when getting dressed, suggests the Arthritis Foundation.
You may also want to invest in some household modifications, like installing lever handles on doors to avoid struggling with traditional door knobs. The same goes for lever faucet handles on your sinks.
These relatively simple fixes will go a long way when arthritis is hurting your hands.
RELATED: Top Assistive Devices for Rheumatoid Arthritis
Additional reporting by Deborah Shapiro.
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