Finger Joint Arthritis – Hand and Nerve Surgeon

What is Arthritis of the Hand?

Arthritis is a disease that attacks the tissues of your joints. A joint is where two bones meet. Arthritis can attack the lining of your joint or the cartilage, the smooth covering at the ends of bones. Eventually the cartilage breaks down, the ends of your bones become exposed, rub against each other and wear away. You have many joints in your hand, therefore it’s a common site for arthritis to happen.

Arthritis of the hand causes pain and swelling, stiffness and deformity. As arthritis progresses, you can’t use your hands to manage everyday tasks as you once could.

Are there different types of arthritis that affect the hands?

Yes. There are many, but these are some of the more common ones.

Osteoarthritis also known as “wear and tear” or degenerative arthritis, is the most common type of arthritis. It causes the cartilage (the smooth, cushion covering at the ends of your bones) to break down and wear away. The ends of bones then rub together without protection, which causes pain, stiffness and loss of movement over time. Osteoarthritis most commonly affects your wrist, joint at the base of your thumb and the middle and top (near fingernails) joints of your fingers. Long-term disease can cause bony lumps to form in the joints of your finger.
Rheumatoid Arthritis is a chronic (long-term, ongoing) inflammatory disease that causes the joint lining to swell, causing pain, stiffness and loss of function. It's an autoimmune disease (your body’s immune system attacks its own healthy tissue). A joint’s lining is called synovium. Your synovium produces the fluid (lubricant) that allows cartilage to easily slide against each other. Eventually the inflammation destroys the cartilage at the end of bones and then erodes the bone itself. The joints lose their shape and alignment as the tendons and ligaments surrounding the bone weaken and stretch. Rheumatoid arthritis commonly affects the small joints of your wrists, hands and fingers. It usually affects the same joints on both sides of your body. For instance, if arthritis affects finger joints one hand, it's likely to affect the finger joints on your other hand too.
Psoriatic Arthritis is a form of arthritis that affects your skin (psoriasis) and joints. Your fingers become swollen. You will also feel joint pain and morning stiffness. In many cases, it is similar to rheumatoid arthritis. However, it may only involve several fingers.

What parts of the hand are most affected by arthritis?

The four areas of your hand attacked by arthritis are:

Who gets arthritis in their hands?

You are more likely to get arthritis in your hands if:

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You’re older. Osteoarthritis is commonly seen after age 50. Rheumatoid arthritis typically first appears between the age of 35 and 50.
You’re a woman.
You’re white.
You have obesity or overweight.
You’ve had previous injuries to your hand. If you’ve dislocated or broken any joints in your hands or fingers, you are more likely to develop arthritis.
You've inherited genes that cause the development of arthritis.

What are the symptoms of arthritis in the hands?

Early symptoms include:

How is arthritis in the hand diagnosed?

Your healthcare provider can make the diagnosis of arthritis of the hand by examining your hand and with X-rays. X-rays show loss of bone cartilage and formation of bone spurs. A blood test for rheumatoid factor and other markers can help determine if the cause is rheumatoid arthritis.

How is arthritis in the hand treated?

Treatment options depend on the type of arthritis, stage of arthritis, how many joints are affected, your age, activity level, the hand affected (if it’s your dominant hand) and other existing medical conditions.

Goals of treatment are to:

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

What type of hand surgery is most commonly performed on the specific joints affected by arthritis?

Base of the thumb: Where your thumb and wrist join. Common surgical options include removing part or all of one of the trapezium bone (the wrist bone immediately below your thumb joint), tendon transfer or joint fusion.
Knuckles (metacarpophalangeal joints): Joint replacement is almost always considered for this repair. Rheumatoid arthritis can cause serious damage and disability to your knuckles.
Second joint of your finger (proximal interphalangeal joints): Osteoarthritis commonly causes stiffness and loss of motion. Joint replacement or fusion are considered for these joints. Because you use these joints frequently, there is a chance your implant could wear out. In this case, your provider may recommend further surgery.
Top of finger joint (distal interphalangeal joints): Joint fusion is commonly used to treat arthritis in this joint.

What should I expect after hand surgery?

You may need a cast or splint after surgery to protect your hand while it’s healing. Your surgeon may refer you to a hand therapist. Your provider will likely prescribe pain medication to take for a limited amount of time to reduce discomfort.

What are the complications of hand surgery?

Complications of hand surgery include:

How long does it take to recover from hand surgery?

Recovery time depends on many factors, including the severity of your condition, type of surgery you had, the skill of your surgeon and your compliance with therapy. Most people can return to their activities about three months after joint reconstruction surgery. Your team of caregivers can give you the best estimate of your particular recovery time.

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