Arthritis in the Fingers and Hands

Types of hand arthritis

Hand osteoarthritis

The most common type. It usually affects:

• the joints closest to the fingertips, sometimes with firm bony lumps (Heberden’s nodes)
• the middle joints of the fingers (with Bouchard’s nodes)
• the base of the thumb, where it joins the wrist, causing pain when gripping, pinching, opening jars or turning keys

It becomes more common with age, especially in women after menopause, and often runs in families.

Rheumatoid arthritis

Usually affects the knuckles and middle finger joints and the wrists, on both hands. Joints feel warm, puffy and stiff, often for more than an hour in the morning. Early treatment prevents damage, so this pattern needs prompt assessment.

Psoriatic arthritis

Can affect the end finger joints, cause a whole finger to swell like a sausage, and often comes with nail pitting or other nail changes. See psoriatic arthritis.

Finger joint pain: other causes

• Trigger finger, where a finger catches or locks when bending
• De Quervain’s tenosynovitis, causing pain on the thumb side of the wrist
• Carpal tunnel syndrome, causing tingling and numbness, often at night
• Gout and injuries

What helps hand osteoarthritis

• Hand exercises to maintain movement and grip strength
• A splint for the base of the thumb, which American guidelines strongly recommend for thumb base arthritis
• Heat, such as warm water, to ease stiffness
• Joint protection and aids, such as jar openers, thicker pens and lever taps
• An occupational therapist or hand therapist can tailor splints and techniques
• Medicines, including some applied to the skin, can help with pain. Ask your GP or pharmacist what suits you.
• Surgery is an option for severe thumb base arthritis that doesn’t respond to other treatment

When to see a GP

See a GP if your hands are swollen, warm or stiff for a long time in the morning, if pain or stiffness is affecting daily tasks, or if a finger joint suddenly becomes red and very painful.

References

1. Marshall M, Watt FE, Vincent TL, et al. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol. 2018;14(11):641-656.
2. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020;72(2):149-162.
3. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016;388(10055):2023-2038.
4. Ritchlin CT, Colbert RA, Gladman DD. Psoriatic Arthritis. N Engl J Med. 2017;376(10):957-970.
5. healthdirect. Osteoarthritis.