Osteoarthritis of the Hands

Where OA Affects the Hand

OA most commonly affects three parts of the hand:

• The base of the thumb, where the thumb and wrist join (the trapeziometacarpal [TMC] or carpometacarpal [CMC] joint)
• The joint closest to the fingertip (the distal interphalangeal [DIP] joint)
• The middle joint of a finger (the proximal interphalangeal [PIP] joint)

Causes of Hand OA

Osteoarthritis usually occurs later in life, with no specific cause. But several factors can play a role, including:

• Age: the older you are, the more likely you are to have hand OA.
• Sex: women are more likely to be affected than men.
• Race: whites are more often affected than African Americans.
• Weight: obese people are more likely to have hand OA than thinner people.
• Genes: some people inherit the tendency to develop osteoarthritis, usually at a younger age.
• Injuries: Even when properly treated, an injured joint is more likely to develop OA over time. Fractures and dislocations are among the most common injuries that lead to arthritis.
• Joint issues: Joint infections, overuse, loose ligaments, and poorly aligned joints can also lead to hand or wrist arthritis.

Symptoms of Hand OA

Along with cartilage loss, OA also causes bone spurs to form. Bone spurs in and around the joints increase your stiffness and pain. With worsening OA, daily activities can become difficult and your finger joints may lose their normal shape.
Symptoms of hand OA can include:

• Pain: At first, pain will come and go. It worsens with use and eases with rest. Morning pain and stiffness are typical. As the osteoarthritis advances, the pain becomes more constant and may change from a dull ache to a sharp pain. It may start waking you up at night.
• Stiffness and loss of motion: As arthritis progresses, you may lose the ability to open and close your fingers completely.
• Crepitus: When damaged joint surfaces rub together, you may feel grinding, clicking or cracking sensations.
• Swelling: Your body may respond to constant irritation and damage to the tissues surrounding the joint by swelling and becoming red and tender to the touch.
• Nodules: Bony lumps may form on the middle joint of the finger (Bouchard’s nodes) or at the joint near the fingertip (Heberden’s nodes).
• Joint deformity: Bone changes, loss of cartilage, unstable or loose ligaments and swelling can make your finger joints large and misshapen.
• Weakness: The combination of joint pain, loss of motion and joint deformity can leave your hands weak. Activities that once were easy, such as opening a jar or starting the car, become difficult.

Diagnosing Hand OA