What is Hand and Wrist Arthritis?
Hand and wrist arthritis is a degenerative condition where the protective cartilage in your hand and wrist joints breaks down over time. This cartilage normally allows smooth, pain-free movement, but as it wears away, bones can rub together, causing pain, stiffness, and reduced function.
Arthritis commonly affects three main areas of the hand:
- Base of the thumb (carpometacarpal or CMC joint)
- Middle finger joints (proximal interphalangeal or PIP joints)
- Fingertips (distal interphalangeal or DIP joints)
- Wrist joints connecting forearm to hand
Over 54 million Americans have doctor-diagnosed arthritis, with hand involvement being among the most common and functionally limiting forms.
Common Types of Hand Arthritis
Osteoarthritis (Degenerative Arthritis)
The most common type, caused by wear and tear over time. Often develops in the thumb base and finger joints, creating bony enlargements called Heberden’s nodes (fingertips) or Bouchard’s nodes (middle joints).
Rheumatoid Arthritis
An autoimmune condition causing symmetric joint inflammation, typically affecting the wrists and knuckles. Unlike osteoarthritis, it can occur at any age and often affects both hands equally.
Post-Traumatic Arthritis
Develops after hand or wrist injuries, such as fractures or ligament damage. The injured joint is more prone to accelerated cartilage breakdown.
Symptoms to Watch For
Hand and wrist arthritis typically develops gradually. Early recognition helps preserve function and prevent progression.
Primary Symptoms
- Pain that worsens with use and improves with rest
- Morning stiffness lasting 30 minutes or longer
- Swelling around affected joints
- Reduced grip strength affecting daily tasks
- Loss of dexterity when buttoning clothes or writing
- Joint instability or feeling of looseness
Advanced Symptoms
- Bony nodules visible on finger joints
- Joint deformity causing fingers to drift sideways
- Persistent pain even at rest
- Significant functional limitation affecting independence
When to See a Doctor
Consult a healthcare provider if you experience:
- Hand pain lasting more than 2 weeks
- Difficulty performing routine tasks like turning doorknobs
- Visible joint swelling or deformity
- Morning stiffness lasting over 30 minutes
- Weakness when gripping objects
- Symmetric joint pain in both hands (possible rheumatoid arthritis)
Diagnosis
Accurate diagnosis ensures appropriate treatment and rules out other conditions.
Clinical Evaluation
- Detailed symptom and medical history review
- Physical examination of hand and wrist function
- Assessment of grip strength and range of motion
- Observation of joint appearance and alignment
Diagnostic Tests
- X-rays reveal joint space narrowing, bone spurs, and alignment
- Blood tests to check for rheumatoid arthritis or other inflammatory conditions
- MRI (when needed) shows detailed cartilage and soft tissue damage
- Ultrasound can detect inflammation and guide injection treatments
Treatment Options
Treatment aims to reduce pain, maintain function, and slow progression. Most patients benefit from a combination approach.
Conservative Treatments
- Hand exercises to maintain flexibility and strength
- Occupational therapy teaching joint protection techniques
- Splints or braces to rest and stabilize affected joints
- Heat and cold therapy for pain and stiffness relief
- Over-the-counter medications like acetaminophen or NSAIDs
- Adaptive devices such as jar openers and ergonomic tools
Medical Interventions
- Corticosteroid injections: Reduce inflammation and provide temporary pain relief, particularly effective for thumb base arthritis
- Prescription medications: For inflammation and pain management
- Topical treatments: Anti-inflammatory creams and gels
Surgical Options (When Conservative Treatment Fails)
- Joint fusion: Eliminates pain by fusing bones together (reduces motion)
- Joint replacement: Replaces damaged thumb base joint with prosthesis
- Osteotomy: Realigns bones to reduce stress on joints
Managing Hand Arthritis Daily
Protect Your Joints
- Use larger, stronger joints when possible
- Avoid prolonged gripping or pinching
- Take frequent breaks during repetitive tasks
- Use assistive devices to reduce joint stress
Stay Active
- Perform gentle range-of-motion exercises daily
- Strengthen hand muscles with therapy putty
- Maintain overall fitness to reduce systemic inflammation
Lifestyle Modifications
- Weight management reduces inflammatory burden
- Anti-inflammatory diet rich in omega-3 fatty acids
- Stress management as stress worsens pain perception
- Adequate sleep supports healing and pain tolerance
Questions to Ask Your Healthcare Provider
- What type of arthritis do I have in my hands?
- Are my symptoms likely to progress, and how quickly?
- Which treatments are most appropriate for my condition?
- What exercises or activities should I avoid?
- When should I consider surgical options?
- Should I see an occupational therapist or hand specialist?