Osteoarthrosis of the hand
Wear and tear of the hand and finger joints / Hand osteoarthrosis

Arthrosis is characterised by pain and stiffness in joints as a result of wear-and-tear of the cartilage. Osteoarthrosis of the hand mainly affects the fingers and the thumb-side of the hand or wrist. The symptoms occur with ageing.

Wear-and-tear of the joints (arthrosis) is a natural process that affects everyone sooner or later. Most people over the age of 55 years have osteoarthrosis of the hand or wrist. Only 20% of them actually experience symptoms.

Description of the condition

Most joints consist of two smooth bone tips covered with cartilage. The cartilage ensures that the bone segments glide over each other smoothly. Arthrosis occurs when the smooth surfaces become irregular. Wear-and-tear occurs. Arthrosis in the hands and fingers causes stiff and painful joints.

Despite the fact that the symptoms caused by osteoarthrosis can be reduced, the cartilage will not recover. Once cartilage has been damaged, it does not grow back.

Cause and origin

Normally, the symptoms develop gradually with ageing or prolonged mechanical load. The cartilage can also deteriorate after joint injury, or as a result of an autoimmune disease such as rheumatoid arthritis leading to osteoarthritis.

Signs & symptoms

Arthrosis in the hand usually occurs in the fingers and on the thumb-side of the forearm. The following symptoms can occur:

• Pain in the fingers or on the thumb-side of the hand palm and wrist.
  
• Stiffness, particularly morning stiffness or stiffness when starting up. The hand and fingers are extra painful when they start moving again after a prolonged period of inactivity. Normally the worst stiffness disappears within 30 minutes.
  
• Pain with wringing motions.
  
• Loss of strength.
  
• As osteoarthrosis often affects multiple joints and both hands can be affected.

Diagnosis

Treatment

If the pain is severe, the joints need to be rested temporarily by avoiding certain activities. Flexing and extending the hand and wrist joints can help to preserve strength and mobility (making a fist, extending fingers, spreading fingers). Controlled movement is good for the cartilage. Physiotherapy can assist you with this.

Various treatments can be implemented in consultation with the specialist:

• A splint can prevent overuse of the joint and can reduce pain symptoms.
  
• Analgesic and anti-inflammatory medication can be used in periods when the pain is most severe.
  
• In severe cases, surgery can be performed to fix or remove the painful joints.
  

Surgery produces varying results. Sixty percent of patients are more or less satisfied, thirty percent continue to experience symptoms.

Exercises

You can check your symptoms using the online physiotherapy check or make an appointment with a physiotherapy practice in your area.

References
Peters-Veluthamaningal, C., Willems, W., Smeets, J.G.E., Windt, D.A.W.M. Van der, Spies, M.N., Strackee, S.D., Vos, K., Wind, L.A. & Geraets, J.J.X.R. (2010). NHG-Standaard. Hand- en polsklachten. Huisarts Wet. 2010:53(1):22-39.