Introduction to Hand Arthritis
Arthritis encompasses a range of conditions characterised by inflammation and stiffness of the joints. It not only impacts the physical functioning of the hands but also the ability to perform daily tasks, leading to a decreased quality of life for those affected.
The hand, a complex anatomical structure with multiple small joints, is particularly susceptible to the wear and tear that can lead to arthritis. Understanding hand arthritis requires a comprehensive look at its types, causes, symptoms, and the mechanisms that affect the joints.
Types of Hand Arthritis
Osteoarthritis
Osteoarthritis (OA) is the most common type of hand arthritis. It usually occurs in older adults, resulting from the breakdown of cartilage that cushions the ends of bones in the joints.
OA commonly affects the base of the thumb and the joints closest to the fingertips, known as the distal interphalangeal joints.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic inflammatory disorder where the body’s immune system attacks its tissues, including joints. RA typically affects the wrist and the finger joints closest to the hand, known as the proximal interphalangeal joints.
Unlike OA, RA affects joints symmetrically. This means that if one hand is affected, the other will likely show similar symptoms.
Psoriatic Arthritis
Psoriatic arthritis affects some people with psoriasis, which features red patches of skin topped with silvery scales. It can affect any part of the body, including the hands, and it may cause swelling, stiffness, and pain in the affected joints.
Gout
Gout is a form of inflammatory arthritis characterised by sudden, severe attacks of pain, swelling, redness, and tenderness in the joints, and it can affect the hands. Gout occurs when urate crystals accumulate in the joint, causing inflammation and intense pain. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances found naturally in your body.
Causes of Hand Arthritis
The causes of hand arthritis vary depending on the type of arthritis. However, several general factors contribute to developing hand arthritis, including genetic predisposition, age, and previous injury.
Genetic Factors:
People with a family history of arthritis are at a higher risk of developing the condition. Specific genes associated with the immune system can increase susceptibility to rheumatoid arthritis, while genetic variations affecting cartilage degradation and inflammation can lead to osteoarthritis.
Age:
The risk of developing arthritis increases with age due to the cumulative wear and tear on the joints and the decreased ability of the body to repair cartilage.
Previous Joint Injury:
Previous injuries to the hand or wrist, such as fractures, dislocations, or ligament tears, can significantly increase the risk of developing arthritis later in life. Injuries can accelerate the breakdown of cartilage or cause joint misalignment, leading to eventual arthritis.
Inflammatory Conditions:
For autoimmune arthritis like rheumatoid arthritis, the body’s immune system mistakenly attacks its own tissues, causing joint inflammation. This can lead to joint damage and arthritis over time.
Environmental Factors:
Exposure to certain viruses or bacteria may trigger autoimmune responses in genetically susceptible people, leading to conditions like rheumatoid arthritis.
Occupational hazards, such as repetitive hand movements or vibrations, can also contribute to the development of osteoarthritis in the hands.
Smoking:
The chemicals in cigarette smoke can induce inflammation throughout the body, including the joints. It can affect the immune system, increasing the risk of autoimmune diseases like rheumatoid arthritis.
Understanding the causes of hand arthritis is important in identifying at-risk people and implementing preventive measures. While not all causes can be controlled, awareness of risk factors can aid in early detection and management.
Diagnosis of Hand Arthritis
The diagnosis of hand arthritis requires a thorough approach to determine the specific type of arthritis, as this influences the management strategy.
Clinical Evaluation:
The initial step in diagnosing hand arthritis is a clinical evaluation, which includes a physical examination of the hands and joints and assessing signs of inflammation, deformity, and decreased range of motion. The examiner will also check for tenderness, swelling, and joint crepitus.
Patient History:
A comprehensive patient history is required for diagnosis. This includes discussing the duration and severity of symptoms and any family history of arthritis or autoimmune diseases.
Lifestyle factors, such as occupation, smoking, and exercise habits, are also relevant.
Blood Tests:
Blood tests can help in diagnosing certain types of arthritis. For instance, the presence of rheumatoid factor (RF) or anti-citrullinated protein antibodies (ACPAs) can support a diagnosis of rheumatoid arthritis.
Imaging Tests:
Imaging tests play a crucial role in diagnosing arthritis and assessing its severity. X-rays can reveal joint space narrowing, changes in bone density, and the presence of bone spurs, which are indicative of osteoarthritis.
Ultrasound and magnetic resonance imaging (MRI) can provide detailed images of soft tissues and are particularly useful for detecting early signs of inflammatory arthritis.
Managing Hand Arthritis
Effective management of hand arthritis involves a multifaceted approach that combines medical treatment with strategies to alleviate symptoms.
Medical Treatment:
Medical treatment options vary depending on the type of arthritis. They may include non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation, disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis, or corticosteroid injections to reduce severe inflammation.
Exercise and Hand Therapy:
Regular, gentle exercises can help maintain joint flexibility and muscle strength, reducing stiffness and pain. A physical therapist can design a personalised exercise program, including finger bends, wrist stretches, and grip strengthening exercises.
Weight Management:
Maintaining a healthy weight can reduce the stress on joints and decrease the risk of developing osteoarthritis, and weight loss can significantly lessen symptoms.
Heat and Cold Therapy:
Applying heat, such as warm towels or heat packs, can relieve stiffness and improve blood circulation to the hands. Cold therapy, using ice packs or cool water, can reduce swelling and numb areas affected by intense pain.
Ergonomic Tools and Adaptive Devices:
Using ergonomic tools and adaptive devices can help reduce hand strain during daily activities. Special utensils, easy-grip pens, and keyboard modifications can make tasks easier and help preserve joint function.
Stress Management Techniques:
Stress can exacerbate arthritis symptoms, making stress management techniques such as meditation, deep breathing exercises, or yoga beneficial for overall well-being and symptom reduction.
Conclusion
Understanding the types, causes, symptoms, and methods for managing hand arthritis is essential for maintaining quality of life and hand function. While having the condition can be challenging, a proactive approach to management can make a substantial difference.
Suppose you or someone you know is experiencing symptoms of hand arthritis. In that case, we encourage you to come in for a consultation to explore the most appropriate strategies for the severity of your condition.
