What is osteoarthritis?
Osteoarthritis (OA) is a degenerative joint disease. It is also otherwise referred to as degenerative arthritis. It often affects the weight-bearing joints of the lower extremities like the hips, feet, and knees. However, it can also affect the hands. Osteoarthritis is characterized by the steady decline of the joint cartilage.
The condition’s onset is typically associated with ageing but other factors are believed to be involved, including:
- Joint misalignment and instability
- Traumatic injuries and heavy usage
- Inherited genes
Who gets OA?
According to the Center for Disease Control, a staggering 27 million adults suffer from osteoarthritis in the United States alone. While the condition is more common in older people, younger individuals may get afflicted through metabolic or generic bone defects and injury. However, since OA results from wear and tear, the risk of developing the condition increases as one age.
What are some of the telltale indicators of osteoarthritis?
While OA may not manifest symptoms all the time, some of the most prevalent includes:
- Grating, crunchy, or grinding sound when the joints move (crepitus)
- Limited motion range in the joint affected
- Joint stiffness
- Joint pain
- Mucous cysts (usually develops near the ends of the fingers)
What is hand OA?
Hand osteoarthritis often occurs as part of nodal OA (a type of osteoarthritis that runs in the family). The condition is more common among women and often starts in the early 40s and 50s (around menopause).
What are the prevalent symptoms of hand OA?
Symptoms of hand osteoarthritis can vary from one person to another. Oftentimes, the symptoms will depend on the joint affected.
However, the following symptoms will often manifest:
- Pain (especially when the hand is used)
- Joint stiffness (this is often more pronounced in the mornings)
- Difficulty moving the fingers
- Tenderness or swelling (around the wrist or in the knuckles)
- Weak grip
The hardened area of the bone that is attached to the joint is called a bone spur. For some individuals, a bone spur is deemed an indicator of advanced OA. For people afflicted with hand OA, the spurs are called Heberden’s nodes.
Heberden’s nodes are the hard, swollen, and round areas that form around the joint (near the fingertips). Heberden’s nodes is a permanent condition and can make the fingers appear out of shape. Those who have arthritis in the joints situated in the middle of the fingers may also develop bony nodes called Bouchard’s nodes.
How is the condition diagnosed?
To diagnose the condition, the doctor will perform a physical examination of the hand. Symptoms of hand OA the doctor will look for can include:
- Limited motion range
In some cases, the doctor may also order an X-ray to check for signs of cartilage loss and bone spurs. An MRI may also be ordered so the doctor can properly assess the soft tissue and the bones. And since some symptoms of hand OA can be similar to the symptoms other joint conditions can manifest, blood tests may also be ordered. In some cases, a joint fluid analysis may also be needed look for signs of inflammation in the joints of the hand. Additional tests are only carried out to help the doctor accurately gauge if there are other possible underlying conditions.
How is the condition managed?
Aching hands can significantly affect the patient’s quality of life. For starters, hand OA can make carrying out hobbies, jobs, and even ordinary activities challenging, if not impossible. Fortunately, there are several treatment interventions available to help manage the condition. Some of the options available include:
1. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Prescription or over-the-counter medications NSAIDs have been known to provide relief for those who are suffering from hand OA. Over-the-counter NSAIDs include ibuprofen, diclofenac and naproxen. Voltaren, Celebrex, Mobic, and Cataflam, on the other hand, are considered prescription-strength NSAIDs.
2. Topical Anti-Inflammatory Medications
Anti-inflammatory creams sometimes act as first-line therapy for osteoarthritis, including hand OA. Some patients experience noticeable relief from joint pain and stiffness using topical creams as opposed to oral medications. Common topical applicants for hand OA are Diclofenac sodium and Voltaren Gel, both of which are only available by prescription.
3. Corticosteroid Injections
When the condition requires a more intense treatment intervention than topical or oral medications, corticosteroids can be an option. The steroid is injected directly into the joint. However, receiving too many injections considered counterproductive as it might only end up causing more damage to the joint.
A visit to a hand therapist is considered ideal (to regain function) especially once the hand has become too painful and disabled. Aside from enhancing dexterity, a hand therapist can also help significantly improve flexibility and strength. Self-management techniques will be taught to help ease pain and maintain the patient’s ability to play and work.
Severe cases of hip or knee arthritis might require joint replacement surgery since both are major and load-bearing joints. For hand arthritis, however, replacing the joint is very rare. The commonly affected small joints just behind the nails can be effectively fused to prevent deformity and motion. Arthroscopic surgery to clean out cartilage and bone fragments might be recommended in some cases but only as far as the wrist joint. However, surgery is often only resorted to when all other conventional treatment interventions have failed to provide the needed relief.