What Is The Best Treatment For Osteoarthritis Of The Hands?

Understanding osteoarthritis of the hands

Osteoarthritis of the hands affects the synovial joints of the hand by breaking down the hyaline cartilage that exists in these joints. Cartilage is a rubbery connective tissue that acts as a shock absorber to reduce friction during joint movement. This causes the bones to rub together and results in pain, swelling, reduced function, and stiffness of the joints.

Osteoarthritis of the hand most commonly affects:

• The distal interphalangeal (DIP) joint or the joint closest to the tip of the finger. It connects the distal and middle phalanx of the hand

• The carpometacarpal (CMC) joint, which is located at the base of the thumb, where the thumb and the wrist join together

• The proximal interphalangeal (PIP) joint, which is located between the first two bones of the hand

Signs and symptoms associated with osteoarthritis

Osteoarthritis affects about 32.5 million people in the US.¹

These are the signs and symptoms of osteoarthritis, and if you experience any or a few of them, you should schedule a checkup with your doctor:

• Pain in the affected area

• Loss of joint flexibility

• Joint tenderness

• Joint swelling

• Bone spurs — extra bits of bone that can surround the affected joint and may feel like hard lumps

• Stiffness of joint

What are the risk factors that contribute to the development of osteoarthritis?

Risk factors that contribute to the development of osteoarthritis include:

Gender

Women are more commonly affected than men.¹

Age

The risk of getting osteoarthritis increases with age.

Obesity

Excess weight puts extra pressure on joints resulting in an increased risk of osteoarthritis.

Joint injury

Joint injury or overuse may result in leakage of proteoglycans or damage to cartilage, resulting in osteoarthritis.

Repeated stress

Repeated stress on a joint may ultimately result in osteoarthritis.

Genetics

Some disorders run in the family and are passed on from generation to generation. Osteoarthritis can be genetically inherited from an affected family member.

How osteoarthritis of the hands is treated

At present, there is no cure for osteoarthritis of the hand. However, doctors have developed treatment plans that aid in relieving the resultant pain and aim to restore loss of function. Treatment options involve integrating various therapies to determine what best works for you.

Here are some of the available treatment options:

Nonpharmacological options

These interventions can be done at home to help relieve stress on the joints and make performing some tasks easier. These include:

Heat and cold therapy

You can apply heat to soothe the affected area using a warm compress or paraffin wax. The applied heat will minimize the stiffness and improve joint flexibility. Try applying heat 2–3 times per day for 20–30 minutes at a time. If using a heating pad, never place it on the high setting to prevent burns. Ideally, keep it in a medium setting.

A cold compress is also highly beneficial in reducing swelling and pain relief, especially after activity. Never put the cold pack directly on the skin; wrap the cold pack in a thin towel or pillowcase to prevent injury to the skin. Try the cold pack for 10–20 minutes at a time.

Massage

Massages are a great way to diminish pain, improve circulation to the affected area, and lessen stiffness and spasms of muscles. However, it is highly advisable for you to find a trained massage therapist to prevent further damage to the site.

Acupuncture

Acupuncture is currently being considered as a treatment option for osteoarthritic joint pain. This procedure is regarded as safe and may even be covered by your insurance.

Regular testing

Your physician’s regular testing and evaluation of your hand joints and tendons help prevent the condition from worsening and lessens inflammation in the area. Your physician can monitor your progress and can note early signs of disease progression.

Weight loss

Weight loss aids in reducing pressure on the affected joints, thus easing your pain and slowing the disorder's progression. Obesity has been associated with the progression of osteoarthritis.² Therefore, weight loss can delay osteoarthritis progression as well as alleviate pain.

Taking an anti-inflammatory diet

While inflammation is an essential process to the body's immune system, it also plays a major role in causing most arthritis pain. Eating foods rich in anti-inflammatory agents can help reduce the pain and discomfort in the affected area. An anti-inflammatory diet includes fruits, vegetables, whole grains, and plant proteins.

Physical therapy

Experts recommend participating in friendly, low-impact physical activities like swimming, light gardening, and walking.

Exercise

According to the American Academy of Orthopedic Surgeons, exercise is a great way to reduce symptoms associated with osteoarthritis as well as strengthen hand muscles around the affected joints to ease the pressure off the joints.³ These exercises include making fists, thumb bends, bending your hand digits, and squeezing a stress ball. They can be done throughout the day with regular rest intervals to prevent further injury.

Patient education

You should be proactive about your medical condition. Learn and read as much as possible about osteoarthritis from reliable sources. This is a great way to involve yourself in your treatment and better manage your condition without feeling dependent upon others. Your doctors should keep you updated on the latest medical findings, offering you educational reading materials that are easy to understand.

Use of orthoses

Orthoses are devices like splints for thumb-base joints affected by osteoarthritis that help in the proper alignment and support of joints. They have been proven to improve joint functionality and decrease joint pain in the affected area.⁴

Protecting your joints

You can protect your joints by making a few lifestyles and product changes like wearing clothes with zippers rather than buttons, using lightweight and friendly tools that are easier to use, and wearing slip-on shoes to avoid tying shoelaces.

Muscle training

Researchers have concluded that strength training programs can alleviate osteoarthritic symptoms and result in weight loss which eases pressure on the affected joints.⁵

Taking supplements

Taking supplements like ginger, omega-3 fatty acids, turmeric, etc., have been found to ease joint pains in most patients with osteoarthritis.⁶

Pharmacological interventions

 A person suffering from osteoarthritis of the hands may be prescribed the following drugs:

Topical capsaicin

Topical capsaicin may be an effective, temporary pain reliever for osteoarthritis that you directly apply to the skin above the affected area.

Topical nonsteroidal anti-inflammatory drugs (NSAIDs)

Topical nonsteroidal anti-inflammatory drugs (NSAIDs) like trolamine salicylate cream or diclofenac are safe pain relief drugs that effectively alleviate minor pain and stiffness symptoms of osteoarthritis of the hands. Topical NSAIDs have similar efficacy to oral NSAIDs and are even preferred over oral NSAIDs since they will have fewer side effects.

Oral NSAIDs like ibuprofen, diclofenac, and naproxen are the main foundation of the treatment and management of osteoarthritis. They do have side effects such as gastrointestinal upset and the potential for kidney irritation. Your physician should closely monitor these medications.

Muscle relaxants like metaxalone may also be recommended to help improve your energy levels and relieve pain.

Therapeutic injections

Therapeutic injections may be recommended when other types of treatments fail. They include:

Steroid injections

Steroid injections act as temporary pain relievers since they lower inflammation associated with the condition. However, this course of treatment is used sparingly since it can weaken the tendons and ligaments.

Viscosupplementation

Viscosupplementation is a treatment option that involves injecting hyaluronic acid into your affected joint to alleviate the pain.

Hyaluronic acid is a viscous substance that is naturally found in your body. Its primary function is the lubrication of joints, growth, and development of cartilage and bone in joints, and reducing inflammation. This course of treatment is occasionally used if the base of the thumb is affected.

Platelet-rich plasma (PRP) injections

Platelet-rich plasma (PRP) injections are regenerative treatments that use the blood's natural healing capacity to repair damaged tissues. It reduces pain in the joints and can help improve overall joint function. Long-term studies are still being conducted for this treatment option.

Transcutaneous electrical nerve stimulation (TENS)

TENS is a non-invasive treatment method that involves applying small amounts of electricity to the affected area to distract the nerves and lessen the pain. Research suggests that TENS can be an effective treatment option for osteoarthritis.⁷ It is a recommended therapy to ease hand arthritis pain.

Surgical intervention

Surgery is rarely considered an initial course of treatment, and most people do not require surgery to treat their osteoarthritis. It is, however, recommended to patients with extreme pain in joints, dramatic loss of hand function, or when other treatments and management plans are not effective.

In that case, it may be deemed necessary for an orthopedic surgeon to perform procedures such as:

Arthroscopy

Arthroscopy is a minimally invasive procedure that involves accessing the affected joints using a flexible tube to project an image that the surgeon uses as a guide to repairing joint damage.

Osteotomy

Osteotomy is a surgical procedure where the bones of the affected joints are chiseled to correct any misalignment errors. This procedure results in joint and bone realignment.

Arthroplasty

Arthroplasty is joint replacement surgery where an artificial joint can substitute for the damaged one.

Bone fusion

Bone fusion is a surgical intervention that involves placing bones or bone-like materials between joints, especially when joint replacement surgery is not a viable treatment option.

Surgical procedures do not cure hand arthritis, but they help better manage the symptoms and slow down the progression of the degeneration process.

The lowdown

Treatment options for osteoarthritis of the hands will not cure the disorder. Still, they help manage the disease by reducing its symptoms — pain, swelling, stiffness, decreased function, and inflammation. These modalities may also slow down disease progression. Various treatment therapies can be combined to see what better works for you.