Osteoarthritis in the hands is a degenerative joint disease . It causes the affected joint to wear and tear more than would be normal for old age. This wear and tear leads to pain, swelling and episodes of inflammation . The intensity of the pain is very individual and does not always correlate with the stage of the disease. As the disease progresses, the diseased joints stiffen and movement is restricted , which can have a strong impact on the individual's everyday life.
Osteoarthritis can basically affect all joints, but is particularly common in the hips, knees or hands - we deal with the special forms in the fingers and hands in this article.
Pain in the finger joints can be related to osteoarthritis
How are joints constructed?
To understand how osteoarthritis works, we first need to look at the structure of joints . All so-called true joints work in a similar way: two bones meet and are connected by a joint that transmits the muscle pull into a specific movement.
The bones of a joint do not meet directly, but are separated from each other by articular cartilage The bones do not meet directly. Articular cartilage on the two bones acts as a buffer for the movement. Several ligaments span the joint to guide the movements and limit them to a certain range. The joint capsule surrounds the entire construct. It is filled with the joint fluid, in which nutrients are dissolved to supply the structures.
What is so special about the joints of the hand?
The finger joints also correspond to the schematic structure of a joint. Compared to the hip or knee, however, they are much smaller and the joint space, the distance between the two cartilage discs, is also much narrower. The hand with its many joints in a small space is therefore a particularly sensitive organ.
The skeleton of the human hand consists of...
19 Bones in the fingers 8 Bones in the wrist 13 Finger joints 1 saddle joint on the thumb This complex structure makes extremely versatile movements possible, which turn our hands into unique tools!
The wrist is not just two bones meeting, but is made up of several partial joints. In addition to the eight carpal bones, the radius is also involved in enabling the flexible movements of the wrist.
27 bones and 15 joints come together in the hand in a very small space The thumb is moved with the help of a saddle joint that allows movements in two degrees of freedom. This special construction allows for firm grasping and has been a great evolutionary advantage in the history of human development.
We see: different types of joints are involved in making the extensive movements of the hand possible. The small structures on the one hand and the high strain on our hands in everyday life on the other lead to arthrosis in the fingers for many people in the course of their lives.
How does osteoarthritis develop?
Osteoarthritis is one of the rheumatic diseases. It can affect all joints of the body. There, the cartilage is gradually lost and the joint wears out step by step. As a result, there is pain, swelling, inflammation and restricted movement .
How does it happen that the joint suffers such damage? A distinction is made between primary and secondary arthrosis. Primary arthrosis cannot be traced back to a specific cause.
With secondary arthrosis , on the other hand, a cause can be identified: In most cases, it is caused by many years of overloading the affected joint due to certain activities at work or in sports. Other causes can be a previous injury , hormonal and genetic reasons or diet. Age also plays an important role: up to 0.5% of the entire population in Europe and the USA suffer from osteoarthritis as their years progress .
The articular cartilage, which protects the two bones involved in the joint, changes in the course of the disease, becomes thinner and gradually loses its buffering effect in the joint. As a result, the joint surfaces also change and the gap between the two bones becomes smaller. Bone outgrowths, so-called osteophytes , can also develop in the area of the joint and make normal movement difficult.
Osteoarthritis in the hands progresses in stages Osteoarthritis in the hands: These joints can be affected
Different joints meet in the hand: three hinge joints per finger, the thumb saddle joint and the complex wrist joint, in which eight wrist bones and the radius are involved. Depending on which joints are arthritically changed, a distinction is made between different clinical pictures:
The most common arthrosis in the fingers: Bouchard's arthrosis
Bouchard's arthrosis, named after a French pathologist, is the most common arthritic disease of the hand. It typically occurs in the second finger joints, the proximal interphalangeal joints, or PIP for short.
In Bouchard's arthrosis, there is often swelling of the middle finger joints The finger joints are thickened as the bones change. This variant of hand arthrosis causes pain in the finger joints , especially in the early stages, when the joints change and bone appendages form. Subsequently, there may be relapses in which the joints become inflamed in phases.
The fingers hurt: Heberden's arthrosis
... In Heberden's arthrosis, on the other hand, the uppermost finger joints are affected. In Herberden's arthritis, bony nodules form on the last joint of the finger, the distal interphalangeal joint, or DIP. This form of arthritis causes quite severe pain in the finger joint and is characterised by reddened skin and sensitivity to pressure at the affected joints.
Rhizarthrosis: When the important thumb falls out
The thumb is involved in up to 50% of hand function. Therefore, rhizarthrosis is often accompanied by particularly severe movement restrictions in everyday hand movements. At first, pain develops in the thumb , and later it can also lead to a malposition. Women are particularly often affected by arthrosis of the thumb.
Arthrosis of the wrist
Arthrosis in the wrist can lead to hand scoliosis, among other things Arthrosis in the wrist is usually due to polyarthrosis. This means that the disease occurs systemically and affects several joints of the body. In the case of the wrist, hand scoliosis can occur as the disease progresses. In this case, the entire hand drifts to one side. Depending on the severity, this results in severe movement restrictions.
The fingers hurt: Which doctor is the right one?
Anyone who experiences persistent pain in the finger joint or wrist should seek medical advice. In the first step, the general practitioner's office can be a good contact. For a more detailed diagnosis, orthopaedic practices specialise in joint diseases such as arthrosis.
Pain and swelling are important indicators for diagnosis. Typically, sufferers experience pain on onset and on exertion . This means that the fingers or wrist are particularly painful in the morning and with greater exertion. If small bone growths have already developed, the joints can make noises when moving.
During the medical examination, after the anamnesis discussion and external examination, an X-ray is often taken, on which bony changes and the reduced joint space can be easily detected.
Arthrosis of the fingers: What helps?
The primary goals in the treatment of osteoarthritis of the hand are freedom from pain and preservation of function so that those affected can maintain their independence.
Movement is an important element in the therapy of hand or finger arthritis . Continuous movement prevents stiffening and promotes the supply of important nutrients to the joints. However, heavy strain, such as lifting heavy objects, should be avoided. In general, a good balance between movement and rest is crucial, in addition to taking into account the individual's sensitivity to pain.
To learn appropriate exercises and the correct amount of movement and rest, physiotherapy or occupational therapy are useful. Ideally, you should visit a specialised hand therapy practice . A list of certified specialist practices can be found on the website of the German Working Group for Hand Therapy (DAHTH).
In addition to exercise therapy, other measures such as heat or cold therapy as well as medication can be used to relieve the pain and contain acute phases of inflammation.
If conservative forms of treatment have been exhausted and the arthrosis in the fingers becomes more and more of a restriction to independent everyday life, surgical treatment is the next option.
Operations for arthrosis in the hands
Patients should only consider an operation when the movement restrictions and pain become an acute problem for everyday life. Surgery entails certain risks that need to be carefully weighed up. Affected persons should discuss the life span of possible joint prostheses and the recovery process with a specialist.
One surgical treatment option is arthroplasty , i.e. the insertion of an artificial joint . While the replacement of a knee joint, for example, is very well established in medicine, joint replacement in the area of the fingers is more difficult.
Arthroplasty involves the insertion of artificial finger joints Therefore, depending on the position of the affected joint, arthrodesis , the stiffening of the diseased joint, is considered. As this completely eliminates movement, the pain is greatly reduced. However, the affected joint remains fixed in one position, so that grasping, for example, is restricted. For this reason, the use of an artificial joint is more likely to be considered in the case of rhizarthrosis , i.e. arthrosis of the thumb, because the overall mobility of the hand depends heavily on the thumb.
Following hand surgery, regular exercise therapy is an important aspect to avoid adhesions in the healing tissue. The unaffected, healthy fingers need constant movement to avoid becoming stiff.
More movement therapy with the AnyHand more info Living with arthritis in the hands
Osteoarthritis does not only bring physical changes. Those affected are confronted with a degenerative, progressive disease that gradually restricts the mobility of the hands and thus endangers independent everyday life.
The psychological side of osteoarthritis in the fingers is therefore an important issue. The association Deutsche Arthrose-Hilfe e. V. offers a wide range of information and networks those affected to promote the exchange of experiences and mutual support.
These 4 tips can help sufferers live with osteoarthritis in the hand:
Accepting one's own stress limits and not going beyond them Accepting help from outside, for example with household tasks Exchange with other sufferers Acquiring anatomical knowledge, e.g. in order to consciously avoid incorrect loading.
Frequently asked questions
How does arthrosis develop in the hand?
Osteoarthritis is one of the rheumatic diseases. The articular cartilage in the finger joints is gradually lost and the joint wears out step by step. This results in pain, swelling, inflammation and restricted movement .
Which doctor is the right contact for finger arthritis?
Anyone who experiences persistent pain in the finger joint or wrist should seek medical advice. In the first step, the general practitioner's office can be a good contact. For a more detailed diagnosis, orthopaedic practices specialise in joint diseases such as arthrosis.
How can osteoarthritis in the fingers be treated?
Before considering surgical treatments such as joint replacement or joint fusion, conservative treatment options should be exhausted. These include physiotherapy, physical therapy and medication against pain and inflammation.
Why is exercise important?
Regular exercise without stress is particularly important in the case of hand or finger arthritis in order to continue to ensure the supply of nutrients to the joints. It is important to find the right balance between moderate exercise and rest.
This article deals with a health topic, but is not suitable for self-diagnosis or the selection of a suitable therapy. The individual case can only be reliably diagnosed by medical expertise
Sources
Waldner-Nilsson (ed.) (2013): Hand Rehabilitation. Volume 1 Fundamentals, Diseases. Heidelberg / Berlin: Springer-Verlag.
Deutsche Arthrose-Hilfe e. V. https://www.arthrose.de/home
