Suffering From Arthritis Hands?
The hand is comprised of many small bones and joints that work together to produce complex but vital movement. In fact, there are 27 bones in the hand and wrist making 22 joints to become inflamed in the case of arthritis. Arthritis of the hands is very common affecting as many as 20% of the population over the age of 50 but affects younger people as well.
Causes of Arthritis of the Hands
Arthritis is inflammation of the joint and the erosion of the cartilage inside of the joint. Cartilage lines each joint providing for smooth gliding motion. Cartilage is lost through inflammatory processes such as rheumatoid arthritis or through degeneration from aging or joint damage from overuse or injury. The body attempts to make up for lost cartilage by filling the joint space with synovial fluid. Swelling of the joint produces stiffness and stretching of the joint causing pain. If left untreated bone ends can begin to erode and joints may change shape, further limiting movement of the wrists, thumbs and fingers.
Two main types of arthritis in the hands are osteoarthritis and inflammatory arthritis. Osteoarthritis is caused by joint degeneration and usually affects older persons; inflammatory arthritis conditions such as Psoriatic and Rheumatoid arthritis is caused by an overactive immune system and may begin in the late teens or early adulthood. Injured joints are also much more likely to become arthritic.
Symptoms of Arthritis Hands
Often the first symptom of hand arthritis is stiffness in the thumbs but any one of the joints of the hands may be affected. Pain and stiffness are most common in the morning but may continue throughout the day. Pain in the joints of the hands may be dull or burning. It also often occurs after periods of increased use and may be immediate or occur the next day after immune processes have increased joint inflammation.
Arthritis of the hands will often limit ability to perform activities such as opening a jar due to lost strength and flexibility. One may have to adapt the way the hand is used and joints may become swollen and malformed, further limiting use. Warmth and redness is common and may progress to crepitus or grating of the joint as cartilage is damaged.
Diagnosis of Arthritis Hands
Diagnosis of osteoarthritis of the hands will be made by examination, counting the number of swollen or painful joints and noting range of motion or the ability to move the wrist, thumb and fingers. X-rays may be taken to look at joint degradation and note the progression of the disease. Inflammatory arthritis such as rheumatoid or psoriatic arthritis may require blood tests to check immune functioning. Laboratory tests will identify certain chemicals present in the blood which show immune over activation. These blood tests will be performed in addition to the other arthritis exam procedures.
Treatment of Arthritis Hands
Treatment of arthritis of the hand will depend upon the severity, number of hand joints or other areas of the body affected, age and activity level. Most often the patient will be advised to start with Non Steroidal Anti Inflammatory Drugs (NSAIDs) such as ibuprofen or naproxen which may be obtained over the counter. Some patients will benefit from acetaminophen while others will need prescription medications such as celecoxib (Celebrex) or stronger medications such as hydrocodone.
In some severe cases, the physician may wish to inject a swollen, highly inflamed joint with anesthetic and anti inflammatory steroids. This injection will be done directly into the joint space and may provide relief for several weeks, possibly even months. Rheumatoid and Psoriatic arthritis may also be treated with oral corticosteroid medications such as prednisone and newer immune modulating medications such as adalimubab (Humira) or eternacept (Enbrel). These medications work by reducing activity of the immune system and suppressing the inflammatory response which will slow destruction of joint tissue.
Many patients benefit from the use of nutraceuticals. Natural supplements of glucosamine and chondroitin have been shown to reduce inflammation and induce joint healing and cartilage repair in cases of arthritis.
