What are the symptoms of osteoarthritis in hands and wrists?

Osteoarthritis is a chronic medical condition in which the cartilage between the bones gets damaged. As a result, instead of smoothly gliding over each other when the joint is used, bone rubs against bone causing pain and inflammation. The disease is progressive. As more cartilage wears out, the pain becomes more frequent and intense, reducing the functionality of the joint. Osteoarthritis can affect different joints such as those in the wrist, hand, hip, and knee.

Risk factors for osteoarthritis include age, sex (females are more susceptible), race, genetics, and prior injury to the joint even if it healed completely. Bones in the hands of older individuals will often show signs of arthritis in an X-ray. However, many people do not experience any symptoms. Symptomatic hand osteoarthritis affects about 16% of the US population. Symptomatic wrist arthritis is also common, affecting 13.6% of the US population.

Symptoms of hand and wrist osteoarthritis

Three parts of the hand are commonly affected by osteoarthritis. These include the base of the thumb in the joint where the thumb bone joins the wrist bone, finger joints closest to the fingertips, and the middle joints of the fingers.

Common symptoms of hand and wrist osteoarthritis include:

1. Pain in the affected joint. In the early stages of the disease, pain and stiffness are felt in the morning and sometimes later in the day after significant joint use. Gradually as the joint deteriorates further, the pain becomes more severe and is felt more often. It can be sharp enough to interrupt sleep at night.
2. Reduced strength and range of motion. The pain and stiffness can reduce the ability to use the joint. In hand osteoarthritis, a person may gradually lose the ability to fully open and close their hands, and properly grab things. In wrist osteoarthritis, the wrist and the hand may hurt making it difficult to do daily tasks such as unlocking a door, starting a car, turning a doorknob, opening screw cap containers, and lifting pots and pans in the kitchen with the affected hand.
3. Swollen joints. The affected joint may be swollen and feel warm to the touch.
4. Bone spurs and joint deformity. Small bony structures called bone spurs begin to grow out of the affected joint. Bone spurs can cause further damage to the joint’s bones, muscles, and tendons. Bone spurs and swelling make the joint look misshapen and feel stiff.
5. Sensations of bone grinding. As the cartilage wears out, a person may feel the sensation of bone grinding against bone.

Treatment options

Treatment options for individuals with hand and wrist osteoarthritis include palliative measures without drugs, medications, and surgery.

Palliative measures without medication

Palliative measures can help ease the pain by using supportive devices or techniques. For example:

• Using a brace or a splint that keeps the hand or wrist stable and prevents the patient from bending the affected joint too much.
• Using hot or cold pads for comfort.
• Using occupational or physical therapy to learn exercises that can help strengthen the hand, and learn ways to go about daily tasks that least stress the joint.

Occupational therapy can benefit patients with advanced hand and wrist osteoarthritis as it can teach patients skills necessary for daily life. Different postures to do daily tasks such as dressing up, lifting a spoon to feed oneself, etc. can go a long way towards maintaining the patient’s autonomy. The occupational therapist may also train the patient to use assistive devices that simplify tasks like opening jars.

Medicare Plan B partially covers medically necessary outpatient occupational therapy if a medical provider certifies that the patient needs it. Depending on the healthcare plan, other insurance providers such as Aetna, BCBS, and Kaiser Permanente may also cover occupational therapy at least in part.

Medication and surgery

Medications such as anti-inflammatory drugs and steroids can temporarily relieve symptoms.

Surgery can provide lasting relief for those suffering from hand or wrist osteoarthritis. The surgery can immobilize the joint in part or completely, preventing the bones in the joint from grinding against each other. While this relieves pain, it also restricts motion and functionality.

Surgery can also replace the affected joint with an artificial joint made of metal and plastic. Joint replacement surgery can provide long-term pain relief, but the artificial materials can corrode over time needing the surgery to be performed again. The patient may need occupational therapy after the surgery to learn how to use their new joint.