Arthritis in the Hands & Fingers
What Is Arthritis?
Arthritis is the loss of cartilage (cushioning material) between the bones, resulting in bone-on-bone contact. Loss of this cartilage results in pain, and a limited range of motion sometimes occurs. In severe cases, the joint may become unstable, resulting in a bony “bump” at the joints.
Two types of arthritis commonly occur in the hand and fingers, rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis is a systemic inflammatory disease that affects the lining of your joints. Another less common inflammatory arthritis, called psoriatic arthritis, occurs in people with psoriasis. The most common type of arthritis, osteoarthritis, is often the result of overuse or an injury and is usually hereditary. Osteoarthritis is a result of the loss of cartilage in the joint and often causes bone spurs to develop around the knuckles. These deformities can be extremely painful and disrupt normal hand function, as arthritis affects the alignment of the joint surfaces. All types of arthritis can cause aching, swelling, and stiff joints.
- Pain in the hand and/or fingers
- Joints of the hand and fingers may be warm and tender to the touch
- Deformities such as enlarged knuckles or crooked finger(s)
TREATMENTS FOR ARTHRITIS IN THE HAND & FINGERS
There are nonsurgical and surgical treatment options available for arthritis in the hand and fingers. Both treatment types are performed by our hand and wrist specialist at Orthopaedic Specialists.
Splinting the affected joint(s), taking anti-inflammatories, and/or receiving corticosteroid injection(s) may help treat the pain and discomfort associated with mild cases of arthritis. Supplementing with glucosamine, chondroitin, or other natural anti-inflammatories may be helpful. While nonsurgical treatment can relieve mild cases of the condition, surgery may be necessary if it continues to worsen.
Small joint replacement or fusion is often performed as a result of arthritis. There are three joints in the fingers with varying treatment needs: the DIP joint (distal interphalangeal joint), the PIP joint (proximal interphalangeal joint), and the MP joint (metacarpophalangeal joint).
The DIP joint is the closest to the fingertip. It typically does not have the best results with an implant because of its small size. If a patient has severe arthritis in this joint, the best option may be to fuse the joint using a minimally invasive technique. A joint fusion eliminates pain and only slightly impairs function. Less severe cases often respond to surgical debridement, which means “to clean up the joint” by removing bone spurs and damaged tissue and improving the healing potential of healthy tissue.
The PIP joint is the closest to the knuckle. Replacement of this joint can be effective. It is most effective for the little finger and ring finger, as they are the most important for grasping an object. Dr. Megan Crosmer, an orthopaedic surgeon and the director of our Hand & Wrist Center, removes the damaged joint and will typically use a pyrocarbon implant to replace it, although a silicone version can also be used. It ultimately depends on the patient’s condition, age, activity level, and bone quality. Postoperative recommendations typically include wearing a splint for about three weeks followed by physical therapy as needed.
The MP joint is the knuckle joint. It is sometimes damaged by arthritis. Dr. Crosmer removes the arthritis and replaces the joint. During the operation, an appropriately fitted prosthesis is inserted between the finger bones of the joint. As a new joint replaces the damaged one, the ligament is wrapped around the joint for added protection. Dr. Crosmer also uses a new technique in which cartilage is harvested from another healthier joint and transferred to the injured joint. New adult autologous stem cell techniques are also being investigated.