Finger Arthritis

The Signs, Symptoms and Treatment of Arthritic Fingers

hand arthritis
Jodi Jacobson / Getty Images

Our fingers are important! We use them from the moment we wake up to brush our teeth, from the emails we send, and to the cooking we do every day. When our fingers don't work the way we want them to, everyday tasks become difficult and painful. So what can we do when our finger joints begin to fail?

A joint is the part of your body where two bones come together. Arthritis is a problem that causes damage to the normally smooth joint surfaces.

These junctions have special surfaces to allow smooth movement between the adjoining bones. This smooth surface is cartilage, and when the cartilage is damaged, arthritis is the condition that results. When our fingers can't bend and move like we expect, all of those activities become difficult.

There are three types of arthritis that commonly affect the fingers:

  • OsteoarthritisOsteoarthritis, also called wear-and-tear arthritis, is the most common type of finger arthritis. In people with osteoarthritis, the normal cartilage is steadily worn away, exposing bare bone at the joints. The most frequently affected joints in the hand are the knuckles of the mid-finger and fingertip (the PIP and DIP joints) and the joint at the base of the thumb.
  • Rheumatoid ArthritisRheumatoid arthritis causes a different type of joint destruction. Rheumatoid arthritis is a systemic autoimmune condition that can cause a number of problems. Among these, rheumatoid arthritis can cause inflammation of the soft-tissue surrounding joints. The most commonly affected joints in the hand are the knuckles at the base of the fingers (the MCP joints).
  • Gout: Gout is a condition that occurs when crystals develop within the joints of your body. These crystals form as a result of the body not properly metabolizing a substance called uric acid. When uric acid accumulates, these crystals can form in one or more joints. While the big toe is the most commonly affected part of the body, finger joints can also be involved.

    Other types of arthritis can also cause problems in the finger joints, but the vast majority of people with finger arthritis have one of the aforementioned problems.

    Signs of Finger Arthritis

    Symptoms of finger arthritis include:

    • Joint pain
    • Swelling
    • Stiffness
    • Loss of motion

    Patients with osteoarthritis often develop lumps or nodules around the knuckles of the fingers. These lumps are called Heberden's nodes (when around the more distant knuckle) or Bouchard's nodes (when around the closer knuckle) and actually consist of bone spurs around the joints. These knuckles often become enlarged, swollen, and stiff. People often complain that their rings do not fit or can't be removed.

    Patients with rheumatoid arthritis often have the aforementioned symptoms, but can also have more complex deformities of the hands. The fingers may begin to shift from their normal position and drift away from the thumb.

    Treatment of an Arthritic Finger

    Early treatments of finger arthritis are focused on managing the symptoms in an effort to avoid surgery. Treatment options include:

    • Anti-Inflammatory Medications
      These medications can help treat the pain of finger arthritis, and also help decrease inflammation and swelling around the joints. While you should always check with your doctor before starting any new medication, these are often prescribed for joint pains in the fingers.
    • Joint Supplements
      Joint supplements consist of glucosamine and chondroitin, two of the major building blocks of normal cartilage. These supplements are very safe to use, although the clinical data to support their use is weak. That said, many people can find them helpful.
    • Cortisone Injections
      Cortisone is a more powerful anti-inflammatory medication and can be useful in limited applications in the hand. While cortisone injections are generally not good to perform frequently, an occasional shot may help calm a flare of arthritis.
    • Hand Therapy
      Hand therapy, usually performed by an occupational therapist, is helpful to maintain motion and prevent stiffening of the joints.
    • Ice and Heat Treatment
      Joint stiffness and range of motion can be improved by ice and heat treatments. Most people with finger arthritis find warming the hands with a warm washcloth or under moderately hot water is most helpful at relieving the stiffness of arthritic fingers.
    • Splints
      Splinting helps to relax and rest the joints. Splinting should be done for limited periods of time to allow for relief without allowing the joint to stiffen.

    If these treatments fail, then surgery may be necessary. In the fingers, several procedures may be done, including removing the bone spurs, fusing the joint, and replacing the joint. The most common surgery is a finger joint fusion. This procedure holds the joint in a fixed position to prevent any further motion at the affected joint. While the joint is then stiff forever, the pain is usually alleviated.  Furthermore, during finger joint fusion surgery, your doctor can straighten any deformity and remove bone spurs.

    Finger joint replacement can be a very effective procedure in some individuals. People who have an artificial finger joint can maintain mobility of the joint without the pain of arthritis. Furthermore, the same deformities and bone spurs can be addressed during this surgical procedure. In general, finger joint replacement is only considered in more sedentary or elderly individuals, as they are not designed for strenuous activity or heavy labor. The implants, which may be made of metal, plastic, ceramic, or a combination of materials, can wear out over time and need to be protected from too much activity.

    Sources:

    Eaton C, "Finger Osteoarthritis" E-Hand.com Electronic Textbook of Hand Surgery.