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What changes in a joint
A joint allows two bones to move relative to each other. Their surface is covered with cartilage. In osteoarthritis, the cartilage, neighboring bone and other tissues of the joint evolve. There may be more inflammatory periods, with pain and swelling. It’s not just the same mechanical wear and tear for everyone.
Osteoarthritis of the hand can affect several joints. Symptoms vary depending on their location and days. A marked image does not automatically imply significant discomfort; conversely, actual pain may be present with modest radiographic changes. Care focuses on comfort, function and activities that matter to you.
Chapter sources [1]
Understand the picture
Thumb and fingers: different needs
Base of thumb
It allows opposition and pincer grips.
Finger joints
Their mobility contributes to the opening and closing of the hand.
Adapted grip
Distributing the effort can make a task easier without requiring the joints to remain still.
Chapter sources [1]
The base of the thumb: rhizarthrosis
The joint at the base of the thumb allows it to oppose the other fingers. It supports stress during gripping and pinching: turning a key, opening a lid or holding a cup by a small handle. Osteoarthritis at this joint is called rhizarthrosis.
The pain is often located near the base of the thumb and increases with certain tasks. The thumb may appear less stable or less strong. Shape changes sometimes appear, without this automatically requiring an operation. The priority is to understand which holds remain effective and which ones would benefit from modification. Related pain related to De Quervain's tendons requires a different approach.
Chapter sources [2]
Fingers: stiffness, bony bumps and fluctuations
Osteoarthritis can affect the joints near the nails or those located in the middle of the fingers. They may become sensitive, stiff or present bony bumps. Difficulty closing the hand completely or grasping small objects can interfere with dressing, cooking, or leisure activities.
Symptoms do not necessarily progress steadily. Calm periods sometimes alternate with more painful episodes. Prolonged stiffness upon waking and persistent soft swelling of several joints, particularly at the base of the fingers, merit medical advice to look for an inflammatory disease. The appearance of the hands alone is not enough to distinguish these situations.
Associated factors and examination
Age, family history, certain old injuries and other biological factors can intervene. Osteoarthritis is not proof that you have been using your hands incorrectly. Manual work can make certain tasks more difficult without alone explaining all joint changes.
The clinician examines joints, movements, stability and movements that are difficult. An x-ray can clarify the changes or help if the diagnosis remains uncertain. Blood tests do not confirm osteoarthritis, but may be requested if another disease is suspected. The results are interpreted along with your symptoms, and not used as an automatic instruction to stop activities.
When pain deserves a quick assessment
A very hot, red and suddenly painful joint can have other causes, including an infection or an inflammatory crisis. Request a same-day evaluation, especially with fever or malaise. After a fall, new pain should not be immediately attributed to known osteoarthritis.
Persistent swelling of several joints, unusual fatigue or significant morning stiffness warrants a consultation promptly. New loss of sensation or weakness in the thumb may signal an associated nerve problem. Don't assume that all change is part of aging; specify what is new compared to your usual hand function.
Adapt grips and objects
Try to distribute the efforts over a larger area. A larger handle, a jar opener, or using both hands can reduce painful pinching. Break up a long task and alternate demanding actions with lighter activities. It’s not about no longer using the joints.
Choose aid according to a concrete difficulty rather than a shopping list. If turning a key bothers you, start by reviewing this task with the clinician. If you like gardening, try a shorter duration before giving up this activity. Adaptations serve to maintain autonomy; they do not promise to prevent all changes in osteoarthritis.
Chapter sources [1]
In everyday life
Open a jar with less hassle
Spot
Identify whether the pain is from thumb pinching or clamping force.
Adapt
Try stable support and an aid that widens the grip.
Maintain activity
Distribute tasks and maintain bearable movements between demanding activities.
Chapter sources [1]
Exercises and the role of physiotherapy
Appropriate exercises can help mobility, strength and function, with generally modest and variable benefit. The program for stabilizing the base of the thumb is not necessarily that of the finger joints. The physiotherapist takes into account the pain, the movements available and the activities you want to regain.
Start with comfortable movements and a small amount, then observe the reaction. A painful flare-up may require temporarily reducing resistance rather than straining or immobilizing the entire hand. Exercises do not regrow cartilage. They aim to better use the capacities present, in addition to the other treatments chosen with you.
Splints and medical treatments
A thumb base splint can reduce pain in some people. Its form and times are chosen according to tasks and tolerance. It must support without compressing or making the other fingers unnecessarily immobile. Its effect on comfort does not mean that it permanently corrects the shape of the joint.
The EULAR recommendations favor, when appropriate, local treatments before certain oral treatments. Ask the doctor or pharmacist what is compatible with your history and medications. Injections are not routinely needed in hand osteoarthritis. An operation can be discussed if the discomfort remains significant despite appropriate care, after comparing the benefits and risks.
Work, leisure and rest
For writing or tools, a looser grip and breaks between sequences can make the activity more bearable. To cook, distribute the weight of a pan between both hands and avoid a strong pinch grip on a small handle. An occupational therapist can also help adapt certain tasks if necessary.
In the evening or when they wake up, some people appreciate gentle heat for comfort. Avoid extreme temperatures, especially if sensation is reduced. A red, warm joint should not simply be rewarmed without evaluation. No accessory or ritual fits all hands: stick to the adaptations that actually help you do what matters.
Progress and realistic objectives
Osteoarthritis is long-lasting, but its presence does not mean an inevitable and ongoing loss of all function. The intensity of the pain may vary. A useful goal may be to button an item of clothing, resume a leisure activity in several stages, or hold a cup more comfortably, rather than returning to a normal x-ray.
Reassess the situation if tasks become more difficult, if the flare-ups repeat, or if the brace and exercises are not helping. The program can be modified and another cause sought. After surgery, protection and rehabilitation depend on the intervention; The general examples in this guide do not replace this protocol.
Chapter sources [1]
Your questions
Will the exercises wear out my fingers more?
Appropriate movement cannot be equated with automatic wear. Exercises are aimed at function and must take into account joint response. A lasting worsening invites you to reduce the dose and seek advice, rather than insisting or abandoning any movement.
Chapter sources [1]
Do you need an splint for each painful joint?
No. The indications differ, and the data on the thumb base splint does not apply in the same way to all fingers. The model must meet a specific need and remain comfortable. Have it checked for usefulness and fit.
Chapter sources [1]
Do bumps on fingers need surgery?
Not automatically. The decision depends above all on the pain, the function and the treatments already tried. Appearance alone is not enough to justify intervention. Discuss the benefits, limitations and expected recovery before making any decisions.
Chapter sources [1]
How to distinguish osteoarthritis and polyarthritis?
The distribution of the joints, the duration of the stiffness, the type of swelling and the examination guide the doctor. Tests can add information to this assessment. Persistent swelling of several joints should not be attributed to osteoarthritis without medical advice.
Chapter sources [3]
Sources and references
- [1] EULAR · 2018 update of the recommendations for the management of hand osteoarthritis
- [2] BSSH: Basal thumb arthritis
- [3] NICE NG100: Rheumatoid arthritis in adults
- [4] NHS: Wrist pain
- [5] NHS Inform: Exercises for wrist, hand and finger problems
- [6] CGDIS · Appeler le 112
Text updated on
Medical review: awaiting Hasib Selimovic.