What Are the First Signs of Arthritis in Your Hands?

Reviewed on 5/26/2021

Arthritis is a condition that causes inflammation of the body's joints. The first signs of arthritis in the hands may include pain, stiffness, swelling, joint tenderness, and warmth and redness in the joints in the hands. Other symptoms of arthritis in the hands may include decreased range of motion of the affected joint(s) and the joints appearing larger, among others.
Arthritis is a condition that causes inflammation of the body's joints. The first signs of arthritis in the hands may include pain, stiffness, swelling, joint tenderness, and warmth and redness in the joints in the hands. Other symptoms of arthritis in the hands may include decreased range of motion of the affected joint(s) and the joints appearing larger, among others.

Arthritis is inflammation of one or more joints in the body. There are over 100 different types of arthritis but the most common types of arthritis are osteoarthritis (degenerative arthritis caused by wear and tear on the joints) and rheumatoid arthritis (an inflammatory type of arthritis caused by inflammation in the joint).

Osteoarthritis is the most common type of arthritis that often develops with age. It is a chronic condition in which the cartilage between the bones that cushions the joints wears down, and as it does, the bones rub against each other causing pain, stiffness, swelling, and reduced joint motion. Osteoarthritis most commonly affects the hands, knees, hips, feet, and spine, though it can affect almost any joint in the body. 

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent joint pain, swelling, and stiffness that affect both sides of the body. It can also affect the skin, heart, lungs, and eyes. 

In osteoarthritis, symptoms are usually worse in the patient’s dominant hand, while in rheumatoid arthritis, both hands are usually affected.

The first signs of arthritis in the hands may include: 

  • Pain in the hands
    • May feel dull or burning 
    • Often occurs after increased joint use such as heavy gripping or grasping
    • May occur hours after the activity or even the next day
    • Pain is relieved by rest
    • Rainy weather may increase joint pain
  • Hand stiffness, especially in the morning
    • Stiffness may ease in 5 to 15 minutes in patients with osteoarthritis
    • Stiffness can be prolonged and last an hour or more in patients with rheumatoid arthritis 
  • Hand swelling
  • Tenderness of the joints in the hands
  • Warmth and redness of the joints in the hands (rheumatoid arthritis)

Other symptoms of arthritis in the hands may include:

  • Decreased range of motion of the affected joint(s)
  • Redness and inflammation of the affected joints
  • A grating sensation or “popping” sound when the joint moves (crepitation)
  • Joint may appear larger than normal (hypertrophic)
  • Small, bony, bump-like nodes on the hand
  • Cysts on the end joints of the fingers
  • Deformities in the affected hands and fingers
  • Fever, if the arthritis is due to an infection
  • Pain and weakness at the base of the thumb 
    • In patients with advanced thumb base arthritis, the neighboring joints may become more mobile than normal

What Causes Arthritis in Your Hands?

Osteoarthritis is caused by the breakdown of cartilage over time. Risk factors for developing osteoarthritis include:

  • Advancing age 
  • Rare in people under 40 years
  • At least 80% of people over age 55 have some X-ray evidence of osteoarthritis
  • Fractures 
  • Gender 
  • Women are two to three times more likely than men to develop osteoarthritis 
  • Obesity
  • Occupation 
  • Occupations that require a lot of dexterity or hand use
  • Joint injury or trauma
  • Sports 
  • Wrestling, boxing, pitching in baseball, gymnastics, and football

The cause of rheumatoid arthritis is unknown, but it is thought that susceptibility factors and initiating factors may affect a person's risk of developing the condition: 

  • Susceptibility factors increase a person’s susceptibility to developing rheumatoid arthritis when exposed to risk factors that initiate the inflammatory process. Susceptibility factors include:
  • Age: middle-aged or older
  • Female sex: twice as likely as men to develop RA
  • Genetics: people with a relative who has RA have an increased risk of developing the condition

Initiating factors (triggers) increase the chances a susceptible person will develop the disease, such as:

QUESTION

The term arthritis refers to stiffness in the joints. See Answer

How Is Arthritis in Your Hands Diagnosed?

Arthritis in the hands is diagnosed with a patient history and physical examination. 

Tests that may be used to confirm a diagnosis of arthritis or determine the type of arthritis that is present may include: 

Imaging studies used to diagnose arthritis include:

  • X-rays (first choice)
  • Ultrasound of joints: Joints, as well as tendon sheaths, changes and degree of vascularization of the synovial membrane, and even erosions
  • Bone scan
  • Magnetic resonance imaging (MRI)

Joint aspiration and analysis of synovial fluid may be indicated, including:

  • Gram stain 
  • Cell count 
  • Culture 
  • Assessment of overall appearance 

What Is the Treatment for Arthritis in Your Hands?

Treatment for arthritis in the hands may involve lifestyle modifications, medications, and/or surgery.

Medications used to treat arthritis include:

  • Corticosteroids 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) 
  • Pain relievers (analgesics)
  • Topical skin products
    • Topical nonsteroidal anti-inflammatory drugs (NSAIDs) 
    • Topical capsaicin
  • Medications used to treat rheumatoid arthritis also include: 
    • Nonbiologic disease-modifying antirheumatic drugs (DMARDS) 
    • Biologic tumor necrosis factor (TNF)–inhibiting DMARDs 
    • Biologic non-TNF DMARDs 

Surgical treatments for arthritis include:

  • Synovectomy 
  • Tenosynovectomy 
  • Tendon realignment 
  • Reconstructive surgery or arthroplasty 
  • Arthrodesis 

Other therapies for arthritis include:

  • Physical therapy and exercise 
  • Occupational therapy 
  • Heat and cold therapies 
  • Joint-protection education 
  • Orthotics and splints 
  • Assistive devices such as canes, walkers, electric-powered seat lifts, raised toilet seats, and tub and shower bars 
  • Energy-conservation education 

 

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Reviewed on 5/26/2021
References
https://creakyjoints.org/symptoms/arthritis-in-hands/

https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-hand

https://www.rheumatoidarthritis.org/living-with-ra/early-signs-symptoms/

https://www.uptodate.com/contents/rheumatoid-arthritis-symptoms-and-diagnosis-beyond-the-basics?search=rheumatoid%20arthritis&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5

https://www.uptodate.com/contents/rheumatoid-arthritis-treatment-beyond-the-basics?search=rheumatoid%20arthritis&topicRef=512&source=see_link

https://www.uptodate.com/contents/osteoarthritis-symptoms-and-diagnosis-beyond-the-basics?search=Osteoarthritis&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4

https://www.uptodate.com/contents/osteoarthritis-treatment-beyond-the-basics?search=Osteoarthritis&topicRef=507&source=see_link