Osteoarthritis (OA) of the hand

A lubricating layer known as articular cartilage covers the ends of the bones in the hand, and this helps to minimise friction within the joint. OA is when there is pain and irritation of the cartilage in the joints of the hand which, if it’s not treated, can cause more pain and limit movement.

Causes

As cartilage wears out, the rough surfaces of the bones begin to rub against one another and the hand becomes painful, stiff and inflamed. OA usually develops after many years of use, which is why it normally affects people who are middle-aged or older. However, it’s also more likely when there has been previous damage to the joint surface, for example a fracture.

Symptoms

These include pain, especially after working the joint, which becomes worse over time. This can make everyday activities, such as opening a jar, more difficult. The joint can also swell and feel warmer and may ‘grate’ when it’s moved, or feel unstable. When OA affects the joint near the end of the finger there may also be small cysts.

Diagnosis

A medical examination and discussion of your symptoms is usually backed up by an X-ray, blood tests and, in some cases, (for example, if the specialist thinks you may have Kienböck’s disease), an MRI scan, or a bone scan which can show signs of arthritis that can’t be seen on an X-ray.

Treatment

Treatment will depend on a number of factors including your medical history, age, how far arthritis has progressed, your personal goals and the results of diagnostic imaging tests.

Non-operative treatment: this includes anti-inflammatory medications (if advised by your doctor) which can help to control the symptoms if the OA is in its early stages. Steroid injections can also help reduce pain and inflammation, especially if you also wear a splint to support the joint when you’re using the hand.

Surgery: if non-operative treatment doesn’t relieve your symptoms, you may be advised to have surgery to clean up the joint (debridement). In the early stages of wrist arthritis, this can be carried out using arthroscopy; however, if your OA is advanced you may need to have joint fusion (where the joint is permanently joined and no longer moves, but the damaged surfaces are removed) or joint replacement surgery, although the long term success for replacing joints in the hand and wrist are variable.

Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please contact us for advice if you’re worried about any aspect of your health or recovery.

This type of surgery is carried out to relieve nerve entrapment (cubital tunnel syndrome)
This procedure is used to release the ulnar nerve when it’s compressed at the elbow.
Arthroscopy allows surgeons to use a type of keyhole surgery to diagnose and treat joint problems.
Joint replacement is less common in the wrist than in other joints such as the knee or hip
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