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Arthritis of the Hand

Arthritis, the medical term for joint inflammation, is an extremely common problem for older adults. Arthritis in the hands can make it difficult to perform everyday tasks. While the condition can be managed with proper medical care, first you must recognize its common warning signs.

  • Dull or burning pain in the fingers and hands, especially after you've been holding tightly to an object for an extended period.
  • Swelling and warmth in and around the joints.
  • A feeling of being able to move the joints less easily.
  • A feeling that the joints in your hand are grinding together.
  • A feeling that your joints are loose, or not as stable as they once were.
  • Cysts, or small bumps that appear around the joints of the fingers.

There are two major forms of arthritis. Rheumatoid arthritis results from inflammation of the joints, and can cause pain, redness, swelling, and eventually deformity and loss of function. Osteoarthritis, the most common form, results from wear and tear on the joints over time, which is why it tends to affect older adults.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease. It causes pain, swelling, stiffness, and loss of function in the joints. RA usually affects the same joint on both sides of the body.

  • Causes. RA is caused by a combination of genetic and environmental factors that trigger an abnormal immune response. Possible causes include genetic factors, defects in the immune system can cause ongoing inflammation, environmental factors and hormonal factors.
  • Risk factors. Family members with RA, females, individuals with Pima Indian ethnic background and smoking increase your chance of developing RA.
  • Symptoms. When RA begins, symptoms may include joint pain and stiffness, red, warm, or swollen joints, joint deformity, mild fever, tiredness, loss of appetite and small lumps or nodules under the skin.
  • Diagnosis. The doctor will ask about your symptoms and medical history. You will also be examined. To be diagnosed with RA, you must have at least one swollen or tender joint or a history of a swollen joint. How many joints, and which joints are involved will help aid your doctor in coming to the diagnosis. The doctor will also rule out other conditions that may have similar symptoms, like  lupus or  gout. To aid in the diagnosis, your doctor will order tests, such blood tests to determine if you have an automimmune disease and imaging tests, such as x-rays.
  • Treatment. There is no cure for RA. The goals of treatment are to relieve pain, reduce inflammation, slow down joint damage and improve functional ability. There are a variety of medicines to treat the pain and inflammation of RA. Rest reduces active joint inflammation and pain and fights fatigue. Exercise is important for maintaining muscle strength and flexibility and preserving joint mobility. Devices that help with daily activities can also reduce stress on joints.  Stress reduction can ease the difficulties of living with a chronic, painful disease (eg, joining a support group, cognitive behavioral therapy, meditation). Joint replacement and tendon reconstruction help relieve severe joint damage.
  • Lifestyle measures. Although there are no guidelines for preventing RA, these may relieve stiffness and weakness and reduce inflammation: maintain a balance between rest and exercise, attempt mild strength training, participate in aerobic exercise (eg, walking, swimming, dancing), avoid heavy impact exercise, quit smoking, control weight and participate in a physical therapy program.


Osteoarthritis is the breakdown of cartilage in the joints. This is followed by chronic inflammation of the joint lining. Healthy cartilage is a cushion between the bones in a joint. People with osteoarthritis usually have joint pain and limited movement of the affected joint.

  • Causes. Osteoarthritis is associated with aging. The exact cause is unclear. As osteoarthritis develops, you experience loss of cartilage, bone spurs around the joint, and muscle weakness of the extremity.
  • Risk Factors. Obesity, genetic factors, injury to the joint surface, occupations and physical activities that put stress on joints and neuromuscular disorders, like diabetes, increase your chance of developing osteoarthritis.
  • Symptoms. Dull or burning pain in the fingers and hands, especially after you've been holding tightly to an object for an extended period. Creaking or grating sound in the joint. Swelling, stiffness, limited movement of the joint, especially in the morning. Weakness in muscles around the sore joint. Deformity of the joint.
  • Diagnosis. The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include and  x-ray, blood tests and/or an  arthrocentesis, a procedure that involves withdrawing fluid from a joint.
  • Treatment. There is no treatment that stops cartilage loss or repairs cartilage that is damaged. The goal of treatment is to reduce joint pain and inflammation and to improve joint function. Treatments may include medications, dietary supplements, alternative therapies (eg, acupunture, relaxation therapy, tai chi, yoga), mechanical aids (eg, shock-absorbing shoes, splints or braces, firm mattress, canes, crutches, walkers), losing weight, exercise and physical therapy, heat and ice, corticosteroid injections or surgery.
  • Prevention. To reduce your chance of getting osteoarthritis, maintain a healthy weight, do regular, gentle exercise (eg, walking, stretching, swimming, yoga), avoid repetitive motions and risky activities that may contribute to joint injury, especially after age 40, and, with advancing age, certain activities may have to be dropped or modified. But, continue to be active.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted March 2011

Contact Information

Carl J. Shapiro Department of Orthopaedics
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215