Finger osteoarthritis – causes, diagnosis and treatment
Overview of finger osteoarthritis
Osteoarthritis is a chronic joint disease. It develops when a joint has been exposed to long-term harmful stress. The disease can develop in any joint in the body, including in the hands and fingers. Of the finger joints, the base of the thumb is most frequently affected. Osteoarthritis in the fingers and/or the base of the thumb can cause significant discomfort and restrictions in your daily life. But there is help to both prevent and relieve the pain. The most long-term method for treating finger osteoarthritis is to perform specific exercises for the hand muscles. A physical therapist can help with this.
Signs of finger osteoarthritis
Osteoarthritis usually affects the outer joints of the finger (DIP joints) and can cause Heberden’s nodes (bony swellings near the fingertips). The disease can also affect the inter-phalangeal joints (PIP joints) – resulting in Bourchard’s nodes – or the metacarpophalangeal joints (MCP joints). These joints feel sore and stiff, and after a long while they protrude and become coarse.
The innermost joint on the thumb is also frequently affected. In this joint, osteoarthritis causes pain both when you move your thumb and when you hold your hands and fingers still. Cysts can sometimes also appear on the finger joints, known as ganglions or digital mucous cysts. The latter term refers to cysts filled with synovial fluid. Osteoarthritis can be the underlying cause of the following symptoms:
● Difficulties holding onto things
● Pain, discomfort and stiffness in the fingers
● Coarsening of the joints and ganglions on the finger joints
Causes of osteoarthritis in the fingers
We still can’t point out exactly what causes osteoarthrits. What we do have knowledge about is a handful of reasons that contribute to the development of the disease. Long-term overloading of the affected joint is one of the main contributory factors to osteoarthritis. The affected joint may have been exposed to monotonous and long-term stress. In other words, the hands and fingers have been used for hard, monotonous work over many years. Another reason is previous injury to the fingers, such as sprains or fractures. This can lead to so called post-traumatic osteoarthritis. Finger and thumb osteoarthritis can often also be hereditary.
Diagnosing finger osteoarthritis
Thumb or finger osteoarthritis does not present any symptoms other than pain and stiffness in the early stages. The more the osteoarthritis progresses, the more pronounced the symptoms become. Ultimately, the joint may change shape. The fingers may then look misaligned. Soft nodules containing synovial fluid can form when the joint produces increasing amounts of synovial fluid as lubrication. These are called ganglions or digital mucous cysts.
The diagnosis of finger osteoarthritis can be made at an early stage based on the typical clinical presentation combined with the patient’s medical history. This means that there is no need for an x-ray to set the diagnosis. This is because an x-ray rarely shows anything in the early stages. In addition to that, the diagnosis should be set based on whether or not the patient needs treatment, and a patient that shows significant changes in the cartilage on an x-ray is not necessarily in pain – and vice versa.
If you recognize your symptoms as potential osteoarthritis, you should visit a physician or physical therapist who can set the diagnosis. Information about the patient’s work and activities also provides important clues that may lead to the diagnosis of osteoarthritis.
Treating osteoarthritis in the fingers
The main treatment for osteoarthritis consists of different exercises. These can both ease the symptoms and prevent the disease. This means that the patient can maintain a good quality of life in spite of finger osteoarthritis. A visit to a physical therapist with expertise in the hands can provide you with various exercises tailored to reduce the symptoms of finger osteoarthritis. Some people need a combination of pain relief in the form of non-prescription painkillers and movement exercises to achieve the best results. The aim of this is to prevent the pain from taking over, which can result in inactivity.
Other treatment methods
There is not yet any medicine to combat finger osteoarthritis, but the right care can alleviate the condition. If someone is suffering with severe pain, anti-inflammatory drugs may help. NSAID variants are a good option here.
In the case of severe symptoms, cortisone injections with an anti-inflammatory and analgesic effect can be an option. However, cortisone injections have a short-lived effect and should therefore always be combined with exercises. Today, cortisone injections are often used for thumb osteoarthritis, as this joint is a little larger and receives more stress than other finger joints.
In the case of pronounced osteoarthritis, where general treatment has not produced sufficient results, surgery may be an option. The outer joints of the fingers are usually fused, but the inter-phalangeal joints can benefit from artificial prostheses. The angle of the base joint of the thumb can be changed using APL suspension arthroplasty. Another option is to insert an artificial point. In advanced cases it may also be necessary to fuse the thumb base joint.