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Osteoarthritis of the Hand

This page has been designed to provide you with the right information about osteoarthritis of the hand and how to manage it from a physiotherapy point of view.

What is osteoarthritis?

Osteoarthritis in general is often misunderstood and as a result there are a lot of mistruths and myths about it.

In simple terms, it is best to consider osteoarthritis as the aging process of your joints. If you look in the mirror, you may find that you do not look like you did when you were 18 years old. You may have a few more wrinkles and a few more grey hairs than back then and these are generally accepted by most people as the outward signs of aging. Your joints undergo an aging process and you are exactly the same age on the inside as you are on the outside. Therefore, it isn’t realistic to expect your joints to look like they did when you were 18 either. Perhaps thinking about osteoarthritis as the grey hair and wrinkles of your joints may help you understand it better.

Why have I heard it described as ‘wear and tear’?

As with many other things, sometimes when certain words or phrases are used to describe something, they stick. Unfortunately, the term ‘wear and tear’ is used very regularly to describe joint issues and it is not really that helpful. Nothing in your hands is ‘worn’ or ‘torn’, therefore the phrase can be misleading as it suggests that the issue you may have with your hands is due to damage.

Does it really matter what you call it?

We really think it does. Words are incredibly important as they help us understand what might be going on in our hands and what we are dealing with. If you have been told that you have hand pain and that it's something you need to be concerned about, then it is only human to find yourself worrying about it. If things are explained correctly and words, phrases and images are used appropriately, you are likely to understand the issue better and be in a better frame of mind to do something about it.

Interestingly, a study by Kim et al. (2017) found that emotional stresses and challenges such as low mood and worry, appeared to be more likely to contribute to pain than physical factors. In other words, how you feel and what you think about your problem does matter!

So, my hands aren’t damaged?

Osteoarthritis isn’t damage and therefore, using the word 'damage' to describe it is not accurate. Osteoarthritis describes the adaptive and useful changes in the way your joints look and work in order for them to cope with getting older (not 18 years older anymore!).

 

What are the common symptoms with osteoarthritis of the hands?

This is a really important question and it is useful for you to know what is normal for hands that may have osteoarthritis. We’ve broken the answer down into things that are found most common:

How is osteoarthritis diagnosed?

In most cases, osteoarthritis can be suspected or diagnosed through the clinical features (what it looks like and how it behaves), your symptoms (what you tell us about your hand and the clinical assessment (testing the movements etc.). An X-ray of the hand is often used to help diagnose osteoarthritis but not always required.

Why are X-rays/scans not always required?

In a lot of cases, the information we as healthcare professionals can get from asking you questions and testing the hands is enough to make a decision. X-rays are a very useful tool as they show you what your joints looks like on the inside, however, in some cases what your hands look like on the inside doesn’t really marry up with what your problem might be.

There is growing evidence (experiments and clinical studies) that demonstrates what you see is not always what you get with X-rays and scans, and that a lot of the so-called ‘worn out’ or ‘abnormal’ findings are seen commonly in people with no pain, stiffness or symptoms.

What this means is that what you say about your hand issue, how you move and how you feel etc. are often more important than the results of an X-ray or scan.

 

 

 

 

 

What causes osteoarthritis?

This is a difficult question and the simplest answer is that it is complicated. As we’ve explained in the last question, what you see is not always what you get and just because an X-ray says you’ve got osteoarthritis of the hand/s, doesn’t mean you’ll actually have any problems.

There are many factors that will influence the development of symptoms, including (not limited to) low activity levels, previous injury, diet, genetics, being less strong, how you feel about your pain and negative beliefs. It is unlikely that just one of these factors will cause you to have any symptoms, however, it may be that they may each have a subtle influence and something (sprain or strain, bad day at work or stress) may act as a trigger for the symptoms to then develop.

 

 

 

What can I do to help myself?

Reassuringly, there are a number of things that you can do to help get your hands going and start your rehabilitation.

Is there anything I can get to help with day-to-day tasks?

For some people, certain day-to-day tasks can prove really quite challenging and they might need some help to get the job done. You can seek a referral from your GP to our Occupational Therapy colleagues who specialise in adaptations to help people remain independent, or explore what options are available to purchase yourself (online search ideas: arthritis hand aids).

Please note, we have no affiliation with any company (online or not), therefore will not recommend any company over another.

 

What can physiotherapy do for me?

Physiotherapy for hand complaints including osteoarthritis can be very effective. We offer a range of options to help you manage your complaint, with exercise, education and lifestyle advice/coaching forming the main part of what we can offer you.

 

Is there anything I should look out for?

In most cases, hand symptoms associated with osteoarthritis are easily recognised, but occasionally there are things that do not fit and should be highlighted to your doctor, nurse or physio.

  • Generally feeling unwell and/or a temperature alongside your hand pain
  • A history of trauma that started your hand pains
  • Swollen or ‘sausage-fingers’ and you are under the age of 40 years old
  • Red, swollen and hot joints
  • Pins and needles or numbness in your hands that is causing difficulties with coordination

Will it get better?

In a lot of cases, it is very much possible for you to improve the symptoms you have with your hands. Obviously, you cannot turn back the clock and the osteoarthritis will still be there even if you feel better. But by being stronger, fitter, more confident and closer to your ideal bodyweight, you can start to regain some more control over your hands.

 

How long will it take before I feel something?

This is a very difficult question. It is best to think about how much time and effort you are going to throw at the challenge and how confident and motivated you are to do something about it. If you work hard and are consistent with what you do, often people will notice signs of positive response within weeks to months. If you are not committed to the challenge, it will take longer or may not respond at all.

Frequently asked questions

Below are some of the common questions that are asked when talking about hand issues that haven’t been covered in the information above.

 

A: Using supports for your wrist and/or hands can sometimes be very useful. If you feel that you need some kind of support, then try to use it sparingly or just during the task that you are having difficulty with to prevent becoming reliant on it.

A: Acupuncture is something that can help some people, however, not everyone benefits from it. Acupuncture is best thought of as a type of pain relief and as such, it might help ease the pain temporarily, but will probably do very little to address the reason why your hands are sore in the first place. Working on normal confident movement and the strength of your neck is likely to help most people.

A: This doesn’t matter. Most, if not all, of the exercises below can be modified or adapted using heavy bags, bottles of water or even books. If you struggle with gripping the thing you wish to exercise with, you may have to be creative to get the best out of the exercise.

For the exercise with the putty, this can be bought easily online (search: therapy putty).

A: If your hands are sore to begin with then it is normal to expect that starting some exercises might be a bit sore to start with. As you get better and start to tolerate the exercises better, you should find that they are more comfortable. However, it is worth knowing that strengthening exercises are meant to be hard work (and a bit sore), so if they’ve become too easy, perhaps you need to increase the challenge.

A: The pain in your hand/s is not an indication of damage, therefore it is safe to move them normally. If something is really sore, it makes sense not to force it and work within a range that is comfortable, but overall it is safe to be sore.

A: Quite simply, no! The exercises will help get you moving and hopefully help with your strength, which are both important for helping hand issues. However, often looking at the things that your hands struggle with, such as writing for long periods/carrying shopping and making some changes/ adaptations to those things will help the exercises be more effective.

As mentioned before, generally being more active, fitter and stronger is an effective way of helping with most aches and pains, including hand issues.

Exercise tips:

For movement exercises, aim to complete the exercises little and often throughout the day within what is comfortable. You may find these most effective either first thing in the morning or after a period of rest. You may also want to explore these exercises in a bowl of warm water.

For strengthening, you may choose to start by simply completing the exercises until your hands get tired, have a brief 1-minute break and try again. Aim to do a total of 3-4 sets of the exercise. Complete these exercises every other day.

Bricca A., Roos E,M.,  Juhl C,B., Skou S,T., Silva D,O., Christian J. and Barton C, J. (2019). Infographic. Therapeutic exercise relieves pain and does not harm knee cartilage nor trigger inflammation. British Journal of Sports Medicine. DOI: 10.1136/bjsports-2019-100727 (accessed 26/01/2021).

 Kim, R., Wiest, C., Clark, K. and Cook, C.   (2017). Identifying risk factors for first-episode neck pain: A systematic review. Musculoskeletal Science and Practice, Volume 33, 77-83 https://doi.org/10.1016/j.msksp.2017.11.007 (accessed 26/01/2021).

Nakashima, H.,   Yasutsugu, Y.,  Suda, K., Yamagata, M., Ueta, T. and Kato, F. (2015). Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine, 40(6):392-8. doi: 10.1097/BRS.0000000000000775 (accessed 26/01/2021).

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