While no one knows exactly why hand osteoarthritis develops, certain risk factors can make it more likely. Some risk factors cannot be changed—such as genetics—while others, such as obesity and everyday activities, may be modified or eliminated.

Read this page to learn how certain risk factors influence the development of hand osteoarthritis.

Hand trauma
A broken bone, dislocation (when a finger bone separates from the joint), or previous surgery can cause damage that eventually leads to hand osteoarthritis. Symptoms may not appear until many years after the trauma.

Malalignment of a joint(s)
If the bones in the fingers or wrists do not align properly, there can be excess joint friction resulting in increased cartilage wear. A joint malalignment may exist for years before arthritis develops and becomes painful.

Repetitive movements
People whose jobs require repetitive hand movements are more likely to develop osteoarthritis. For example, research suggests that people who work as clothing manufacturers, hairdressers, or bakers have higher rates of hand osteoarthritis compared with professional workers. 1 Rossignol M et al. Primary osteoarthritis of hip, knee, and hand in rela tion to occupational exposure. Occup Environ Med 2005; 62: 772–777. As cited in Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488. , 2 Rossignol M, Leclerc A, Allaert FA, Rozenberg S, Valat JP, Avouac B, Coste P, Litvak E, Hilliquin P. Primary osteoarthritis of hip, knee, and hand in relation to occupational exposure. Occup Environ Med. 2005 Nov;62(11):772-7. PubMed PMID: 16234403; PubMed Central PMCID: PMC1740886.

See Osteoarthritis Causes

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Advanced age
Hand arthritis is most likely to cause symptoms beginning in a person’s 50s or 60s. 3 Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73(9):1659‐1664. doi:10.1136/annrheumdis-2013-203355 , 4 Marshall M, Watt FE, Vincent TL, Dziedzic K. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol. 2018;14(11):641‐656. doi:10.1038/s41584-018-0095-4 Most adults over the age of 55 have signs of hand osteoarthritis that can be seen on X-rays, 5 Dahaghin S, Bierma-Zeinstra S, Ginai A, Pols H, Hazes J, Koes B. Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Annals of the Rheumatic Diseases. 2005;64(5):682-687. doi:10.1136/ard.2004.023564. even though many do not experience pain and stiffness.

Female gender
Women are more likely to develop hand osteoarthritis than men. 6 Arthritis: Osteoarthritis. Centers for Disease Control and Prevention. http://www.cdc.gov/arthritis/basics/osteoarthritis.htm Page last reviewed May 4, 2020. Accessed June 25, 2020. In fact, the authors of one research study found women aged 50 to 60 years were 3.5 times more likely to develop hand osteoarthritis than men in the same age group. 3 Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73(9):1659‐1664. doi:10.1136/annrheumdis-2013-203355 Women’s overall risk peaks after menopause, around ages 60 to 65 years. 3 Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73(9):1659‐1664. doi:10.1136/annrheumdis-2013-203355

Family history
Similar to height and hair color, the likelihood of a person developing hand osteoarthritis is influenced by genetics. Researchers suspect that the genes A2BP1 and TBGF1 increase a person’s susceptibility to hand osteoarthritis, 7 Hämäläinen S, Solovieva S, Vehmas T, Luoma K, Leino-Arjas P, Hirvonen A. Genetic Influences on Hand Osteoarthritis in Finnish Women – A Replication Study of Candidate Genes. Prokunina-Olsson L, ed. PLoS ONE. 2014;9(5):e97417. doi:10.1371/journal.pone.0097417. though genetic testing is not necessary or recommended for diagnosis.

Obesity
Being overweight is regularly considered a risk factor for osteoarthritis in weight-bearing joints, such as hips and knees, but not for the hands. However, some researchers have found links between obesity and arthritis in the hands. 8 Carman WJ et al. Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. Am J Epidemiol 1994; 139: 119– 129. As cited in Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488. , 9 Grotle M et al. Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord 2008; 9: 132. As cited in Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488.

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Evidence suggests the link between excess fat and hand osteoarthritis is related to the body’s biochemistry. 10 Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488. Obesity is associated with low-grade, systemic (body-wide) inflammation, which may contribute to the development of osteoarthritis. 11 King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013;138(2):185‐193. Sartori-Cintra AR, Aikawa P, Cintra DE. Obesity versus osteoarthritis: beyond the mechanical overload. Einstein (Sao Paulo). 2014;12(3):374–379. doi:10.1590/S1679-45082014RB2912. , 12 Sartori-Cintra AR, Aikawa P, Cintra DE. Obesity versus osteoarthritis: beyond the mechanical overload. Einstein (Sao Paulo). 2014;12(3):374–379. doi:10.1590/S1679-45082014RB2912. ], 13 Rosen, CJ, "Pathogenic mechanisms of obesity-induced osteoarthritis: new clues from old joints." Osteoarthritis and Cartilage (2019), phone interview, June 10, 2019. doi:10.1016/j.joca.2019.02.007; (Obesity is defined as a BMI ≥ 30.) More research is needed in this area.

Risk factors cannot predict disease
Although these risk factors predispose certain individuals to hand osteoarthritis, some people without any of the above risk factors may develop the condition and some people with all of the above characteristics may never develop osteoarthritis.

  • 1 Rossignol M et al. Primary osteoarthritis of hip, knee, and hand in rela tion to occupational exposure. Occup Environ Med 2005; 62: 772–777. As cited in Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488.
  • 2 Rossignol M, Leclerc A, Allaert FA, Rozenberg S, Valat JP, Avouac B, Coste P, Litvak E, Hilliquin P. Primary osteoarthritis of hip, knee, and hand in relation to occupational exposure. Occup Environ Med. 2005 Nov;62(11):772-7. PubMed PMID: 16234403; PubMed Central PMCID: PMC1740886.
  • 3 Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73(9):1659‐1664. doi:10.1136/annrheumdis-2013-203355
  • 4 Marshall M, Watt FE, Vincent TL, Dziedzic K. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol. 2018;14(11):641‐656. doi:10.1038/s41584-018-0095-4
  • 5 Dahaghin S, Bierma-Zeinstra S, Ginai A, Pols H, Hazes J, Koes B. Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Annals of the Rheumatic Diseases. 2005;64(5):682-687. doi:10.1136/ard.2004.023564.
  • 6 Arthritis: Osteoarthritis. Centers for Disease Control and Prevention. http://www.cdc.gov/arthritis/basics/osteoarthritis.htm Page last reviewed May 4, 2020. Accessed June 25, 2020.
  • 7 Hämäläinen S, Solovieva S, Vehmas T, Luoma K, Leino-Arjas P, Hirvonen A. Genetic Influences on Hand Osteoarthritis in Finnish Women – A Replication Study of Candidate Genes. Prokunina-Olsson L, ed. PLoS ONE. 2014;9(5):e97417. doi:10.1371/journal.pone.0097417.
  • 8 Carman WJ et al. Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. Am J Epidemiol 1994; 139: 119– 129. As cited in Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488.
  • 9 Grotle M et al. Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord 2008; 9: 132. As cited in Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488.
  • 10 Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13. Review. PubMed PMID: 24329488.
  • 11 King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013;138(2):185‐193. Sartori-Cintra AR, Aikawa P, Cintra DE. Obesity versus osteoarthritis: beyond the mechanical overload. Einstein (Sao Paulo). 2014;12(3):374–379. doi:10.1590/S1679-45082014RB2912.
  • 12 Sartori-Cintra AR, Aikawa P, Cintra DE. Obesity versus osteoarthritis: beyond the mechanical overload. Einstein (Sao Paulo). 2014;12(3):374–379. doi:10.1590/S1679-45082014RB2912.
  • 13 Rosen, CJ, "Pathogenic mechanisms of obesity-induced osteoarthritis: new clues from old joints." Osteoarthritis and Cartilage (2019), phone interview, June 10, 2019. doi:10.1016/j.joca.2019.02.007;

Dr. Anuj Netto is a board-certified orthopedic surgeon specializing in conditions of the hand and upper extremity. Dr. Netto performs hand, microvascular, and peripheral nerve surgery; wrist, elbow, and shoulder joint replacement; and upper extremity reconstruction.

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