Pain and stiffness due to arthritis in a hand(s) can affect a person’s ability to do everything from preparing meals to using a cell phone. Recognizing the symptoms of hand osteoarthritis and getting an accurate diagnosis are the first steps to getting treatment and making everyday tasks easier.
Symptoms of Osteoarthritis of the Hand
There are a number of key signs and symptoms practitioners look for when diagnosing osteoarthritis in the fingers and wrists:
- Pain and stiffness. People with hand arthritis often complain of localized pain in the thumbs, knuckles (DIP/PIP), and/or wrists. Stiffness may be worse after periods of inactivity. Everyday tasks such as using a smartphone or buttoning a shirt may become more difficult to perform.
- Hand weakness. A person with hand osteoarthritis may notice that the affected hand(s) seems weaker than it was before osteoarthritis symptoms occurred. Gripping and pinching objects may be more difficult. For example, a person may have trouble opening jars or turning the ignition key of a car.
- Carpal tunnel syndrome. When arthritis changes the bony and soft tissue structures in the wrist, an area within the wrist called the carpal tunnel can shrink, becoming more narrow. As the tunnel shrinks, it squeezes the nerve that travels through it, causing numbness and/or tingling in the thumb, index finger, long finger, and half of the ring finger.
- Bouchard’s nodes. These bony growths develop in the middle knuckle, or PIP joint, making the knuckle look bigger or swollen. Bouchard’s nodes can make it difficult to get a ring on and off a finger.
- Heberden’s nodes. Like Bouchard’s nodes, Heberden’s nodes are bony growths that develop in the end-most knuckle, or DIP joint.
- Knobby-looking thumb. People who have osteoarthritis at the basilar joint of their thumbs may notice the base of the thumb looks “knobby” or “squared off.” This is a sign that bony growths have developed on the bones of the joint.
If hand pain comes on suddenly, it is more likely to be caused by trauma or another condition, not by osteoarthritis. If fingers, palms and/or wrists feel hot or the skin around a joint turns red, then osteoarthritis is probably not the culprit. An infection, rheumatoid arthritis, or another condition may be the cause, and consultation with a medical professional is advised.
Diagnosing Osteoarthritis of the Hand
There is no single test for osteoarthritis of the hand. Rather, doctors use several approaches to decide whether hand symptoms are caused by osteoarthritis or something else.
- Patient interview. The doctor will ask the person about which joints hurt, what activities make the pain worse, and how long he or she has been experiencing symptoms. Some patients may be asked to fill out a questionnaire about how pain affects their everyday activities. The doctor may also ask if the patient has a family history, previous injury, or job that puts him or her at higher risk for hand osteoarthritis.
- Clinical evaluation. Just looking at the hands can give a doctor an idea whether or not a person has osteoarthritis. Bouchard’s nodes, Heberden’s nodes, and a knobby-looking thumb are all indicators of osteoarthritis. The doctor will also try to trigger pain by palpating the hands—feeling them and pressing on certain areas—and asking the patient to do certain tasks, such as grasping an object.
- Medical imaging. X-rays can show the development of bony growths called osteophytes, loss of joint space caused by the loss of articular cartilage, and other changes.
- Lab testing. There are no lab tests that confirm osteoarthritis in the hand. However, a doctor may order lab tests to rule out other possible causes of hand pain, such as rheumatoid arthritis or psoriatic arthritis.
Many people experience hand pain and stiffness. Recognizing these symptoms and getting a diagnosis can lead to an individual treatment plan that makes day-to-day living easier and less painful.