RA is a systemic disease that is frequently treated with medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs)—including methotrexate—and biologics. However, there are certain treatments recommended specifically for the hand.
Read on to learn about home care, medical treatments, and surgeries to address the pain and symptoms related to hand RA.
Home Care Strategies for RA in the Hands
When rheumatoid arthritis limits hand strength and dexterity, people may try a few home treatments and workarounds. Below are examples of tools and shortcuts that can help reduce hand strain and make everyday tasks less difficult and painful.
Rest the hands periodically
It helps to give the joints, tendons, and ligaments in the hand periodic breaks. For example, musicians or people who type at a computer may need to take regular breaks or work in short segments of time.
Apply a cold or warm compress
A cold compress can ease inflammatory symptoms, such as swelling. Applying a warm compress to the hand can ease stiffness by warming up the synovial fluid that lubricates joints. People with rheumatoid arthritis may decide either warm or cold compresses work best for them, or alternate between the two.
Adapt when possible
A few simple lifestyle changes and products can reduce strain on the hands and minimize arthritis pain and swelling. For example:
- Wear clothes that pull-on or use zippers and avoid clothes with buttons
- Use long zipper pulls, which are larger than regular zipper pulls, making them easier to grasp
- Choose lightweight cooking and gardening tools that are easier to hold
- Wear slip-on shoes to avoid having to tie shoelaces
People may find additional ways to customize their homes and routines to help them work around the pain and swelling associated with rheumatoid arthritis of the hand.
In addition to appropriate prescription oral or injectable medications, a rheumatologist or hand surgeon may recommend:
A licensed occupational therapist can assess a patient’s needs and develop a customized hand-exercise program. Hand exercises can improve dexterity and function—such as the ability to pinch and grip objects—and decrease the risk of future hand deformities. An occupational therapist can also recommend hand splints and identify adaptation strategies for work, home, and hobbies.
A splint that minimizes hand movements may reduce joint strain and limit further deformity. There are several different types of braces, including smaller braces that stabilize individual knuckles and larger ones that stabilize the wrist and hand. Splinting is commonly recommended by physicians.
Tight-fitting, flexible compression gloves are made of nylon and elastane. People typically wear them at night. The hope is that wearing compression gloves will relieve hand pain and stiffness and improve hand function. While these gloves are common and considered safe, there is very little research regarding whether or not they are beneficial.1,2
Topical medications provide short term pain relief and are ideal for use on the hands, where joints lie just below the skin. Topical pain relievers come in the form of creams, balms, gels, or patches, and are sold over-the-counter and by prescription.
Topical medications are generally safe and less likely than oral medications to cause gastrointestinal side effects. However, they still carry potential side effects and may interact with other (oral or injected) medications. To avoid these problems, patients should always tell their health care provider about any other drugs and supplements they take.
Read more about Topical Pain Relief for Arthritis
Other treatments, including integrative medical treatments such as an anti-inflammatory diet, may also help reduce rheumatoid arthritis symptoms in the hands and other joints.
While most people with rheumatoid arthritis never need hand surgery, it may be recommended if a deformity or joint malalignment prevents a person from being able to work or care for themselves.
Finger and wrist joint replacement surgery
Joint replacement surgery is not a cure but a treatment for people who have lost hand function due to deformity. During the procedure, a hand surgeon will remove the damaged surfaces of the joint’s bones and replace them with prostheses made of metal and plastic.
Tendon repairs and tendon transfers
Rheumatoid arthritis can cause tendons in the hand to become injured and strained, eventually leading to a torn tendon. In some cases, a torn tendon may be surgically repaired. In other cases, the tendon may be so damaged that it cannot be repaired3 and a tendon transfer may be recommended.
During a tendon transfer surgery, the surgeon will transfer tendon tissue from a larger, healthy joint to the injured joint in the hand. The surgeon will also try to repair or correct other joint abnormalities to help decrease the likelihood of a future tendon rupture.
The hand tendons most likely to tear include the ulnar-sided extensor tendons, flexor pollicis longus, and the flexor digitorum profundus.
Hand surgery for RA may become less common
Physicians expect that recent improvements in medications for rheumatoid arthritis will reduce the need for corrective surgeries in the hand.3 The sooner steps are taken to prevent joint damage the better the chances for avoiding hand surgery.
There is no known cure for rheumatoid arthritis, but symptoms in the hand and wrist can be managed with home and medical care and—in some cases—surgery.