Hand Osteoarthritis

What Is Hand Osteoarthritis?

Hand osteoarthritis (OA) is a degenerative joint condition affecting the small joints of the fingers and thumb. It's very common, especially in women over 50. While it can cause pain and stiffness, many people maintain good hand function with proper management.¹

Commonly Affected Joints²

DIP joints (end of fingers—Heberden's nodes)
PIP joints (middle of fingers—Bouchard's nodes)
Thumb base (CMC joint—very common)
Can affect multiple joints

Symptoms

Pain with grip and pinch
Stiffness, especially in morning
Swelling around joints
Bony bumps on finger joints
Reduced grip strength
Difficulty with fine motor tasks
Joint deformity over time

Risk Factors

Age (increases over 40)
Female sex
Family history
Previous hand injury
Repetitive hand use
Obesity

Diagnosis³

Physical examination
X-rays (show joint space narrowing, spurs)
Usually no blood tests needed
Distinguish from rheumatoid arthritis

Treatment

Non-Drug

Hand exercises
Splints (especially for thumb OA)
Heat or cold
Joint protection techniques
Occupational therapy

Medications

Topical NSAIDs (first-line)
Oral NSAIDs
Acetaminophen
Capsaicin cream

Surgery

Joint fusion (DIP/PIP)
Joint replacement (some joints)
Thumb CMC surgery
Usually when severe

Self-Management

Use larger handles on tools
Avoid tight gripping
Use two hands when possible
Daily hand exercises
Warm hands before activity

Hand Exercises

Finger bends
Finger spreads
Thumb circles
Make a fist and release
Theraputty exercises

References

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.
Kloppenburg M, Kroon FP, Blanco FJ, et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis. 2019;78(1):16-24.
Zhang W, Doherty M, Leeb BF, et al. EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis. Ann Rheum Dis. 2009;68(1):8-17.