Osteoarthritis of the small joints of the hand

Osteoarthritis of the small joints of the hand

 

Cause

 

Osteoarthritis occurs when the joint cartilage gradually deteriorates leading to inflammation.

 

Factors that can increase the risk of osteoarthritis include:

 

• Older age
• Gender: Women are more likely to develop osteoarthritis
• Genetics
• Joint injuries
• Occupations requiring repetitive stress on the joint
• Lifestyle factors such as smoking

 

Symptoms 

 

Osteoarthritis symptoms often develop slowly and worsen over time.

 

• Pain and tenderness of the joints
• Stiffness or loss of flexibility
• Swelling
• Weakness and/or instability
• Deformity
• Bone spurs
• Grinding sensation with range of motion

 

Diagnosis

 

X-rays or other imaging can help confirm the diagnosis of osteoarthritis however the appearance of the disease on x-ray does not always correlate to symptoms severity.

 

Photo source: https://www.researchgate.net/figure/Plain-radiographic-changes-in-hand-osteoarthritis-due-to-thumb-first-carpometacarpal_fig1_328940288

 

 

Referral

 

Early referral is important to help slow the progression of the disease and improve pain and joint function.

 

Management

 

Treatment is based on individual symptoms and presentation. Arthritis is not curable however treatment aims to alleviate symptoms, protect joints and strengthen supporting soft tissues:

 

• Joint protection and education
• Education regarding activity modification
• Pain management
• Custom and pre fabricated orthosis prescriptions
• Exercises to maintain joint range of motion
• Strengthening and stability exercises of ‘joint friendly’ muscles

 

Surgery might be appropriate for more severe cases of osteoarthritis for which a referral to an orthopaedic hand surgeon may be required.

 

 

Splinting

Photo source: https://www.ncmedical.com/

 

 

 

Photo source: https://bracelab.com/