When Arthritis Damages Hands, Everyday Tasks Are Hard 

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Every day you use your hands for dozens of precise movements from tying your shoes, to buttoning your clothes to feeding yourself. Because of our constant reliance on our hands, pain, stiffness and swelling in them is especially disruptive to our daily lives. Frequently the cause of that discomfort is arthritis.

The most common form of arthritis in the hands is osteoarthritis, and it usually affects older people. Arthritis occurs when the cartilage that provides a cushion in our joints begins to wear away. In reaction, the joints produce fluid. However, the fluid causes swelling in the joint, which results in pain. Without treatment, the bones in the joint may lose their normal shape.

Osteoarthritis develops most frequently at the base of the thumb, at the joint closest to the finger tip and at the middle joint of the finger. Bony knots may form at the joints. Symptoms include a dull or burning sensation in the joints, swelling, joints that are warm to the touch, and grating or grinding in the joints. When arthritis is found in the base of the thumb, nearby joints in the thumb may become more mobile than usual.

Doctors diagnose arthritis by examining the hands and taking X-rays. Medications may treat the symptoms but cannot reverse the damage. Some of the most common drugs used are anti-inflammatory medications, such as Tylenol or Advil and prescription medications such as Celebrex.

In some cases, doctors inject the affected joints with an anesthetic and a steroid, which may provide relief for months. However, these injections can be used a limited number of times because of the potential side effects. Some patients also wear splints on fingers or on their wrists.

Surgery usually is not an option unless more conservative treatments are unsuccessful. There are several types of surgery. One is joint fusion in which the arthritic surface is removed and the bones are fused together, eliminating motion. During another type of surgery called joint reconstruction, the damaged joint surface is removed and may be replaced with soft tissue, such as a tendon or a joint replacement implant.

In addition to osteoarthritis, another form of arthritis that may affect the hands is rheumatoid arthritis. It can affect the whole body, usually on both sides. Other causes are injuries, infection, gout and psoriasis. Studies show that 80 to 90 percent of adults over the age of 75 have arthritis, and women are more severely affected than men. To learn more about arthritis of the hands, visit the website of the American Academy of Orthopaedic Surgeons at http://orthoinfo.aaos.org or the American Society for Surgery of the Hand at www.assh.org.