Hand Osteoarthritis Definition and Meaning
Arthrosis of the hand is understood to mean a degenerative disease of the joints in the hand, which is accompanied by accelerated wear and tear of the articular cartilage. Due to the general increase in joint degeneration from the age of 50, the risk of joint arthrosis increases with this age.
What is hand osteoarthritis?
Arthrosis of the hands is a degenerative disease of the cartilaginous structures of the wrists, which is characterized by an accelerated wear and tear process.
In particular, the middle and end joints of the fingers, the thumb saddle joint and the wrist (especially between the radius and ulna as well as the radius and navicular bone) are often affected by hand arthrosis. Damage to the cartilaginous joint structures leads to roughening and cracks, so that they lose thickness and can no longer fulfill their impact or pressure-reducing function and relieve the joint.
As the affected cartilage structures and adjacent bones are subjected to increasing loads, the bones condense (subchondral sclerotherapy) and form attachments (osteophytes). In the further course, secondary inflammation of the synovial membrane ( arthritis ) and joint effusions can manifest themselves, which can lead to pain in addition to the joint stiffness that is characteristic of hand osteoarthritis.
Arthritic wear is usually caused by damage to the articular cartilage layer, although in most cases the underlying cause of this damage cannot be determined (primary hand osteoarthritis).
In addition to genetic factors (familial accumulation), hormonal causes are suspected, since women in particular are affected by finger joint arthrosis after the menopause. In addition, crystalpathies (crystal deposits such as gout ), metabolic diseases, rheumatoid arthritis, osteoporosis (bone atrophy), osteonecrosis (death of a bone section) as well as genetic or accident-related joint malpositions can damage the cartilage structures in the joints and thus cause arthrosis of the hand (secondary arthrosis of the hand).
The process of wear and tear is also promoted by permanent overloading of the corresponding joints ( overweight, activities that put a strain on the joints) and a lack of exercise.
Symptoms, Ailments & Signs
Osteoarthritis of the hand does not initially cause any symptoms. As the disease progresses, various symptoms and symptoms can appear. Typically, the first thing that occurs is a slight stiffening of the fingers, which is noticed by those affected especially in the morning and after longer periods of rest. Later, the fingers swell, making it increasingly difficult to form a fist.
Finally, the pain also occurs at rest and leads to further restrictions in movement. The joints often swell and are red or very warm. If the finger end joints are involved, thickenings sometimes occur that can fill with jelly or pus and empty after a few days or weeks. New thickenings then form.
In the later stage, these thickenings give rise to bony skin changes, which first appear on the right and left of the joints and then eventually spread to the entire hand. Arthrosis of the hand at the thumb saddle joint causes pain and restricted movement. During everyday movements, there is severe pressure pain that only subsides slowly.
Accompanying these symptoms, arthrosis of the hand can cause circulatory disorders, [[paralysis9]s and sensory disturbances in the affected hand. If the course is severe, the affected hand or finger can no longer be moved or can only be moved to a limited extent.
Diagnosis & History
Hand arthrosis is diagnosed based on the characteristic symptoms (pain, swelling, redness, overheating, joint stiffness). The diagnosis is backed up by an X-ray examination, which makes the typical arthrosis-related joint changes such as narrowed joint space, compression of the bones near the joint and bone attachments (osteophytes) visible.
In addition, an X-ray image allows statements to be made about the stage of the hand arthrosis. Underlying metabolic diseases or osteopathies can be detected as part of a computed tomography, magnetic resonance imaging or blood test. Joint punctures and urographies (X-ray contrast imaging of the kidneys and urinary tract) are used to diagnose crystallopathies such as gout.
In contrast to other endogenous structures such as skin, nails or hair, cartilaginous structures lose the ability to regenerate after puberty, so that damage can only be compensated to a very limited extent or not at all. With early prevention or diagnosis and the start of therapy, degenerative changes and the progression of hand arthrosis can be slowed down.
Arthrosis of the hands causes rapid wear and tear on the wrists and thus relatively severe pain. This pain can occur either in the form of movement pain or pain at rest and thus has a negative impact on the quality of life in each case. The pain also leads to considerable restrictions in movement, so that normal activities with the hands can usually no longer be carried out easily.
The pain often spreads to the entire hand. Pain at rest can lead to trouble sleeping at night. It is not uncommon for the joints to swell. The pain and impairments in everyday life due to hand arthrosis can also lead to psychological complaints or other upsets. Patients often withdraw from active life and no longer participate in social interactions.
Osteoarthritis of the hand is treated with medication, therapy or surgery. There are no further complications. However, it cannot be predicted whether the fingers and the entire hand will be fully usable again after the treatment. Life expectancy is not affected by hand arthrosis.
When should you go to the doctor?
As soon as there are inexplicable complaints in the wrist or hand, a visit to the doctor is highly recommended. This is especially true when wrist movement is restricted. In this case, the orthopedist should clarify whether hand arthrosis is present or where the cause of the symptoms lies.
The symptoms often develop rather insidiously over months or even years. In this case, those affected should consult a doctor as soon as they become aware of the symptoms in everyday life. A visit to the doctor is particularly unavoidable when the hand is only performing to a reduced extent or the strength in the fingers is increasingly decreasing.
Circulatory disorders in the hand area must also be examined and treated in good time. The same applies if the affected person cannot hold objects or can only do so with great difficulty, or if the hand trembles frequently when at rest. Many patients develop what is known as avoidance behavior in order to protect their hands.
However, this is rather counterproductive. Instead, a doctor should be consulted so that he can carry out the necessary examinations and initiate appropriate therapeutic measures. Particular urgency is required if the symptoms are already spreading to other areas or the pain is so severe that regular medication is required.
Treatment & Therapy
The therapeutic measures for hand arthrosis are primarily aimed at reducing pain, improving mobility and slowing down joint wear. First of all, conservative therapy consisting of physiotherapy as well as cooling or heat application and medication with pain and anti-inflammatory drugs (non-steroidal anti- inflammatory drugs ) are used for acute pain.
In the case of pronounced pain and inflammation, cortisone or radionuclides (radiosynoviorthesis) are also injected locally into the affected joint to reduce pain. If conservative therapy does not improve symptoms, surgical intervention may be necessary.
Various surgical treatment methods are available for this purpose. In the case of primary hand arthrosis, a so-called denervation can be considered, in which the pain-conducting nerves in the wrist are severed and switched off, while the joint itself and its mobility remain intact.
In the case of arthritic wear and tear of the finger middle joints or the wrist, a prosthetic joint replacement or a placeholder made of silicone is often used surgically to ensure freedom from pain and mobility of the affected joint. Another procedure is joint stiffening, which is recommended in the event of wear and tear of the finger end joints and those affected who place heavy demands on these joints at work.
If the thumb saddle joint (rhizarthrosis) or the wrist in the area of the thumb saddle joint is affected, a partial joint removal (carpal bone) with simultaneous tendon suspension or plastic from the body’s own structures for joint stabilization is usually used (epping plastic).
In addition, in the case of hand arthrosis, a change in diet in favor of a plant-based diet with food supplements that support the cartilage metabolism (including synthetic cartilage building blocks, glucosamine sulfate, collagen hydrolysates) as well as antioxidants and vitamins is recommended.
Outlook & Forecast
The prospects of hand arthrosis must be considered in a differentiated manner. Although there are no chances of recovery, those affected can slow down the progression of an illness. Behavior must be shown that allows living with osteoarthritis of the hand without pain. With the right individual attitude, a positive prognosis can be formulated.
There are professions that lead to different strains on the fingers. Patients with hand osteoarthritis should consider a career change if their hands are the primary source of income. In these cases, the pension insurance often helps by financing retraining. It has been proven that obesity increases the typical symptoms of arthrosis. The joints have to carry too much mass. The same applies to the hands. Freedom from symptoms and a low body weight usually go hand in hand.
Doctors also recommend a healthy diet. Fruits and vegetables are high in omega-3 fatty acids, which inhibit inflammatory responses. Meat, nicotine and alcohol, on the other hand, are harmful and should be avoided. Preventive measures also include preventing joint wear. You can also do regular and varied exercises with your fingers. Therapists impart knowledge about suitable training sessions.
Arthritic wear and tear processes and, accordingly, hand arthrosis can be prevented by regular sporting activity that is easy on the joints. This promotes blood circulation in the synovial membrane that supplies the cartilage and ensures the build-up of stabilizing muscles. Likewise, avoiding one-sided and unfavorable permanent strain on the wrists prevents hand arthrosis.
One goal of follow-up care is to prevent disease recurrence. This cannot be the case with arthrosis of the hand because there are no chances of recovery. Therefore, it can only be about making everyday life pain-free. Starting therapy early has been shown to alleviate the condition.
Patients continuously present themselves to their treating doctor in order to document the progress of the arthrosis of the hand and to initiate countermeasures. In addition to a detailed discussion, imaging is particularly suitable as a diagnostic method. X-rays, a CT and an MRT allow statements to be made about joint changes.
Sometimes a blood test is also ordered. There are three components available for treatment: general measures, medication and physiotherapy. Special aids such as suitable cutlery or thumb splints promise independence. Some of them can be prescribed on prescription.
Drugs that reduce inflammation and protect cartilage may be prescribed depending on the status of the disease. Physiotherapy is also available to patients. Sometimes young people suffer from hand osteoarthritis. The diagnosis is particularly difficult for them when they can no longer practice their profession. In this case, the social insurance institutions will help you with a career change.
You can do that yourself
Reducing pain and maintaining mobility are top priorities in the treatment of hand arthrosis. In addition, those affected can do a number of things to alleviate their symptoms and improve their quality of life.
Regular exercise is the top priority, but it should be as easy on the joints as possible. Even sports in which the hands are not used or only to a small extent are suitable. They promote blood circulation and in this way help to ensure that the articular cartilage is optimally supplied with nutrients. In addition, regular, individually adapted exercise strengthens the muscles in the joint area. This can also have a positive effect on the course of the disease.
Furthermore, heat and cold applications are excellent for self-help with hand arthrosis. If the finger joints are acutely inflamed, cold packs have proven their worth. They relieve pain, inhibit inflammatory processes and have a decongestant effect. Osteoarthritis of the hand is also associated with pain between attacks. In this case, warm compresses and heat packs are suitable methods to relieve the discomfort. The heat promotes blood circulation and contributes effectively to muscle relaxation.
In addition, with arthrosis, it is generally advisable to rethink your own diet in order to support the therapy. Sausage and meat in particular contain the pro-inflammatory arachidonic acid, which can aggravate an existing hand arthrosis.