OSTEOARTHRITIS

What is osteoarthritis? 

osteoarthritisOsteoarthritis is the natural age related degenerative change that occurs within the joints of the body. It is usually associated with age as symptoms presenting and becommore problematic in the later decades of life. Osteoarthritis in the hands, thumb and wrist is often quite disabling and can cause problems with what should be simple functional tasks such as opening doors, carrying items, using cutlery or writing 

Occasional flares of pain in addition to more common symptoms may occur after minor trauma but also with no obvious trigger. These “flare ups will usually settle with time but can occur for several months. Medication as advised by your GP/Pharmacist and following the advice as detailed below should be considered.

Symptoms of osteoarthritis

The most common symptoms associated with osteoarthritis in the hands and wrist: 

  • Stiffness and pain in the hands, thumb, fingers and wrist. 
  • Pain and stiffness often worse on a morning or after a period of not using your hands. This often eases within 30mins of moving the hands and joints. 
  • Difficulty holding items, you may drop things and struggle with dexterity tasks such as doing buttons or opening jars etc. 
  • Enlargement and nodules (Bouchard and Heberden nodes) over the knuckles and joints in the hands and fingers.  
  • You may also experience some swelling around the hands and wrist.  
  • More commonly seen in the dominant hand. 
What causes osteoarthritis?

There are several factors associated with osteoarthritis including: 

  • Increasing age, especially over 40yrs old and above 
  • Occupational and recreational factors, such as those who use their hands regularly or use machinery etc. 
  • Cold or damp weather 
  • Female gender 
  • Family history of osteoarthritis 
  • Obesity 
  • Previous hand or wrist injury or trauma 
  • Joint mobility and laxity 
  • Menopausal status 
Management options:

Advice: 

  • Avoiding repetitive tasks or activities that cause symptoms or pain to present – as well as regular breaks from activity.  
  • Relax your grip, and avoid increased force gripping activities. 
  • Changing and modifying activities or using aids to support function.  
  • There is evidence for using heat for osteoarthritis if the joints are painful but regular cold packs if there is any swelling associated 
  • Wearing gloves and keeping the hands warm in colder/damp months. 

Physiotherapy: 

There is evidence to suggest that regularly exercising the hands and wrist improves stiffness, pain and function with osteoarthritis, and this is where physiotherapy can be beneficial. By improving the range of movement and strength in the hands and wrist, the condition can generally be well managed long term. Please see the exercise sheet specifically for the hands and for the wrist.  

See Hand and Wrist Movement and Strength Exercises handout

Splints

Splints

Splints:  

Evidence  supports the use of splints for osteoarthritis, as they can improve function and grip – making everyday tasks more manageable. However prolonged use of splints should be avoided and can cause increased stiffness in the joints as they restrict  joint movements, as well as causing weakness in the muscles around the hands.  

 Corticosteroid injections:  

Steroid injections can be used to reduce any inflammation and pain in and around the joint and can provide short term benefit for pain and function. However injections also have associated risks including risk of infection and potential problems to the skin and joints with repeated use.  

Surgery: 

Surgery is very rarely a first line treatment for hand and wrist OA and is only considered after conservative treatments have been exhausted. Surgery can provide pain relief; however functionally people may be more limited after procedures have been done.  

Please note -
These are general exercises, seek advice if you are unsure.

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