Finger Arthritis

What is finger arthritis?

Joints are places in your body where two bones come together. Arthritis is a problem that causes damage to the normal joint surfaces. These junctions have special surfaces to allow smooth motion. This smooth surface is cartilage, and when the cartilage is damaged, arthritis is the condition that results.

There are two types of arthritis that commonly affect the fingers. These are osteoarthritis and rheumatoid arthritis.

• Osteoarthritis
  Osteoarthritis, also called wear-and-tear arthritis, is the most common type of finger arthritis. In people with osteoarthritis, the normal cartilage is steadily worn away, exposing bare bone at the joints. The most frequently affected joints in the hand are the knuckles of the mid-finger and fingertip (the PIP and DIP joints), and the joint at the base of the thumb.

• Rheumatoid Arthritis
  Rheumatoid arthritis causes a different type of joint destruction. Rheumatoid arthritis is a systemic disease that can cause a number of problems. Among these, rheumatoid arthritis can cause inflammation of the soft-tissue surrounding joints. The most commonly affected joints in the hand are the knuckles at the base of the fingers (the MCP joints).

What are the symptoms of finger arthritis?
Symptoms of finger arthritis include:

• Joint pain
• Swelling
• Stiffness
• Loss of motion

Patients with osteoarthritis often develop lumps or nodules around the knuckles of the fingers. These lumps are called Heberden's nodes (when around the more distant knuckle) or Bouchard's nodes (when around the closer knuckle), and actually consist of bone spurs around the joints. These knuckles often become enlarged, swollen, and stiff. People often complain that their rings do not fit, or can't be removed.

Patients with rheumatoid arthritis often have the aforementioned symptoms, but can also have more complex deformities of the hands. The fingers may begin to shift from their normal position, and drift away from the thumb.

What are the treatments for finger arthritis?
Early treatments of finger arthritis are focused on managing the symptoms in an effort to avoid surgery. Treatment options include:

• Anti-Inflammatory Medications
  These medications can help treat the pain of finger arthritis, and also help decrease inflammation and swelling around the joints.

• Joint Supplements
  Joint supplements consist of glucosamine and chondroitin, two of the major building blocks of normal cartilage. These supplements may be helpful for osteoarthritis.

• Cortisone Injections
  Cortisone is a more powerful anti-inflammatory medication and can be useful in limited applications in the hand.

• Hand Therapy
  Hand therapy, usually performed by an occupational therapist, is helpful to maintain motion and prevent stiffening of the joints.

• Ice & Heat Treatment
  Joint stiffness and range of motion can be improved by ice and heat treatments.

• Splints
  Splinting helps to relax and rest the joints. Splinting should be done for limited periods of time to allow for relief without allowing the joint to stiffen.

If these treatments fail, then surgery may be necessary. In the fingers, several procedures may be done, including removing the bone spurs, fusing the joint, and replacing the joint. The most common surgery is a finger joint fusion. This procedure holds the joint in a fixed position to prevent any further motion at the affected joint. While the joint is then stiff forever, the pain is usually alleviated. Furthermore, during finger joint fusion surgery, your doctor can straighten any deformity and remove bone spurs.

_Sources:

Eaton C, "Finger Osteoarthritis" E-Hand.com Electronic Textbook of Hand Surgery.