Osteoarthritis (OA) is a degenerative joint disease that affects more women than men. OA in fingers is also more common in women, particularly after menopause. Knowing the early signs may help caught the existence of this joint problem at early stage. And early diagnosis is helpful to determine the effective treatment in controlling the progression of the disease more effectively.
The anatomy of joints in the finger is complicated. Like most things in arthritis, OA of the fingers occurs when the cartilage in the joints of the finger breakdown and wear away, typically related to the age.
Yap, age is the common risk factor for OA. Though this joint disease can affect people of all ages, but it is rare to be found in children or young adults. Most likely, it affects older adults – specifically those aged 45 or over.
However, the problem may also occur due to an injury that affects the cartilage in the joint. Some people are also born with bone or cartilage deformities. All of these things can trigger the cartilage to wear away more quickly.
In the hand, this degenerative joint problem can affect wrist. But it most often develops in the following 3 major sites:
- DIP (distal interphalangeal ) joint, it is the closet joint to the finger tip.
- PIP (proximal interphalangeal) joint, it is the middle joint – the second closet joint to your finger tip.
- And basilar joint, it is a joint that link your thumb and wrist – located at the base of your thumb.
See the following picture (credit to ASSH)!
At early stage, the degenerated cartilage may not cause any symptoms. The reason is because the problem usually develops gradually over time, unless if there is a trigger such as physical trauma /injury that causes a sudden damage to the cartilage.
But in general – pain and stiffness in the affected joint is the common signs of all types of arthritis, including for OA in the fingers. As the disease gets worse, it may also cause swelling.
At first, there is usually only one joint in the finger that is affected by the disease. But multiple joints of the finger may also become affected.
The affected finger can be painful when you move it, causing limited range of motion. The pain usually strikes when you start an activity with your hands, then it may improve as the activity progresses. At the advanced stage of the disease, pain can be felt at rest.
The stiffness is commonly felt in the morning, but it usually lasts shortly (not more than one hour). The morning stiffness in the affected joint that lasts more than one hour could be a sign of rheumatoid arthritis (RA) – see more in here for the differences between OA and RA!
As the cartilage is no longer to support the joint, this can narrow the space between the ends of bones, creating more friction and strain every time you move the affected joint which then eventually will cause the development of nodes (Heberden’s nodes at DIP and Bouchard’s nodes at PIP – see the picture below, image credit to ASSH)!
Like most things in diagnosing other types of arthritis, physical examination of the symptoms that you have is usually the first step.
Your doctor may also ask you whether the symptoms give a significant impact on your daily routines. Many times, the disease can make the fingers become difficult in performing any activity that involves pinch or grip.
But analyzing the symptoms is not enough. Imaging tests such as x-rays or MRI can help doctor closely evaluate the joint visually.
For instance, x-ray test doesn’t show detailed image of the damaged cartilage. But it can help show the narrowed joint space. Here is in-depth information about how OA is diagnosed in general.
Unfortunately, OA of the fingers doesn’t have a cure. The treatment is currently designed to help improve the symptoms, prevent the disease from worsening, and restore the function of the affected joint as normal as possible.
So, the treatment is depending on the symptoms and the severity of the disease. For mild or moderate cases, the use of non-surgical options is helpful enough. These include:
- Prescribed medicines (anti-inflammatory medicines or pain relievers) such as NSAIDs and acetaminophen.
- Lifestyle approaches such as some diet changes, stress management, and both strengthening & range-of-motion exercise.
- Temporary withdrawal from any activities that can worsen the problem. Avoid task /activity that predisposes to repetitive finger motions! If necessary, your doctor may recommend the use of wrist or finger splints when the problem has flared-up.
- Taking glucosamine and chondroitin supplements. Though the result of studies for these active ingredients in helping to treat arthritis is still debatable, but some doctors prescribe them for coping with early symptoms of OA.
- Dipping the affected finger in hot wax dips!
- Some topical creams are also available. It can be applied on the affected joint topically. These creams contain active ingredients to help relieve the pain such as menthol, methyl salicylate, and capsaicin.
- The use of cortisone, injected into the affected joint.
While these non-surgical options are not helpful enough, surgery may be the answer – particularly if the problem cause too much pain and significantly interferes with your daily routines.
The goal of surgery is to restore the function of the affected finger as normal as possible, and relieve the symptoms and make them to a tolerable level!
Actually, you are the only one who completely understands your own body. Most people with OA of the fingers usually know the best time of when they need to take surgery.
There are several kinds of surgery to choose from. Since surgery can be costly and potential to cause some side effects, make sure to completely understand the risk and seek the second opinion before taking the surgery!