It’s not often that someone books in with me for hand pain alone, it tends to be something they mention later. The two main forms of arthritis that affect the hands are osteoarthritis (OA) and rheumatoid arthritis (RA).
Osteoarthritis in the hands is no different to an arthritic hip or knee from a treatment perspective. No joints are out of your osteopath’s remit. The joints of the hand I see most affected by OA are in the thumb. The pain is often described as deep and achey, or sometimes grinding or catching.
Arthritic thumbs may be predisposed by injury, or just wear and tear. Either way, the process is the same.
- Cartilage is irritated
- Movement is reduced
- The cartilage is not receiving the necessary movement to push out waste and push in nutrients
- Cartilage degrades further and cycle continues
Although overuse can be a cause of arthritic hands, the treatment plan is to get the joints moving. Joints in the hand are quite easy to get moving when you know how to, and often the exercises I prescribe are based on the techniques I use during treatment. Alongside specific exercises, there are other activities that can help, such as:
- Knitting or crochet
- Playing an instrument
- Using therapeutic putty
Rheumatoid Arthritis (RA)
RA is a very different condition to OA. RA is an inflammatory disease where the body attacks itself (autoimmune). Joint swelling, pain, and loss of movement are some early signs. A general feeling of being under the weather is a common early symptom. Some joints are more affected than others, typically:
- Joints of the hands and feet
- Wrists and ankles
- TMJ (jaw)
In contrast to OA, where the cartilage is mechanically irritated, in RA the damage is done by inflammatory cells. These cells erode the joint surfaces, and in response to this, the body lays down excess cartilage and bone. This can cause deformities to the wrist and fingers.
Diagnosis should be confirmed with a blood test and potentially an X-ray or MRI. There are a range of medications available to help manage RA. Exercise and movement are important parts of an effective treatment plan to keep joints as mobile as possible.