One of the most common causes of pain and stiffness in the joints of the hand is osteoarthritis. Statistics reveal that around 20% of adults over 60 years develop this disease in Singapore. This type of arthritis, or joint inflammation, causes the cartilage to degenerate resulting in not only pain but also deformity and joint stiffness.
What are the risk factors of osteoarthritis?
Numerous risk factors have been identified. Advancing age is perhaps the most important one. Osteoarthritis is also more prevalent in females with a positive family history of the disease. Fractures or other types of bone and joint injuries can accelerate the process of developing arthritis.
How do I know if I have osteoarthritis?
This joint disease typically affects the distal joints of the finger as well as the joint of the thumb. Patients with osteoarthritis usually complain of pain, stiffness and swelling in the affected joint. These symptoms improve with rest and medication. The pain is usually mild and worsens by the end of the day. Early morning stiffness and swelling is classic of osteoarthritis.
Certain movements of the hand and wrist joints will become uncomfortable to perform such as grasping or pinching an object and opening a jar.
As the disease progresses the joints begin to deform eventually causing a permanent deformity in the fingers. The last resort in this advanced stage of osteoarthritis is surgery.
How is osteoarthritis treated?
The treatment depends on the stage of the disease. When diagnosed at an early stage, conservative treatment will be given preference. This includes using NSAID whenever a painful episode arises and using hand and finger splints to support the affected joints. Some patients will also benefit from physiotherapy.
When the disease has progressed to a moderate stage, an intra-articular steroid injection is recommended along with other agents like chondroitin and glucosamine sulphate.
Surgery for osteoarthritis
Although not the first line of treatment in most cases of osteoarthritis, surgery might become necessary in certain cases. The permanent deformity is one of the indications of surgery.
Joint arthroplasty or arthrodesis is the procedure of choice. Some surgeons may also prefer a mucous cyst excision surgery combined with joint debridement.
Currently, joint arthroplasty is the most common surgical method used to treat advanced cases of osteoarthritis. This procedure improves the mobility of the joint; reconstruction with implants corrects the deformity in the fingers as well.
Joint arthrodesis is the preferred surgery in younger patients. This surgical procedure aims to relieve the pain and stiffness of the hand, but the mobility of the finger is seldom improved. Joint arthrodesis is done on the distal finger joints most frequently.
It’s important to check in with a doctor when symptoms appear. The best treatment modality will be advised after a complete history and physical examination.