Osteoarthritis (OA) of the hand

Osteoarthritis is characterised by degeneration/ thinning of the articular cartilage and subchondral bone which subsequently leads to narrowing of the joint space. This can cause increased friction within the joint as well as tightening of the surrounding muscles. For a more in depth explanation of arthritis is then please follow the link here.

The most common site of arthritis in the hand is at the base of the thumb (see diagram above). This occurs at a joint known as the carpometacarpal joint (CMCJ). This joint is a saddle joint which means that the surfaces are convex in one direction and concave in the other to allow the thumb to be very flexible and mobile.

Symptoms of small joint osteoarthritis

Joint stiffness (particularly if you haven’t moved the joint for a while)
Joint pain with certain activities
Weakness in grip strength
Limited range of movement of a joint
Joint swelling
Slightly thickened or enlarged appearance to the joint
A grating sensation of a joint known as crepitus

Why do we get small joint osteoarthritis?

There are some risk factors than can predispose you to developing osteoarthritis your shoulder, these are:

Advancing age - although this is not a normal part of aging, the risk of osteoarthritis increases with age – we all get grey hairs and wrinkles and the same changes occur internally.
Previous trauma to the shoulder is linked to subsequently developing arthritis. This might include fracture or dislocation.
An occupation that requires heavy manual work is thought to be associated.
Genetics - osteoarthritis can run in families.
Obesity – a high body mass index (BMI) is associated with osteoarthritis in the shoulder.
Smoking is also linked to poor joint health.
Gender – women are more likely to develop osteoarthritis

It’s important if you have any coexisting health problems or lifestyle factors that these are well managed. Why not visit our lifestyle and MSK health page for help managing these risk factors?

So… what can I do about my pain right now?

The current arthritis guidelines recommend the use of paracetamol and/or non-steroidal anti-inflammatories (NSAIDs) for the management of arthritic pain. Both types of medication are available over the counter at your local pharmacy. We would always advise discussing your suitability for the medication with the Pharmacist before starting a course of treatment.

Often people may report difficulties with specific tasks or activities that involve gripping. It may be helpful to modify or adapt how you complete these activities to make it more comfortable. Simply pacing or completing tasks to a tolerance level only can be helpful rather than pushing into pain. Where possible it may be helpful to purchase equipment or kitchen aids to help with difficult tasks.

Exercises for finger and thumb osteoarthritis

What next?

If symptoms do not settle or become unmanageable then a night resting splint may be appropriate. This can help to give the joint some relative rest and help symptoms settle. The most effective splint is thermoplastic and requires molding to the individual. Your physiotherapist could supply and fit one if required.

Optimising conservative measures is key in the management of thumb osteoarthritis. Should symptoms fail to settle, an anti-inflammatory corticosteroid injection maybe helpful to ease symptom. The MSK team may be able to perform the injection for you.

If you would like further physiotherapy advice then please speak to your GP about an MSK referral or alternatively refer yourself here. Our Physiotherapy team will be able to offer alternate strategies in order to enhance your rehabilitation and ease your symptoms.