Osteoarthritis, also called degenerative arthritis, is a condition that is caused by deterioration of the joints and is due to increased wear and tear due to aging, injury, and obesity. It affects the small joints of the fingers and the base of the thumb, and it is common in both men and women. Osteoarthritis can cause the joints to become swollen, stiff and painful over time. If left untreated, it can lead to joint enlargement, which interferes with normal hand function and impacts quality of life.
The two types of osteoarthritis of the hand are primary generalized osteoarthritis and erosive osteoarthritis- both affect the hands in different ways. Osteoarthritis is caused primarily as a result of aging, heredity, joint stress and gender. Osteoarthritis affects women more than men, often occurring shortly after menopause. As the body ages, the cartilage that lines the ends of the bones may begin to weaken and wear away with time. In the joints where the bones meet and rub against one another the loss of cartilage can lead to inflammation and pain. Over time, the cartilage deteriorates, resulting in bone rubbing directly against bone. This results in further pain and difficulty with motion. Symptoms of generalized osteoarthritis include pain, swelling and stiffness of joints in the hand, numbness, loss of flexibility, and bone spurs. This pain is most noticeable during and after activity; however, pain may also be felt during periods of limited activity due to worsening over time. Mucous cysts may also develop at the joints nearest the fingernails, resulting in the thinning of the overlying skin. This may cause a groove to develop in the nail.
Erosive osteoarthritis is a type of osteoarthritis that is inflammatory in nature. Symptoms of erosive osteoarthritis may include pain, swelling and bony erosions in the middle joints of the fingers. The thumb is not usually affected. Deformity in the joints may develop as the arthritis progresses.
There is no reliable treatment that can reverse joint damage as a result of the osteoarthritis. The goal of treatment is to reduce pain and improve function of the affected joints. Treatment options of this condition may include cortisone injections, anti-inflammatory medications, the use of an immobilization device such as a splint or brace, exercise, and modification of daily activities. Surgery may be required to fuse or replace the joints. In the event that mucous cysts are present, surgical excision may be required to prevent rupture and alleviate pain or nail deformity.