Rheumatoid arthritis is a condition that attacks the joints of the body, commonly affecting the joints of the fingers and the surrounding tendons of the wrist and fingers. It can result in swollen, painful and possibly deformed joints. It can also interfere with normal hand function and impact a person’s quality of life. The causes of rheumatoid arthritis are not fully understood. It is believed to be caused by inherited genetic factors, however environmental factors may also play a role in the development of the condition. The condition results in the immune system attacking the joints, causing the synovial membranes surrounding the joints to become inflamed and swollen. This can lead to cartilage damage and bone loss around the surrounding joint. Symptoms of rheumatoid arthritis in the hand can include stiffness in the hands that is often worse in the morning, pain and swelling in the joints at the base and middle of the fingers, the hand and wrist. The joints may become unstable and deformed and the knuckles may become inflamed and the fingers may eventually lose their normal alignment. The tendons of the wrist may also become inflamed, and in severe cases rupture. Early inflammation may result in soft lumps on the back of the hand and wrist. Other hand problems such as carpal tunnel syndrome may develop as a result of rheumatoid arthritis. Treatment for rheumatoid arthritis includes include anti-inflammatory medications, disease-modifying antirheumatic drugs, and biological response modifiers. The use of immobilization devices such as splints or braces, exercise and modification of daily activities may also be prescribed. Surgery may be required when joint synovitis is unable to be controlled by medication, or if the tendons of the hand and wrist become weakened or inflamed as a result of disease. Surgery may also be recommended if deformities are present in the fingers to improve appearance of the hand and to restore function.