Osteoarthritis of the hand causes bones over the outermost joints of the fingers (Heberden nodes) and the middle joints of the fingers (Bouchard nodes) to become larger. These joints and the base of the thumb become stiff and sometimes painful. The wrists and the joints between the fingers and hand are usually not affected. The involved joints can become misaligned.
(See also Overview of Hand Disorders.)
Doctors usually can base the diagnosis of osteoarthritis of the hand on an examination. The deformity can also be seen on x-rays.
To rule out rheumatoid arthritis and other types of arthritis, doctors do blood tests to look for indications of inflammation. These tests are almost always negative in people who have osteoarthritis.
Treatment of osteoarthritis of the hand may include range-of-motion exercises in warm water (to relieve pain during the exercises and to keep the joints as flexible as possible), rest, splinting intermittently to prevent deformity, and use of analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and swelling.
Occasionally, a corticosteroid may need to be injected into severely affected joints to relieve pain and increase range of motion.
Sometimes, when osteoarthritis is advanced and other treatments are not effective, the joint may need to be reconstructed or fused surgically. The hand joint that most often requires surgery for osteoarthritis is the one at the base of the thumb.