finger arthritis

Symptoms

Arthritis of the joints of the finger can cause pain, stiffness, swelling and weakness. Overtime, motion can decrease, and deformities can develop. The cause of finger arthritis is oftentimes unknown, but it is likely due to a combination of genetics and use. With increasing age, arthritis (like grey hairs), can be inevitable. Prior injuries to a joint can increase the likelihood of developing arthritis, as can inflammatory and auto-immune conditions, such as seen in rheumatoid and psoriatic arthritis.

Diagnosis

Arthritis is oftentimes a clinical diagnosis, and can be made by your physician with a history and physical examination. Swelling of the joints, decreased motion, pain with pressure applied to joints, and development of bone spurs can all be seen by a physicians. X-rays are oftentimes helpful to see the location and severity of arthritis.

Non-surgical treatment

  • Anti-inflammatories - pain from arthritis is due to inflammation within the joint. Oral NSAIDs, such as ibuprofen or naproxen can be helpful. Sometimes prescription strength anti-inflammatories or topical anti-inflammatories will be prescribed. Topical gels (e.g. diclofenac) can effectively penetrate into the finger joints and not subject your body to the side effects of oral NSAIDs (pills). Some patients appreciate benefits from anti-inflammatory supplements, such as turmeric.

  • Heat - running the hands under warm water, or using a paraffin bath to warm the hands can help with symptoms. The blood vessels throughout the hand and fingers dilate when heat is applied. Increased blood flow can help decrease pain and inflammation.

  • Splints - splints can be helpful for pain and deformity. Pain can sometimes be decreased by limiting motion or improving alignment.

Surgical treatment

  • Surgery for finger arthritis involves either a joint replacement (metal and/or plastic) or a joint fusion.

  • A fusion, or “arthrodesis”, turns two bones into one. Fusing a joint prevents any further motion, which can significantly decrease, or eliminate, the pain. It is a tradeoff, as that joint will no longer bend. Sometimes a splint is used pre-operatively to help a patient decide if the decreased motion is acceptable.

Distal interphalangeal (DIP) joint arthrodesis. A DIP joint arthrodesis is a common procedure for finger arthritis. The DIP joint is the joint nearest the fingernail. When there is significant pain and deformity in the joint (see x-ray on the left), a fusion can be an excellent option. By placing a screw across the joint (see x-ray on the right), the deformity (or crooked appearance) of the joint can be improved. By preventing motion, pain can significantly decrease. After the procedure, a splint is oftentimes used for ~6 weeks to allow the bones to fuse together.

 

Dr. Schreiber is a board certified orthopedic surgeon specializing in hand, wrist, and elbow conditions. Dr. Schreiber practices at the Raleigh Orthopaedic Clinic in Raleigh, North Carolina.