How Hand Osteoarthritis Is Treated

Osteoarthritis (OA) of the hand can be painful and debilitating, making everyday tasks difficult and causing fingers to become swollen and crooked. The recommended treatments for hand osteoarthritis, as laid out by the American College of Rheumatology (ACR) and the Arthritis Foundation (AF), include multiple strategies. These range from home remedies such as using ice or heat to relieve inflammation and pain and over-the-counter (OTC) analgesics to steroid injections and acupuncture.

Home Remedies and Lifestyle

The ACR/AF recommendations for treating osteoarthritis for the hands include a number of effective options that do not require a prescription or procedure.

• Exercise: Strengthening the muscles that support joints affected by OA can help maintain the function of the hands and fingers and help prevent ongoing damage to the cartilage.
• Self-efficacy and self-management programs. These typically are group classes for learning about hand arthritis and the ways to deal with pain and limitations it causes.
• Hot or cold therapy, including ice packs to relieve swelling due to inflammation and the application of heat to ease pain. The ACR/AF guidelines specifically recommend paraffin wax as a source of heat for treating hand OA.
• Cognitive behavioral therapy (CBT): In studies, CBT has been found to help people with osteoarthritis to deal with fatigue, disability, low mood, and pain, and to improve overall quality of life.
• Kinesiotaping: Kinesiotape is a stretchy adhesive that can be applied much like a brace to support inflamed or injured joints. Because it's stretchy, the tape allows the joint to move. The ACR/AF guidelines recommend kinesiotaping specifically for the first carpometacarpal (CMC) joint of the hand, which is at the base of the thumb.
• Orthoses: These braces can stabilize and protect the joints, and are especially useful for the CMC joint.

Over-the-Counter Therapies

Pain and swelling are hallmarks of all types of osteoarthritis. Among the first-line treatments for these symptoms of OA are products that don't require a doctor's prescription and can be purchased at pharmacies, supermarkets, big box stores, and other venues.

• Oral non-steroidal anti-inflammatory drugs (NSAIDs): The most common of these are ibuprofen (Advil and other brands) and naproxen (Aleve).
• Topical NSAIDs: Creams, ointments, gels, and medicated patches can provide symptom relief directly to the affected joints, such as Voltaren Gel (diclofenac, 1%). Note that the ACR/AF conditionally recommends against using topical capsaicin (the ingredient in chili peppers that makes them hot) to treat hand OA.
• Acetaminophen: The active ingredient in Tylenol, this pain reliever works by reducing pain signals in the brain.

Prescriptions

When self-treatment and OTC medications don't work well enough, it may take stronger medication to relieve hand osteoarthritis symptoms. In addition to prescription-strength NSAIDs or acetaminophen, these may include:

• Tramadol, an opioid that's sold as ConZip or Qdolo
• Cymbalta (duloxetine), a type of antidepressant known as a selective serotonin and norepinephrine reuptake inhibitor (SNRI) that has been found to help relieve joint and muscle pain

Surgeries and Specialist-Driven Procedures

These treatments typically are not considered unless the damage caused to the joints in the hands by OA is severe and less aggressive measures haven't worked.

• Intra-articular corticosteroid injection involves injecting a steroid medication, which works by relieving inflammation, between the bones of the affected joint. They sometimes are referred to as cortisone shots.
• Surgery used to treat hand arthritis may be either arthroplasty (removing a damaged joint and replacing it with an artificial one) or arthrodesis (fusing the bones of an affected joint together). Neither is ideal: Finger joint replacement doesn't always result in improved mobility and arthrodesis decreases flexibility and movement.

Complementary and Alternative Medicine (CAM)

Included in the ACR/AF recommendations for treating hand osteoarthritis are a couple of CAM options.

• Choindroitin is a substance that occurs naturally in cartilage. A manufactured form of chondroitin, chondroitin sulfate, made from animal cartilage, has been touted as useful for treating arthritis. Although not recommended for hip or knee arthritis, it is conditionally recommended for hand OA.
• Acupuncture is an ancient Chinese medicine technique in which slender needles are inserted into specific sites on the body to relieve pain.

A Word From Verywell

Losing ability and flexibility in your hands due to osteoarthritis is nothing short of frustrating. It can mean you aren't able to do simple and necessary tasks such as opening jars or squeezing lemons; it also can make it difficult to do things you enjoy, like playing the piano or knitting. Therefore, it's vital to see a doctor, preferably a rheumatologist who specializes in arthritis, as soon as you notice stiffness, pain, swelling, and other symptoms of OA in your fingers or hands.

It's also important that you turn to treatments that have been found effective and safe. You should be aware that the ACR/AF recommend against a number of strategies for managing hand OA, among them bisphosphonates, glucosamine, hydroxychloroquine, methotrexate, and hyaluronic acid injections.

There are other treatments experts don't know enough about to advise for or against. An informed and frank discussion with your doctor about the pros and cons of the available treatments for OA and which are most likely to be effective for your symptoms is the best way to retain and maintain the ability to use your fingers and hands.