Types of Hand Arthritis

Osteoarthritis, rheumatoid arthritis, gout, and more

There are over 100 different forms of arthritis known to date, with the most common being osteoarthritis, rheumatoid arthritis, gout, and lupus. While arthritis can affect any joint in the body, it often occurs in the joints of the hands and fingers.

This article discusses the different types of hand arthritis along with symptoms, causes, and treatment options.

Man trying to open jar with hands affected by arthritis

bloodstone / Getty Images

What Is Hand Arthritis?

Healthy joint spaces with adequate cartilage and synovial fluid (fluid between the joints) enable the joints of the body to move smoothly and without pain.

While many different forms of arthritis exist and vary by disease, most lead to the development of similar symptoms:

  • Joint pain
  • Stiffness
  • Swelling
  • Joint deformities
  • Decreased range of motion

Arthritis affecting the hands and fingers specifically can lead to long-term disability. This is because it impacts a person's ability to eat, get dressed, and perform activities of daily living.

While untreated or severe arthritis of the hands may decrease a person's quality of life, there are treatments and preventative measures available to thankfully slow its progression.

Prevalence of Arthritis

According to the Centers for Disease Control and Prevention (CDC), nearly 59 million Americans (over 20% of the population) are affected by some form of arthritis. Arthritis costs the healthcare system hundreds of billions of dollars each year and is the leading cause of disability amongst Americans.

Types of Arthritis That Can Affect the Hands

The most common forms of arthritis which affect the joints of the hands and fingers are osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, post-traumatic arthritis, and lupus. These can cause damage to the hands as well as other joints.

Each of these has specific symptoms, causes, and treatment options.

Osteoarthritis

Osteoarthritis (OA) is a form of degenerative arthritis often referred to as "wear and tear" arthritis. It is more common in older adults.

According to the Arthritis Foundation, nearly 50% of all women and 25% of all men will develop osteoarthritis of the hands by age 85.

Hand Joints Commonly Affected by OA

OA can affect any joint of the hands and fingers. However, the most commonly affected joints are:

  • The carpometacarpal (CMC) joint or the area where the base of the thumb articulates with the wrist joint
  • The middle joint of the finger, known as the proximal interphalangeal (PIP) joint
  • The small joint closest to the fingertip, known as the distal interphalangeal (DIP) joint

Other than natural wear and tear, there's no definitive cause of OA in the hands. There are, however, several contributing factors that may increase a person's risk of developing the disease. These factors include but are not limited to:

  • Older age
  • Female sex
  • Obesity
  • Genetics

Often the first noticeable signs of OA of the hands are when affected individuals start to ask those around them for help with previously simple tasks, such as opening jars or buttoning shirts.

Typical symptoms of OA of the hands and fingers include:

  • Joint pain and stiffness
  • Joint swelling and warmth
  • A grinding, crunching, or clicking sensation/sound with movement
  • Joint deformities
  • Decreased range of motion
  • Mucoid cysts
  • Bony enlargements of the joints

Bony Enlargements of the Joints

Bony overgrowths of the PIP joints are referred to as Bouchard's nodes. If they occur on the DIP joints, they are known as Heberden's nodes.

In severe cases of thumb joint osteoarthritis, people may develop an extensor thumb deformity in which the thumb is extended to approximately 90 degrees and is unable to move due to complete loss of cartilage. In these cases, the remaining joint in the thumb becomes hyper-mobile to compensate.

Common treatments for hand OA include:

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic inflammatory disease in which an individual's own immune system attacks their joints and organs. RA can lead to permanent joint deformities if the disease is not managed and treated promptly.

The exact cause of RA remains unclear; however, genetics are known to play a large role.

In addition to genetics, some risk factors include:

  • Female sex
  • Being between the ages of 30 and 60
  • Strong maternal family history of inflammatory disease
  • Smoking
  • Obesity
  • Previous viral or bacterial infection

Palindromic Rheumatism

Palindromic rheumatism is a rare condition in which RA symptoms develop suddenly and then resolve just as quickly. In between attacks, symptoms completely disappear. Approximately 50% of people with palindromic rheumatism will progress to develop RA in the future.

Common symptoms of RA in the hands include:

Hand Joints Commonly Affected by RA

The metacarpophalangeal (MCP) joints, known more commonly as the "knuckles" of the hand, and the PIP joints tend to be affected more often in people with rheumatoid arthritis.

The main goal of treating RA is to decrease systemic inflammation throughout the entire body. If inflammation levels are well-managed, hand symptoms should begin to improve as well.

Treatment options include:

If treated early enough, some biologic medications may be able to reverse previous joint damage as well as slow the progression of future damage.

Psoriatic Arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory condition affecting the joints, which can be seen in people with psoriasis. Typically affecting the larger joints like the knees and wrists, PsA can affect the big toe and the hands and finger joints as well.

Like RA, the exact cause of PsA remains unclear. However, genetics appear to play a large role in this disease. Nearly 40% of people with PsA have a family member with either psoriasis or other forms of arthritis.

In addition to joint pain, stiffness, and swelling, there are some characteristic signs of PsA of the hands, including:

  • Pitting of the nails of the hands
  • "Oil drop" discolorations of the nails
  • Dactylitis (swelling of the finger)

Psoriatic Arthritis Mutilans

Arthritis mutilans, a rare form of severe and destructive PsA, occurs when joint spaces are almost completely destroyed and even fuse in some areas. This leads to severely deformed fingers and the loss of functionality. An "opera-glass deformity" occurs when the fingers telescope backwards and bend unnaturally.

Like RA, the goal of PsA treatment is to reduce inflammation throughout the body. This can be achieved through the use of:

  • NSAIDs
  • Corticosteroids
  • DMARDs
  • Biologics

Gout

Gout is a form of inflammatory arthritis in which uric acid crystals accumulate within a joint and cause symptoms.

A buildup of uric acid within the joints can occur due to:

  • Eating foods high in purine (includes alcoholic beverages, red meat, organ meats, some fish and shellfish)
  • Producing too much uric acid
  • Excreting too little uric acid

Uric acid crystal accumulations within the hands and fingers can lead to joints which are:

  • Red
  • Swollen
  • Hot
  • Extremely tender to touch

Gouty tophi (hardened, white accumulations of uric acid crystals) can also present on any of the joints of the fingers, usually in the DIP and PIP joints.

Since gout is a chronic disease characterized by intermittent acute attacks, finding a treatment option that helps lower the body's uric acid levels will help resolve flare-ups and decrease the frequency of attacks.

Treatment options include:

  • Low purine diet
  • NSAIDs
  • Corticosteroids
  • Colcrys (colchicine)
  • Uric acid-lowering medications, including Zyloprim (allopurinol), Uloric (febuxostat), and Krystexxa (pegloticase)

Lupus

Lupus is an autoimmune disorder in which the body's immune system starts attacking its own healthy organs and tissues. Lupus is a multi-system disease affecting various parts of the body including the joints of the hands and fingers.

Similar to most other autoimmune illnesses, the exact cause of lupus is unknown. Genetics play a significant role, along with other risk factors.

Common symptoms of lupus include:

  • Joint pain and swelling
  • Joint stiffness
  • Rashes on the knuckles

Like other inflammatory illnesses, treatment for lupus of the hands includes:

  • Occupational therapy
  • NSAIDs
  • Corticosteroids
  • DMARDs
  • Biologics

Post-Traumatic Arthritis

Any time there is trauma or injury to a joint, arthritis will develop more aggressively in that area. Types of trauma to the hands or fingers may include:

  • Fractures
  • Dislocations
  • Tendon or ligament injuries

This is known as post-traumatic arthritis. Depending on the severity of the injury, arthritis may develop quickly or years later.

Symptoms of post-traumatic arthritis include:

  • Pain and swelling in the injured area
  • Joint deformities, possibly from a poorly healed fracture or a dislocation that wasn't properly treated

If the trauma has just occurred, then immediate medical attention is required. A healthcare provider will be able to properly splint or cast any fractures or treat any dislocated joints.

Arthritis which has formed in areas of previous trauma is treated similarly to OA, including:

  • Occupational Therapy
  • NSAIDs
  • Steroids
  • Cortisone injections
  • Surgical intervention

Summary

Arthritis in the hands and fingers can be caused by osteoarthritis, rheumatoid arthritis, psoriatic arthritis, lupus, gout, or prior traumatic injury. Hand arthritis symptoms can range anywhere from minor discomfort (like stiffness and swelling) to disabling pain and deformities. There are many options available to treat all of these forms of hand arthritis.

A Word From Verywell

Though the various forms of hand arthritis may present with similar symptoms, it's important to be properly diagnosed by a healthcare provider and identify the type of arthritis that's affecting you. Getting to the root cause of your hand pain will help your healthcare provider tailor your treatment plan. This helps ensure long-term damage can be avoided as much as possible and improve your quality of life.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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