Arthritis targets the joints where bones come together, which is why the fingers are so often affected. Fingers and hands have many small joints that need to work together fluidly to allow everything from writing to tying shoes to throwing a punch. If arthritis, which the American Academy of Orthopaedic Surgeons defines as inflammation in one or more of the joints, makes those movements difficult and painful, daily living can become extremely challenging.
Worse still, without treatment, arthritis can cause permanent damage to the finger joints' normal shape, causing more pain and impacting motion even further.
Types of Finger Arthritis
There are actually more than 100 different types of arthritis, but the two most common types are osteoarthritis and rheumatoid arthritis. Osteoarthritis, the far more common type, typically affects older adults. It is the result of years of stress and strain on the structures of the joint and is often called "wear and tear" arthritis. Healthy joints move smoothly because of a slippery tissue called cartilage that covers the ends of the bones where they meet at the joint. The cartilage is lubricated by synovial fluid, which the AAOS says "looks and feels like oil" and is produced by a structure in the joint lining called the synovium. Over time, cartilage breaks down and wears away. Without sufficient cartilage the bones rub together, causing pain and swelling.
Osteoarthritis of the fingers occurs most often in adults over age 40, says Dr. Paula Marchetta, clinical professor of medicine at the New York University School of Medicine and president of the American College of Rheumatology. "It usually involves the distal joint, behind the fingernail, and the middle or proximal joint. Also, the middle thumb joint and the base of the thumb, where it meets the wrist."
Rheumatoid arthritis is a chronic, autoimmune disease that can affect many parts of the body. The AAOS says it causes the joint lining (synovium) to swell, leading to pain and stiffness in the joint. In fact, rheumatoid arthritis most often starts in the small joints of the fingers, hands and feet. It usually affects the same joints on each side of the body. There are other inflammatory forms of arthritis, including psoriatic arthritis and lupus.
Doctors distinguish one type of arthritis from another by various methods, including the pattern of distribution and symptoms. "Knuckles are rarely impacted by osteoarthritis, but are very common in inflammatory arthritis," Marchetta says. "Swelling is more common with inflammatory arthritis. With osteoarthritis, finger joints often develop nodules that come up around the joint in the middle and end of the finger. They start out tender and get harder over time, and can make it hard to make a fist and close the fingers."
Causes of Finger Arthritis
"You usually can't blame any one thing for your arthritis. The exception might be joint injury," says Cindy McDaniel, senior vice president of consumer health and impact at the Arthritis Foundation. Tissue tears and other trauma that destabilizes the joint can be a direct cause of osteoarthritis. Some common risk factors across most types of arthritis include:
-- Being female. According to the Centers for Disease Control and Prevention, from 2013 to 2015 in the U.S., 26 percent women and 19.1 percent men ever reported doctor-diagnosed arthritis.
-- Being older and/or overweight.
-- Having a family history of arthritis.
"Weight seems to be important across all types of arthritis, relating to both onset and progression," she says, with the risk for finger and hand osteoarthritis even increasing with obesity. "That's been an intriguing finding of the last few years. It means there's something systemic, not just mechanical damaging those joints," she says.
Early Signs of Arthritis in the Fingers
People who are starting to experience occasional hand pain, stiffness and weakness may have early osteoarthritis. "They may start seeing nodes, or bumps, emerge on the joints by the fingernails or in the middle of the fingers," McDaniel says. "Pain and weakness at the base of the thumb is common too."
Knuckles that are warm, red and swollen may indicate rheumatoid arthritis, McDaniel says. Fingers that are swollen full-length may be a sign of psoriatic arthritis. "Both types of arthritis, if not treated promptly, can cause permanent joint damage," she says. "It's typical for those hand symptoms to come and go, but don't put off seeing a doctor."
Treatment for Finger Arthritis
Currently there are no drugs that stop the progression of osteoarthritis, Marchetta says. Likewise, no treatment can slow or reverse the growth of nodules from osteoarthritis. To treat the aches, pain and swelling, try an analgesic drug like Tylenol or a low-dose nonsteroidal anti-inflammatory drug like ibuprofen. You can also try applying heat or cold, though there isn't much data to support either treatment, she says. "If it feels better, then try it. It's whatever helps the patient."
However, Marchetta says inflammatory arthritis is a whole different story. Major new therapies developed over the past 20 years can stop progression and lead to complete remission, she explains. Commonly prescribed brand-name drugs include Plaquenil, Orencia, Humira and Xeljanz. "These drugs entirely changed these diseases and how we manage them. It is really a very exciting time to be in the field and effectively treat inflammatory arthritis. We are waiting for a similar breakthrough in osteoarthritis."
Beyond medication, patients can take steps at self-care. Try to avoid putting stress on the joints of the fingers and hands. "That means doing things differently, like carrying objects with your arms and holding them close to your body, rather than with your fingertips," McDaniel says. "Assistive devices, like jar openers, come in handy, too."
Working with a physical therapist or occupational therapist can help maintain function and strength in the fingers and hand, Marchetta. So can "judicious" use of splinting. "Working with hand therapists for splinting does help reduce daytime pain and symptoms," she says.
And, Marchetta adds, "a healthy lifestyle is a healthy lifestyle. Doing every other thing that supports and improves your health in any way makes treating any illness easier."