Spotting... Osteoarthritis In The Fingers
Recognise It, Get A Diagnosis, Get It Treated...Get The Best Results
The Short Answer – We have seen how osteoarthritis starts and presents with different symptoms according to the area it affects.
In this article we look at osteoarthritis in the fingers, analyse the differences in your fingers and what this means for recognising the potential causes and beginning signs of osteoarthritis.
Understanding Why Osteoarthritis Has Different Causes In Different Areas Of Your Body…
We’ve outlined in other articles, the change in medical understanding around how osteoarthritis is first caused.
Originally, we thought all osteoarthritis was caused entirely by a wearing down of the cartilage (the cushioning) between your joints. This eventually meant bone on bone rubbing and the crippling pain when it becomes advanced.
However, new understanding has taught us it is actually a disease that affects the entire matrix of the joint (all surrounding muscles, tissues, ligaments as well as the parts that make up the joint).
With this in mind, we know that the anatomy of the hip is different to that of the fingers and therefore different causes have different levels of effect on the development of your osteoarthritis.
For example, when it comes to the ball/ socket shape of your hip, deformity or potential displacement caused by childbirth can have a disproportionately large effect on the chances of you developing osteoarthritis in the hip.
In the spine however, your age is one of the most important factors, causing loss of bone strength that leads to osteoarthritis, while your gender is also important because women are more likely to suffer curvature of the spine (due to their shape) that again leads to the disease.
For ankles/ knees, body weight and a history on injuries are more relevant to the likely development of osteoarthritis.
What Is Unique About Osteoarthritis In The Fingers?
According to the Arthritis Foundation, approximately 50% of all women and 25% of all men will suffer with osteoarthritis in their hands by the time they reach 85.
Your fingers themselves are particularly vulnerable to developing osteoarthritis because they have a lot of very small joints – 28 in total. That’s 3 joints in each finger and 2 in each thumb (14 joints per hand).
The structure of your fingers is also such that they don’t have the extra muscular support that your hips or spine might have for example. They are also used probably more than any other joint – from typing to driving to shaking hands, your fingers are always working and their joints are always moving.
However, to their advantage they are at least not weight-carrying joints, so your body weight will not be a factor in the development of osteoarthritis.
Another slightly unique factor about your fingers is that you can get parallel osteoarthritis. This is unusual because it is normally only rheumatoid arthritis that has similar symptoms in parallel joints such as your right and left hip.
A key distinguishing point with osteoarthritis is that it doesn’t normally have this parallel effect.
However, in the case of your fingers, it is quite possible to get osteoarthritis of the same stage in multiple fingers. (Cushnaghan and Dieppe, Annals of the Rheumatic Diseases)
Although osteoarthritis in the fingers can affect all your joints, it is most likely to affect the following –
- The joint closest to the fingertip (aka the distal interphalangeal joint)
- The middle joint of your fingers (aka the proximal interphalangeal joint)
- The joint between the base of your thumb and your wrist (aka The carpometacarpal joint)
Osteoarthritis In The Fingers – Causes
Injuries. Fractures and dislocations are the most common finger injuries that lead to finger osteoarthritis. Unfortunately, even with proper treatment, the injuries will still leave a much higher chance of developing osteoarthritis in later life.
Playing games such as Rugby or Cricket can leave you particularly vulnerable to finger injuries.
Joint Problems. Infections or deformed digits can also greatly increase the chances of you developing osteoarthritis in the fingers.
Age. While hand osteoarthritis is not all about wear and tear, a large element is still reliant on it.
As such then, the older you get, the more wear and tear your fingers will suffer.
Sex. Women are more likely to get most forms of osteoarthritis in their lifetime, although prevalence evens up in old age, where men are just as likely to develop it. The reason is thought to be partly hormonal, but not definitive reason has been established.
Genes. Osteoarthritis has a strong connection to your parents/ grandparents. Partly, this could be put down to similar environments, but there is also a clear connection to your genes that leaves some people more likely to develop osteoarthritis in the fingers.
Occupation. Heavy lifting in your job will eventually damage your tendons, potentially leading to ‘trigger finger’ (locked fingers) and eventually osteoarthritis if not treated.
Similarly office roles that are heavily dependent on typing can lead to osteoarthritis in the fingers in later life, if not cared for properly.
Osteoarthritis In The Fingers – Early Signs
Spotting the signs of osteoarthritis early is critical to halting it’s quick progression and the permanent damage that is irreversible once established. We list the basic signs to look out for if you start experiencing discomfort with your fingers…
- A dull ache in your fingers is a key sign of the early stages. The pain will typically come and go.
- Pain that gets worse throughout the day, the more you use your fingers.
- Sharper Pain. If you ignore the first signs, the pain will become sharper and may wake you up at night.
- Stiffness in the mornings that loosens up in under 30 minutes
- Reduced Mobility. If you ignore the stiffness, you are likely to lose some motions in your fingers altogether eventually.
- Bony lumps on the middle and end of your fingers. On the idle joint they are known as ‘Bouchard’s nodes’ while at the joint nearest your fingertip they are known as ‘Heberden’s nodes’.
- Misshapen Digits. If ignored your fingers will start to become misshaped as loss of cartilage and unstable ligaments take their toll.
- ‘Knobby Thumb’. The base of your thumb starts looking square or knobby, because bony growths have formed (osteophytes).
- Swelling in your fingers caused by inflammation and damage to surrounding tissues.
- A grinding or clicking sensation when you try to use your fingers. Also known as ‘crepitus’.
- Weakness in your fingers. The combination of several of the factors above will ultimately culminate in an overall weakness and instability in your fingers.
Diagnosis of Finger Osteoarthritis
This is relatively simple in comparison to diagnosis in some other areas, but is complicated by the fact that there is no universal criteria and where several sets of criteria exist, none have been scientifically tested. (Kloppenburg et al, Annals of the Rheumatic Diseases)
Any diagnosis should however comprise 3 basic steps…
- A basic discussion around your lifestyle and family history will reveal how prone you are to developing osteoarthritis. They will also focus on any injuries you may have suffered in the past.
- A medical will examine your fingers, assessing pain levels, stiffness, bony nodule formation (if any), range of motion and whether there is any connection when moving (crunching or locking).
- Finally an x-ray will show any loss of space in your joints, any bone growths not obvious on physical inspection and any other damage from osteoarthritis.
It is very unlikely that an MRI or CT scan will ever be required (unlike with some other areas of osteoarthritis) and similarly blood tests that rule out rheumatoid arthritis/ infections are less likely to be required.
The Final Word –
Your fingers are particularly vulnerable to the wear and tear element of osteoarthritis. This can be managed with clever treatment, but needs to be uncovered early.
Without the supporting muscles and padding that some other joints benefit from, your fingers are also particularly vulnerable to injury – another key cause of osteoarthritis.
Hopefully you can now recognise the early signs of osteoarthritis in the fingers and take the right steps in seeign a doctor to get it diagnosed. Check out our other articles, particularly our one on treatment for osteoarthritis in the fingers for more pain relieving help…
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References Used –
2. J Cushnaghan and P Dieppe. (Jan 1991). Study of 500 patients with limb joint osteoarthritis. Analysis by age, sex, and distribution of symptomatic joint sites. Annals of the Rheumatic Diseases.
3. Margreet Kloppenburg, Tanja Stamm, Iain Watt, Franz Kainberger, Tim E Cawston, Fraser N Birrell, Ingemar F Petersson, Tore Saxne, Tore K Kvien, Barbara Slatkowsky‐Christensen, Maxime Dougados, Laure Gossec, Ferdinand C Breedveld, and Josef S Smolen. (Sept 2007). Research in hand osteoarthritis: time for reappraisal and demand for new strategies. An opinion paper. Annals of the Rheumatic Diseases.
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