Treatments for Osteoarthritis in Hands

While there is no cure for osteoarthritis of the hand, patients and doctors can devise a treatment plan to relieve hand pain and restore function. Treatment plans usually involve a combination of therapies. It may require a little trial and error to figure out which therapies work best for an individual.

Read on to find out what treatments are available for hand arthritis, ranging from tips for relieving hand pain at home to hand surgery.

Treating Hand Arthritis at Home

Arthritis limits hand dexterity and makes everyday tasks more difficult. Described below are several ways people can help relieve stress on their hand joints and make some tasks easier.

Rest the hands periodically
Give the joints and tendons in the hand a needed break. For example, people who type at a computer may need to take regular breaks or divide their work into regular intervals, working for just 2 or 3 hours at a time.

Apply heat
A warm compress or paraffin wax hand bath can soothe affected joints. Applying heat to the hand warms up the synovial fluid that lubricates joints, easing stiffness, and improving flexibility.

See When and Why to Apply Heat to an Arthritic Joint

Adapt when possible

A few simple lifestyle changes and products can reduce strain on the hands and minimize arthritis pain and swelling. For example:

• Wear coats and shirts with zippers instead of buttons.
• Use long zipper pulls, which are also larger than regular zipper pulls and therefore easier to grasp. Some specialized zipper pulls are made with looped cloth or nylon and allow the user to stick a finger through and pull up or down.
• Choose lightweight cooking and gardening tools that are easier to lift and hold.
• Buy slip-on shoes to avoid having to tie shoelaces.

In addition to making changes at home, people with arthritis may consider treatments recommended by their physician.

Integrative Medicine Treatments for Hand Arthritis

Many doctors today recommend a treatment plan that uses integrative medicine—a combination of conventional Western medicine and alternative medicine. Both Western and alternative treatments are supported by research.

Occupational therapy
For many patients, hand exercises can be the most cost-effective treatment option.¹Oppong R, Jowett S, Nicholls E, Whitehurst DG, Hill S, Hammond A, Hay EM, Dziedzic K. Joint protection and hand exercises for hand osteoarthritis: an economic evaluation comparing methods for the analysis of factorial trials. Rheumatology (Oxford). 2015 May;54(5):876-83. doi: 10.1093/rheumatology/keu389. Epub 2014 Oct 21. PubMed PMID: 25339642; PubMed Central PMCID: PMC4416082. A licensed occupational therapist can teach a person exercises that help strengthen the joints in the wrists and fingers, improve hand dexterity, and protect joints from further degeneration.

Splinting
Stabilize and support the hand joints with splints. There are several different types of braces, including smaller braces that stabilize individual knuckles and larger ones that stabilize the wrist and hand. Bracing at night can prevent pain from interrupting sleep (commonly seen in carpal tunnel syndrome).

People who find braces too cumbersome or rigid to wear all the time may wear compression gloves or sleeves instead. The goal of these products is to support joints while allowing for some flexibility.

Medications
Both topical and oral pain medications can temporarily ease pain caused by hand arthritis.

• Topical pain relievers come in the form of creams, balms, gels, or patches, and are sold over-the-counter. Certain topical products require a physician’s prescription.

  See Topical Pain Relief for Arthritis

• Oral pain medications most frequently recommended to treat hand arthritis include acetaminophen and/or non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen.

  See Pain Medications for Arthritis Pain Relief

While topical medications can be absorbed into the bloodstream, they are less likely than oral medications, such as NSAIDs, to have gastrointestinal side effects. To avoid potential side-effects and interactions between any medications, patients should always tell their health care provider about any other drugs and supplements they take.,/

Transcutaneous Electrical Nerve Stimulation (TENS)
Research suggests Transcutaneous Electrical Nerve Stimulation (TENS) may be useful in treating knee osteoarthritis²Osiri M, Welch V, Brosseau L, et al. Transcutaneous electrical nerve stimulation for knee osteoarthritis. Cochrane Database Syst Rev. 2000;(4):CD002823. doi:10.1002/14651858.CD002823 and rheumatoid arthritis in the hand.³Brosseau L, Judd MG, Marchand S, et al. Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database Syst Rev. 2003;(3):CD004377. doi:10.1002/14651858.CD004377 Occasionally, TENS may be recommended to decrease hand pain caused by osteoarthritis.

This non-invasive therapy is available over the counter or by prescription. It uses small amounts of electricity to distract nerves and reduce pain. Most people feel a gentle vibration or tingling during TENS treatment. TENS may be used by wearing special gloves or applying electrodes to the affected hand(s).

Read more about Transcutaneous Electrical Nerve Stimulators (TENS) on Spine-health.com

Lose excess weight
Obesity is linked to low-grade, systemic (body-wide) inflammation, which may contribute to the development of osteoarthritis.⁴King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013;138(2):185‐193.^,5Sartori-Cintra AR, Aikawa P, Cintra DE. Obesity versus osteoarthritis: beyond the mechanical overload. Einstein (Sao Paulo). 2014;12(3):374–379. doi:10.1590/S1679-45082014RB2912.^,6Rosen, CJ, "Pathogenic mechanisms of obesity-induced osteoarthritis: new clues from old joints." Osteoarthritis and Cartilage (2019), phone interview, June 10, 2019. doi:10.1016/j.joca.2019.02.007; While not all physicians agree, losing excess weight may lower inflammation and decrease arthritis hand pain and swelling.

Anti-inflammatory diet
Even if a person does not have excess weight to lose, an anti-inflammatory diet may help reduce inflammation in the body that can contribute to arthritis and joint pain.⁷Basu A , Schell J , Scofield RH . Dietary fruits and arthritis. Food Funct. 2018;9(1):70‐77. doi:10.1039/c7fo01435j^,8Szarc vel Szic K, Declerck K, Vidaković M, Vanden Berghe W. From inflammaging to healthy aging by dietary lifestyle choices: is epigenetics the key to personalized nutrition?. Clin Epigenetics. 2015;7(1):33. Published 2015 Mar 25. doi:10.1186/s13148-015-0068-2^,9Dai Z, Niu J, Zhang Y, Jacques P, Felson DT. Dietary intake of fibre and risk of knee osteoarthritis in two US prospective cohorts [published correction appears in Ann Rheum Dis. 2017 Dec;76(12 ):2103]. Ann Rheum Dis. 2017;76(8):1411‐1419. doi:10.1136/annrheumdis-2016-210810 An anti-inflammatory diet emphasizes:

• Eating fruits and vegetables as well as whole grains, such as wheat, rice, barley, and quinoa
• Avoiding foods that contribute to inflammation, including but not limited to foods that are processed, fried, or contain refined sugar (sugar, corn syrup, fructose, sucrose, and maltose)

Food reactions can vary for each individual. For example, while whole wheat is normally part of a healthy diet, some people may discover the protein found in wheat, gluten, causes them excess inflammation.

See An Anti-Inflammatory Diet for Arthritis

Supplements
Some of the most common and well-researched supplements for treating arthritis are turmeric (curcumin), ginger, omega-3 fatty acids, glucosamine, and chondroitin sulfate. Most research studies have shown mixed results, suggesting supplements may provide some people with limited pain relief.¹⁰Liu X, Machado GC, Eyles JP, Ravi V, Hunter DJ. Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. Br J Sports Med. 2018;52(3):167‐175. doi:10.1136/bjsports-2016-097333

See Dietary Supplements for Treating Arthritis

Additional alternative medicine treatments
While less common, acupuncture and chiropractic manipulation may be tried to ease arthritis pain and stiffness in the hands as well as other joints. These treatments are not well-researched for hand arthritis but may work for some people.¹¹Kyongha Cho, Yoonsik Kim, Sang-Hoon Yoon. The effect of miniscalpel acupuncture and splint treatment for joint deformity of hand osteoarthritis: a case report. Integr Med Res. 2019;8(2):120‐122. doi:10.1016/j.imr.2019.04.004^,12Hulbert JR, Osterbauer P, Davis PT, Printon R, Goessl C. Strom N. Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 2: cohort natural-history treatment trial. J Chiropr Med 2007; 6(1):32-41.

See Alternative Treatments

Therapeutic Injections for Arthritic Hand Joints

If other types of nonsurgical, integrative medicine treatments for hand arthritis fail, therapeutic injections may be recommended.

• Steroid injections can provide temporary pain relief for some people. However, these injections are not recommended for repetitive, long-term use, because they can weaken tendons and ligaments.

  See Cortisone Injections (Steroid Injections)

• Viscosupplementation is a treatment that attempts to reduce pain in the affected joint by injecting a viscous, lubricating substance called hyaluronic acid. Viscosupplementation is not a common treatment for hand osteoarthritis, but it is occasionally used, particularly if arthritis affects the base of the thumb.

  See What Is Hyaluronic Acid?

• Platelet-rich plasma (PRP) injections are a type of regenerative medicine treatment. The hope is to reduce hand pain, improve joint function, and possibly repair damaged tissue.¹³Steiner MM, Calandruccio JH. Biologic Approaches to Problems of the Hand and Wrist. Orthop Clin North Am. 2017;48(3):343-349. doi:10.1016/j.ocl.2017.03.010^,14Malahias MA, Roumeliotis L, Nikolaou VS, Chronopoulos E, Sourlas I, Babis GC. Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial [published online ahead of print, 2018 Oct 20]. Cartilage. 2018;1947603518805230. doi:10.1177/1947603518805230^,15Evans A, Ibrahim M, Pope R, et al. Treating hand and foot osteoarthritis using a patient's own blood: A systematic review and meta-analysis of platelet-rich plasma. J Orthop. 2020;18:226-236. Published 2020 Jan 28. doi:10.1016/j.jor.2020.01.037 While the use of PRP injections to treat hand and wrist joints is becoming more common, more research is needed.

  See Platelet-Rich Plasma (PRP) Therapy for Arthritis

To ensure the steroid or hyaluronic acid is injected into the correct area, a physician may use ultrasound to help guide the needle placement.

Hand Surgery

Most people never need surgery to treat their hand osteoarthritis. Surgery may be recommended to people who have severe hand pain or have lost significant function due to osteoarthritis and have not had satisfactory results from other treatments.

Two common surgeries for osteoarthritis in the hand are joint fusion and joint replacement:

• Joint fusion fuses two bones together. The goal of this surgery is to eliminate the source of the pain, but the joint will no longer move.
• Finger and wrist joint replacement involves surgically removing the damaged cartilage and bony surfaces of the joint and replacing them with artificial surfaces. These prostheses are typically made of metal and plastic.

Surgery is not a cure for hand arthritis—even when surgery is successful, some symptoms may remain. It is also possible that different symptoms may appear and/or arthritis may develop in other hand joints. A hand surgeon can describe the potential risks and benefits of surgery and help decide if it is appropriate.

There is no known cure for hand arthritis, but treatments can help manage symptoms and may slow down or prevent further degeneration.