Treatments for Rheumatoid Arthritis in Hands

Many home care strategies, medical treatments, and surgeries help relieve rheumatoid arthritis symptoms in the hands. Through trial and error, an individual may find one treatment or a combination of treatments that works best for them.

Treatments specifically for the hand joints may be used in addition to treatments aimed at the whole body, such as medications and dietary or other lifestyle changes. A complete treatment plan can be designed with the help of a rheumatologist, orthopedist who specializes in the hand, or another physician familiar with rheumatoid arthritis in the hand.

Home Care Strategies for RA in the Hands

These home care strategies and shortcuts may reduce hand strain and make everyday tasks less difficult and painful. Reducing hand strain today can also ward off future pain and prevent deformities from developing.

Rest the hands periodically

It helps to give the joints, tendons, and ligaments in the hand periodic breaks. For example, musicians or people who type at a computer may need to take regular breaks or work in short segments of time.

Apply a cold or warm compress

A cold compress can ease inflammatory symptoms, such as swelling. Applying a warm compress to the hand warms up the synovial fluid that lubricates joints, easing stiffness. People with rheumatoid arthritis may decide either warm or cold compresses work best for them, or alternate between the two.

See Applying Heat vs. Cold 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 clothes that pull-on or use zippers and avoid clothes with buttons
• Use long zipper pulls, which are larger than regular zipper pulls, making them easier to grasp
• Choose lightweight cooking and gardening tools that are easier to hold
• Wear slip-on shoes to avoid having to tie shoelaces

People may find additional ways to customize their homes and routines to help them work around the pain and swelling associated with rheumatoid arthritis of the hand.

Medical Treatments

In addition to appropriate prescription oral or injectable medications, a rheumatologist or hand surgeon may recommend:

Occupational therapy

Strengthening the joints in the wrists and fingers may improve hand dexterity. In addition to improving a hand’s ability to function, occupational therapy can decrease the risk of future hand deformities.

See Therapy for Rheumatoid Arthritis in the Hand

Splinting

A splint that minimizes hand movements may reduce joint strain and limit further deformity. There are several different types of braces, including smaller braces that stabilize individual knuckles and larger ones that stabilize the wrist and hand. Splinting is commonly recommended by physicians.

Compression gloves

Tight-fitting, flexible compression gloves are made of nylon and elastane. People typically wear them at night. The hope is that wearing compression gloves will relieve hand pain and stiffness and improve hand function. While these gloves are common and considered safe, there is very little research regarding whether or not they are beneficial.¹Prior Y, Sutton C, Cotterill S, et al. The effects of arthritis gloves on people with Rheumatoid Arthritis or Inflammatory Arthritis with hand pain: a study protocol for a multi-centre randomised controlled trial (the A-GLOVES trial). BMC Musculoskelet Disord. 2017;18(1):224. Published 2017 May 30. doi:10.1186/s12891-017-1583-4^,2Hammond A, Jones V, Prior Y. The effects of compression gloves on hand symptoms and hand function in rheumatoid arthritis and hand osteoarthritis: a systematic review. Clin Rehabil. 2016;30(3):213‐224. doi:10.1177/0269215515578296

Topical medications

Topical medications provide short-term pain relief and are ideal for use on the hands, where joints lie just below the skin. Topical pain relievers come in the form of creams, balms, gels, or patches, and are sold over-the-counter and by prescription.

Topical medications are generally safe and less likely than oral medications to cause gastrointestinal side effects. However, they still carry potential side effects and may interact with other (oral or injected) medications. To avoid these problems, patients should always tell their health care provider about any other drugs and supplements they take.

See Topical Pain Relief for Arthritis

Other treatments, including integrative medical treatments such as an anti-inflammatory diet, may also help reduce rheumatoid arthritis symptoms in the hands and other joints.

Hand Surgery

While most people with rheumatoid arthritis never need hand surgery, it may be recommended if a deformity or joint malalignment prevents a person from being able to work or care for themselves.

Finger and wrist joint replacement surgery

This surgery is not a cure but a treatment for patients who have lost hand function due to deformity. During the procedure, a hand surgeon will remove the damaged surfaces of the joint’s bones and replace them with prostheses made of metal and plastic.

Tendon repairs and tendon transfers

Rheumatoid arthritis can cause tendons in the hand to become injured and strained, eventually leading to a torn tendon. In some cases, a torn tendon may be surgically repaired. In other cases, the tendon may be so damaged that it cannot be repaired³O'Sullivan MB, Singh H, Wolf JM. Tendon Transfers in the Rheumatoid Hand for Reconstruction. Hand Clin. 2016;32(3):407‐416. doi:10.1016/j.hcl.2016.03.014 and a tendon transfer may be recommended.

During a tendon transfer surgery, the surgeon will transfer tendon tissue from a larger, healthy joint to the hand. The surgeon will also address any related structural abnormalities to help decrease the likelihood of a future tendon rupture.

The hand tendons most likely to tear include the ulnar-sided extensor tendons, flexor pollicis longus, and the flexor digitorum profundus.

Hand surgery for RA may become less common

Physicians expect that recent improvements in medications for rheumatoid arthritis will reduce the need for corrective surgeries in the hand.3 The sooner steps are taken to prevent joint damage the better the chances for avoiding hand surgery.

There is no known cure for rheumatoid arthritis, but symptoms in the hand and wrist can be managed with home and medical care and—in some cases—surgery.

Read more about Rheumatoid Arthritis (RA) Treatment