About 40 percent of adults in the United States are likely to develop osteoarthritis (OA) in at least one hand by age 85, and some people are more at risk than others, according to researchers at the Centers for Disease Control and Prevention (CDC). Their findings were published recently in the journal Arthritis & Rheumatology.
Hand OA gets less publicity than knee or hip arthritis, but it can be just as debilitating. Painful, stiff, sometimes-bent fingers can make it hard to eat, dress or type. Although it’s commonly associated with old age, hand OA often starts in midlife, affecting a person’s ability to work.
Despite this, hand OA isn’t well studied and is often underreported, so lead study author Jin Qin, ScD, and colleagues in the Arthritis Program at the Centers for Disease Control and Prevention decided to find out just how common it is and whom it most commonly affects.
They looked at data from 1999 to 2004 and from 2005 to 2010 on more than 2,200 people enrolled in an ongoing arthritis study in Johnston County, North Carolina. Participants were considered to have hand OA if they complained of symptoms such as hand pain and stiffness and they had signs of damage to at least three finger joints on X-rays. Overall, the researchers calculated the lifetime risk of hand OA to be 40 percent; by comparison, it is 45 percent for knee osteoarthritis and 25 percent for hip OA.
But the risk for hand OA wasn’t evenly distributed. The research showed that women were twice as likely as men to develop hand OA (47 percent vs. 25 percent), whites were more affected than African Americans (41 percent vs. 29 percent) and people with obesity (having a body mass index of 30 or more) were at greater risk than those without obesity, regardless of their race or sex (47 percent vs. 36 percent).
The authors speculate that dwindling hormones after menopause may explain the gender gap between men and women, especially because the gap widens with age; other theories for the gap include variations in pain perception and anatomical differences.
The relationship between weight and hand OA is less clear. David Pisetsky, MD, a rheumatologist at Duke University Medical Center in Durham, North Carolina, who wasn’t involved in the study, says obesity can cause systemic inflammation that can affect joints throughout the body.
Not much is known about preventing hand OA, although jobs that involve prolonged pinching or gripping, repetitive motion or heavy vibrations are known to damage cartilage and joint tissues in the fingers.
Still, Dr. Pisetsky says it’s nearly impossible to predict which joints might be affected by OA, so prevention should focus on improving overall musculoskeletal health through exercise, maintaining a healthy weight and avoiding overuse and injury.
Few Treatment Options
Compared to the wide range of therapies for hip and knee arthritis, effective treatments for hand osteoarthritis are limited. They include topical and oral pain relievers and nondrug therapies including splints, hand exercise, heat, massage and medical-grade chondroitin (which is not typically available in the United States). Surgery is rarely successful and usually recommended only as a last resort, according to David Ruch, MD, chief of the hand surgery at Duke University Medical Center.
Of the available options, hand exercise has been shown to be one of the most effective. In a study published in Rheumatology (Oxford) in 2016, Dutch researchers found that patients with osteoarthritis who avoided using their hands and were passive about their own care were more disabled than people who remained active and effectively managed symptoms.
That finding is echoed by Melissa Peavy, senior hand therapist at RPSC Hand Therapy Center in Rockwall, Texas, who says hand exercise is “always helpful” in decreasing [OA] swelling and pain.
“Patients don’t have to perform a lot of repetitions to get a benefit from exercise,” she says. “Simple exercises…help with flexibility and prepare the hands for [daily activities].”
Author: Linda Rath for the Arthritis Foundation
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