Although osteoarthritis is termed the ‘wear and tear’ (or degenerative) type of arthritis, it rarely results from how the hands have been used, and more commonly is a result of normal ageing and genetics. It is known as primary osteoarthritis. 

Osteoarthritis can also occur following a previous injury of a joint (such as a break/fracture or dislocation), and this is known as secondary osteoarthritis.

Inflammatory types of arthritis (including rheumatoid and psoriatic) can also affect the hands. Inflammatory arthritis is not discussed on this page.

Some of the potential symptoms of finger arthritis (osteoarthritis) are listed below. Any finger and multiple joints can be affected in the same hand. Many with finger arthritis will experience little or no pain despite swelling, stiffness and deformity.

Typically present:

• Joint swelling or deformity (including bony nodes).

• Joint stiffness.

Sometimes present:

• Joint pain (usually worse with activity and during cold or damp conditions).

• Terminal joint mucous cyst (a fluid filled cyst that can sometimes burst).

Nodes are bony bumps on the back of the joint, which represent bone spurs or swellings (also termed osteophytes).

It is important to correctly diagnose finger arthritis (osteoarthritis) and exclude other causes of pain or deformity, such as inflammatory arthritis.

The diagnosis is usually made on the history (your symptoms) and clinical examination. Plain radiographs (X-rays) are commonly completed to confirm the type, distribution and severity of the arthritis.

If an inflammatory type of arthritis is suspected, then a blood test may be recommended.

Many with finger arthritis (osteoarthritis) will never require treatment as the hands usually continue to work well with this condition. If present, pain and swelling can fluctuate and will frequently resolve spontaneously or ‘burn out’ after months or years of symptoms. 

There is no harm in using arthritic hands normally and the condition will not worsen as a result (any deterioration will be due to ageing and genetics).

• Non-surgical treatment options include simple painkillers, avoidance of painful activities, hand therapy (mostly functional advice and rarely splintage) and steroid injection (e.g. cortisone).

• Surgical treatment depends on the joint affected and sometimes the mobility of the joint. 

  DIPJ (terminal joint of finger) arthritis can be treated surgically with joint fusion (also termed arthrodesis), which involves the use of metalwork to permanently remove the joint to produce a single bridging bone with no joint movement. By excising the DIPJ (and its worn cartilage surfaces) the cause of your pain is removed. A screw is typically used.

  PIPJ (middle joint of finger) arthritis can be treated surgically with either joint fusion (arthrodesis) or replacement. PIPJ joint fusion permanently removes the joint to produce a single bridging bone with no joint movement. By excising the PIPJ (and its worn cartilage surfaces) the cause of your pain is removed. The PIPJ is fused with wires in a semi-flexed (bent) position. PIPJ replacement is not suitable for all types of arthritis but can help to maintain some movement if still present.

  MCPJ (basal joint of finger) arthritis can be treated surgically with joint replacement, which aims to reduce pain and maintain some movement.

Matthew offers all the above treatments. He can refer you for hand therapy if required.

Finger arthritis surgery can be performed under local, regional or general anaesthesia. Click here for an overview of the different types of anaesthesia and the general risks of hand surgery.

The specific risks associated with the different operations for finger arthritis will be discussed if surgery is an option.

You can read more detailed information about hand osteoarthritis in general on the Lothian Hand Unit website.

The British Society for Surgery of the Hand (BSSH) has an informative webpage on terminal joint (DIPJ) arthritis which can be downloaded as a patient information leaflet PDF.