Hand Osteoarthritis Treatment
Once diagnosed, treatment for hand osteoarthritis will depend on how advanced the arthritis has become, your age, activity level and other factors.
Treatment for hand osteoarthritis can involve learning how to avoid over-exerting the affected joints, medications, injections, splinting or surgery. The type of treatment you receive will depend on how far your arthritis has progressed, how many joints are involved, your age, activity level and other medical conditions, and whether the arthritis affects your dominant or non-dominant hand.
Often, treatment starts with a combination of learning how to use your hand to protect your joints, along with medication. You also may be advised to wear a wrist and thumb brace. A hand therapist can teach you exercises and ways to modify your activities to protect your hand joints.
Acetaminophen: Before recommending any other medication, your doctor may have you try acetaminophen (such as Tylenol)—a common over-the-counter pain medication. It's typically considered a safe and effective medication for osteoarthritis. To avoid rare but serious side effects of kidney and/or liver damage, follow dosing instructions and avoid drinking excessive amounts of alcohol.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs): This medication addresses both the pain and the inflammation associated with osteoarthritis. Ibuprofen (Advil) or naproxen (Aleve) are examples of over-the-counter NSAIDs. To avoid unwelcome side effects on your heart, stomach, intestines, and kidneys, take these medications exactly as directed.
Capsaicin skin cream, derived from chili peppers, may be used to relieve pain.
Prescription-strength NSAIDs: These are the most commonly prescribed prescription medications used to treat osteoarthritis. They help relieve pain and inflammation; however, they carry certain risks, such as stomach and kidney problems if used without proper monitoring by your doctor. The US Food and Drug Administration has also warned that patients with a history of heart disease should be cautious when taking this medication. Because of these risks, it's important to talk with your doctor about being on these medications for a long period of time.
Patients older than 75 may be advised to use topical NSAIDs applied to the skin instead of a pill, because they are thought to cause less stomach bleeding and fewer other side effects.
COX-2 inhibitors: COX-2 inhibitors are the newer class of prescription-strength NSAIDs. COX-2 inhibitors help reduce pain and inflammation as effectively as traditional NSAIDs but are believed to carry fewer risks for stomach problems. Celecoxib (Celebrex) is the only COX-2 inhibitor currently on the market in the US.
Corticosteroids (cortisone, prednisone) are powerful anti-inflammatory drugs that can be injected into the joint. The injection can provide pain relief for weeks or even months. The injection can be repeated only a limited number of times because of possible side effects, including weakening of the tendons and ligaments, and infection. A person receiving an injection usually also wears a splint to support the affected joint. A splint is worn when the joint hurts. It can be rigid or soft.
Surgery for hand osteoarthritis may be an option when non-surgical treatments have not succeeded. Types of surgery for hand osteoarthritis include:
- Joint fusion. The surgeon removes the worn cartilage and fuses the bones on each side of the joint together. The joint will not move, but it will no longer hurt.
- Joint reconstruction. The rough joint surface is removed and replaced with your own soft tissue or an implant made of ceramic, long-wearing metal or plastic.
After surgery, you may be referred to a hand therapist. Wearing a splint or cast to help protect the hand while it heals may be recommended. Most people are able to return to most if not all of their daily activities in about three months after a major joint reconstruction procedure.