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Arthritic Hands: What Works (and Doesn't) To Ease The Pain?

Millions of people who live with the pain and stiffness of arthritis in their hands get steroid or hyaluronic acid injections directly into their finger joints in the hopes of feeling better.

Now, a new review shows that even though these injections are widely recommended in treatment guidelines, they don't really work.

Joint injections to relieve the symptoms of hand osteoarthritis were no better than dummy (placebo) injections, the study found.

That's not all current treatment recommendations for hand arthritis seem to get wrong, either. Most also call for topical pain relievers as the first-line therapy for hand osteoarthritis, but the evidence on those is iffy, said study author Dr. Anna Døssing, a rheumatology resident at the Parker Institute in Copenhagen, Denmark.

"Oral nonsteroidal anti-inflammatory drugs [NSAIDs] and oral glucocorticoids effectively reduce pain in people with hand osteoarthritis," Døssing said. Of these, glucocorticoids (steroid) pills were most effective, the study showed.

Oral NSAIDs also improved function and grip strength, and oral steroids improved function and people's health-related quality of life, a measure that encompasses physical and mental health status. People who took either of these medications reported improvements in hand symptoms and their overall health.

For the study, Døssing and her colleagues reviewed 65 studies of close to 5,250 people with hand osteoarthritis. The studies looked at 29 types of treatment for the condition.

Injections were found to be ineffective, but most people in the study received injections for osteoarthritis in the base of their thumb. Hydroxychloroquine, an arthritis medication that affects the immune system, was also found to be ineffective for hand arthritis, and the effectiveness of topical creams and gels for pain wasn't clear, the study showed.

The findings were published Sept. 28 in the journal RMD Open.

The article reveals a "surprising lack of effectiveness of intra-articular glucocorticoids, a widely employed and traditionally fundamental treatment for hand arthritis, specifically thumb-base arthritis," said Dr. Daniel Polatsch, co-director of The New York Hand and Wrist Center of Lenox Hill Hospital and an associate professor in the department of orthopedic surgery at Zucker School of Medicine/Northwell in New York City.

"This discovery stands in stark contrast to the prevailing beliefs and experiences of most hand surgeons, myself included, in our clinical practice," Polatsch said.

He said that treatment for hand arthritis should be individualized. "I consistently advocate for commencing treatment with the option that carries the lowest risk," he said. "Short-term usage of oral NSAIDs or glucocorticoids is a reasonable approach."

That said, long-term use of these medications can cause side effects. Prolonged use of NSAIDs has been linked to bleeding ulcers. Oral steroids, when taken for prolonged periods of time, can cause high blood pressure, weight gain, thinning skin and infections.

"My recommendation is to engage in a discussion about the different treatment options with your health care provider and formulate a plan together," Polatsch advised.

It's also a good idea to see a hand surgery specialist if symptoms persist.

"A hand surgery specialist … can thoroughly assess the full spectrum of alternatives, including medication, splinting, hand therapy, injections and, as a final resort, surgery," Polatsch said.

More information: Anna Døssing et al, Comparative effectiveness of pharmacological interventions for hand osteoarthritis: a systematic review and network meta-analysis of randomised trials, RMD Open (2023). DOI: 10.1136/rmdopen-2023-003030

Citation: Arthritic hands: What works (and doesn't) to ease the pain? (2023, December 27) retrieved 28 December 2023 from https://medicalxpress.Com/news/2023-12-arthritic-doesnt-ease-pain.Html

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What Causes Finger Joint Pain, And How To Remedy It

Finger joint pain can affect a person's everyday activities and may have several causes. It is common for swelling and stiffness to accompany finger joint pain.

Some people experience finger joint pain that worsens when they move or press on the finger. Others may have persistent finger joint pain that does not improve with rest or over-the-counter (OTC) treatment.

This article discusses the causes, symptoms, and treatment of finger joint pain.

Finger joint pain can result from:

Finger injuries are common, especially in athletes and people who work with heavy machinery. As trauma can often result in pain and inflammation, people will likely experience discomfort when pressing on the finger. Common causes of finger injuries include:

a sprain, which refers to a stretched or torn ligament

a strain, when a muscle or tendon becomes stretched or torn

a dislocated finger joint, when something forces a finger bone out of its joint

a fractured or broken bone, when a finger bone breaks

Read about the difference between a sprain and a strain.

Treatment

People can treat mild sprains and strains with RICE (rest, ice, compression, and elevation) therapy.

Rest: Avoid moving or using the injured finger for a few days. Consider immobilizing the injured finger using a splint or buddy-taping it to another finger.

Ice: Place an ice pack on the injured finger for 20 minutes, between four and eight times daily. Applying ice can help reduce swelling and minimize pain.

Compression: Wrap the injured finger in a soft dressing or a bandage. Make sure the bandage is snug but not constricting.

Elevation: Keep the injured finger above the heart to reduce blood pressure and swelling in the finger.

Taking OTC pain medicines, such as ibuprofen and aspirin, can help alleviate pain and reduce swelling.

Severe injuries, such as dislocations and fractures, require medical intervention. A healthcare professional can move a finger bone back into its joint and reset a fractured bone. They will then immobilize the finger to allow it to heal properly.

Tendons are cords of collagen tissue that attach muscles to bones. Two common problems that affect the tendons are tendonitis and tenosynovitis.

Tendonitis occurs when a tendon becomes inflamed, which can lead to swelling, discomfort, and reduced movement.

Tenosynovitis refers to inflammation of the tendon sheath, which is the thin membrane that encloses a tendon. It can lead to joint pain, swelling, and stiffness.

Treatment

People can treat mild tendon problems with RICE therapy. People who have severe or persistent symptoms may require:

Ganglion cysts are fluid-filled growths that usually develop on the back of the wrist and the end of finger joints. These growths can feel soft or firm to the touch. They are usually harmless, but some people report feeling tenderness, pain, or weakness near a ganglion cyst.

Treatment

The exact cause of ganglion cysts remains unknown. However, researchers believe these fluid-filled growths develop from connective tissue injuries and chronic conditions that affect the joints, such as arthritis.

Ganglion cysts typically resolve without medical intervention. Doctors typically only recommend treatment for ganglion cysts that cause pain or affect mobility. Depending on its location, a doctor can drain or surgically remove a ganglion cyst.

Arthritis is a general term for conditions that lead to joint inflammation, pain, and stiffness. As a result, these conditions will likely cause pain and discomfort when a person presses on their finger. Two common types of arthritis include osteoarthritis (OA) and rheumatoid arthritis (RA).

OA involves the loss of cartilage, the tissue that lines the joints. It is also the most common form of arthritis, especially among adults over the age of 50. It usually develops in either the base of the thumb, the top joint near the tip of the finger, or the middle joint of a finger.

RA is a chronic inflammatory condition that occurs when the body's immune system mistakenly attacks healthy tissue.

Other types of arthritis include lupus, gout, juvenile arthritis, and psoriatic arthritis.

Symptoms of arthritis include:

joint pain and swelling

joint stiffness that lasts up to 2 hours, especially in the morning

difficulty walking, sitting, or standing up

loss of mobility in the small joints of the hands and fingers

difficulty performing fine motor tasks, such as gripping and tying shoelaces

Treatment

The goals of arthritis treatment include:

reducing pain

improving joint mobility

slowing disease progression

A doctor may recommend one or more of the following treatments:

disease-modifying medications that inhibit the body's natural immune response

oral or topical pain relievers

NSAIDs or corticosteroids to reduce inflammation

physical therapy to improve mobility and strengthen the joints

surgery to repair or replace joints

supportive devices, such as braces and walkers

lifestyle changes, including weight loss, to relieve stress on the joints

Compression Gloves For Conditions With Hand Pain Symptoms

Medically reviewed by Theresa Marko, PT, DPT, MS

Compression gloves work to improve blood flow in your hands, warm your hands, and provide stability to the joints of the fingers through compression. They can help reduce symptoms of pain, joint stiffness, and swelling that often occur with problems like arthritis.

Though research on how compression gloves work has been inconclusive, there is some proof that they provide relief. Wearing well-fitting gloves for at least eight hours daily can help you achieve the most benefits.

This article describes the types of problems that these gloves treat. It also explains how to select and use them.

Benefits of Compression Gloves for Different Conditions

Compression gloves for hands are also called arthritis gloves. They are often prescribed as part of an overall treatment plan to reduce symptoms in several types of hand disorders.

While compression gloves do not provide the same results as treatments like cortisone shots or surgery, they may improve comfort and hand function by providing the following benefits:

Reduce or control swelling in your hands and fingers

Support joints

Ease joint pain

Decrease joint stiffness

Increase hand temperature

Improved hand dexterity

Extend hand range of motion

Increase pinch strength

However, it is important to note that some people report that compression makes no difference in hand symptoms compared to regular gloves.

Since pain and symptoms are different in each individual and according to their condition, your experience with compression gloves can vary. Here are some of the conditions that are most likely to benefit from the use of compression gloves:

Peripheral Neuropathy

Peripheral neuropathy is nerve pain, weakness, and numbness affecting your peripheral nerves (those outside your brain and spinal cord, such as in the hands and feet). The condition often occurs due to diabetes though other factors such as physical trauma, autoimmune diseases, and certain medications are also causes.

Symptoms often include chronic pain, tingling, numbness, and weakness in your hands and feet. The pressure from compression gloves may improve these symptoms as it helps to increase blood flow to your hands and reduce inflammation and swelling.

Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs due to excessive pressure on your median nerve (one of the major nerves to your hand) at your wrist. It often results from repetitive hand motions like typing, driving, or writing that involve flexing and extending your wrist.

Symptoms can include pain, tingling, or muscle damage in your hand and fingers. Compression gloves, especially those with a carpal tunnel brace, can help keep your wrist in a neutral position to reduce strain, though they won't cure the cause of the pain.

Hand Arthritis

Hand arthritis is inflammation of the joints between the bones of your wrist, hand, and fingers. The problem causes stiffness and pain, limiting movement and hand function.

Compression gloves are often prescribed to improve circulation and treat rheumatoid arthritis and other types of arthritis. This can ease pain and inflammation. While people who use these gloves report improvement, these gloves do not treat the underlying cause of the disease.

Tendonitis

Tendonitis is inflammation of a tendon (the connective tissue that attaches muscle to bone). The condition typically occurs due to the stress of repetitive muscle contraction during overuse.

Symptoms of tendonitis include pain and tenderness along the affected tendon, usually near a joint. Pain can worsen with activity. Stiffness can occur after sleep or inactivity. The warmth and support provided by compression on joints may help relieve these symptoms.

Swelling

Edema, or swelling, of your hands occurs when fluid becomes trapped in tissue as a result of injury or inflammation. Swelling in your hands can occur due to arthritis, medications, and serious medical conditions like deep vein thrombosis (DVT).

While compression gloves will not correct the cause of hand swelling, they can help reduce the discomfort of swelling. The gentle compression of the gloves helps to push the excess fluid out of your hands during wear.

How Long to Wear Compression Gloves

You should wear compression gloves for a minimum of eight hours to experience their benefits. However, you can wear them as long as needed to help with swelling, pain, or stiffness symptoms.

Compression gloves can be worn while you sleep to reduce morning stiffness and joint pain. Wearing them during the day can help improve hand function, though you should not wear them for 24 hours without removing them occasionally to maintain your skin hygiene.

Many people experience improved hand function and reduced swelling and pain by wearing compression gloves daily. However, they can be inconvenient to take on and off to wash your hands or perform wet and dirty tasks.

Compression gloves should not be worn while driving because they can interfere with your ability to safely grip the steering wheel. In addition, some compression gloves can make your hands too hot to wear for long periods while you perform daily tasks.

Consult your healthcare provider regarding the best way to use compression gloves for your condition. Discontinue using compression gloves and contact your healthcare provider for guidance if you have any of the following symptoms while wearing them:

Numbness in your fingers and/or hand

A sensation of tingling or pins and needles

An allergic reaction (typically itchy skin, redness, or increased swelling)

Skin irritation

Sleep disturbance due to the effects of the gloves

Compression Glove Materials and Sizing

Selecting the right compression glove size and materials is important because you will be more likely to wear them as advised if they fit comfortably.

Compression gloves are typically manufactured from one or more of the following materials:

Lycra

Neoprene

Nylon

Cotton

Copper fibers

Elastane and nylon blend

When selecting the right size of compression gloves, follow the manufacturer's instructions, since sizes can vary by brand. To get a proper fit, consider visiting a medical supply store to have your hands measured and correctly sized.

Look for the following qualities to ensure a comfortable and proper fit when choosing compression gloves:

A snug fit that does not feel too tight

Freedom to move your hands and fingers to perform daily tasks

Gloves that are free of exterior seams that could exert too much pressure

Coverage that supports the parts of your hand that have symptoms (the hand but not the fingers, the full hand and wrist, fingers only, wrist only, or both the hand and fingers)

The Best Compression Gloves

Based on research and the comparison of dozens of compression gloves, the editors at Verywell Health have identified the following products as the best compression gloves available in the categories mentioned:

Summary

Compression gloves can relieve the pain and swelling of some hand problems. While some research suggests they can improve symptoms, everyone does not achieve the same benefits.

Wearing well-fitting compression gloves as advised can help you get the best results. While they will not provide a cure, they may help you with daily functions.

If you have hand pain or swelling symptoms, consult your healthcare provider before treating these problems with compression gloves. Though they may improve symptoms, compression gloves do not treat the underlying causes of these symptoms.

Read the original article on Verywell Health.

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