Hand and Thumb Osteoarthritis: Practical Ways to Keep Hands Working
Quick summary
- Hand osteoarthritis commonly affects the finger joints nearest the nails, the middle finger joints and the base of the thumb, causing pain, stiffness, bony swelling and a weaker grip.
- The 2018 EULAR recommendations advise education and training in joint-friendly ways of doing tasks, hand exercises to improve function and strength, and splints for thumb-base OA (Kloppenburg et al., 2019).
- Topical anti-inflammatory gels are preferred over tablets for safety reasons. Talk to your GP or pharmacist about medication.
- Numbness or tingling in the fingers is not typical of osteoarthritis and may point to a nerve problem in the wrist or neck.
Opening jars, turning keys, writing, gardening, picking up grandchildren: our hands do thousands of small jobs a day, and we often only notice that when they start to hurt. Hand osteoarthritis (OA) is common, particularly in women from middle age onward. It is a condition where the right everyday strategies make a real difference.
What Hand Osteoarthritis Looks Like
- pain and stiffness in the finger joints, often worse after use or first thing in the morning
- firm, bony lumps at the finger joints nearest the nails (Heberden's nodes) or at the middle joints (Bouchard's nodes)
- pain at the base of the thumb when pinching, gripping or twisting, such as turning a key or opening a bottle
- a weaker grip and difficulty with fine tasks
Hand OA tends to vary over time, with flare-ups and quieter periods. Sudden hot, red, very swollen joints, or joint pain with marked morning stiffness lasting well over an hour, can suggest an inflammatory arthritis such as rheumatoid arthritis. That needs assessment by your GP.
What the Recommendations Say
The European League Against Rheumatism (EULAR) updated its hand OA recommendations in 2018. The key non-drug points are (Kloppenburg et al., 2019):
- Education and ergonomic training, including pacing activities and using assistive devices, should be offered to every patient.
- Exercises to improve function and muscle strength, and to reduce pain, should be considered for every patient.
- Orthoses (splints) should be considered for symptom relief in people with thumb-base OA, with long-term use advised.
- Topical treatments are preferred over oral medicines for safety reasons, with topical anti-inflammatories as the first choice.
Everyday Strategies That Help
Work smarter, not harder
- Use larger-handled tools and kitchen utensils, which need less grip force.
- Use jar openers, electric can openers and key turners for twisting jobs.
- Spread hand-heavy tasks through the day, and alternate them with lighter ones.
- Carry bags over your forearm or shoulder rather than gripping handles.
Keep the hands moving and strong
- Gentle range of motion: make a loose fist, then straighten the fingers fully. Touch the thumb to each fingertip in turn.
- Grip and pinch strength: squeeze a soft ball or therapy putty, building up gradually.
- Thumb stability: gently press the thumb pad against the side of the index finger and hold, which helps the muscles that support the thumb base.
- Warm water before exercising can ease morning stiffness.
Where Chiropractic Fits, and Where It Doesn't
We'll be straightforward: hand OA is best managed with the self-management strategies above, often with input from a hand therapist or occupational therapist for splints and joint protection, and your GP for medication. At Spirit Chiropractic in Kogarah, our role is to:
- check whether your hand symptoms are truly coming from the hand joints, or whether a nerve problem at the wrist or neck is involved (see Carpal Tunnel vs. Cervical Radiculopathy)
- help with related neck, shoulder or elbow problems that often travel with heavy hand use
- teach and progress a hand exercise program, and point you to a hand therapist when a custom splint would help
Sore hands making everyday jobs harder?
We can check whether the problem is in the joints themselves or a nerve further up, set you up with a practical exercise and pacing plan, and point you to the right next step.
Spirit Chiropractic is at Shop 23/6 Belgrave Street, Kogarah. If your GP has put you on a chronic condition management plan, here's how Medicare works for chiropractic.
Request an appointment Call 0410 420 856Frequently Asked Questions
Do hand exercises help osteoarthritis?
Yes. The 2018 EULAR recommendations advise considering exercises for every patient with hand osteoarthritis to improve function, strength and pain. Gentle range-of-motion and grip-strength exercises are a good starting point.
Does a splint help thumb arthritis?
For osteoarthritis at the base of the thumb, EULAR recommends considering a splint (orthosis) for symptom relief, with long-term use advised. A hand therapist can fit one to suit your activities.
Is hand osteoarthritis the same as rheumatoid arthritis?
No. Osteoarthritis usually affects the finger joints nearest the nails, the middle finger joints and the thumb base, with bony swelling. Rheumatoid arthritis is an inflammatory condition that typically causes warm, soft swelling and prolonged morning stiffness, and needs medical management.
Why are my fingers numb as well as sore?
Numbness and tingling are not typical of osteoarthritis. They may come from a nerve being compressed at the wrist, as in carpal tunnel syndrome, or in the neck. An examination can help tell these apart.
Should I stop using my hands if they hurt?
No. Keeping the hands moving and strong is part of good management. Pace hand-heavy tasks, use tools that reduce grip force, and adjust the amount if pain stays higher the next day.
References
- Kloppenburg, M., Kroon, F.P., Blanco, F.J., et al. (2019). 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Annals of the Rheumatic Diseases, 78(1), 16–24. https://doi.org/10.1136/annrheumdis-2018-213826
This article is general information, not a diagnosis or a substitute for an individual assessment. If you have new or worsening symptoms, see a registered health practitioner.
