Osteoarthritis of the hands (hand arthrosis) | Cause, symptoms, exercises and treatment

Osteoarthritis of the hands, also known as osteoarthritis of the hands, can cause pain and stiffness in the hands and fingers. In this guide you will learn everything about hand osteoarthritis.

Hand osteoarthritis involves joint wear and tear in the hands, fingers and wrists. Physically, this can lead to cartilage wear, reduced joint space and calcifications. Such degenerative changes can lead to pain, pain in the fingers, pain in the hand, stiffness and reduced grip strength. Something that can affect everyday tasks such as holding the coffee cup or opening jam lids.

- Osteoarthritis can be slowed down if you take active measures

The diagnosis can, in many cases, be kept in check by physical treatment, daily stretching and exercise exercises. In this guide, we will, among other things, go through a training program with 7 exercises against hand osteoarthritis (with video).

"The article has been written and quality checked by publicly authorized health personnel. This includes both physiotherapists and chiropractors at Pain clinics Interdisciplinary Health (see clinic overview here). We always recommend having your pain assessed by knowledgeable healthcare personnel."

Tips: In addition to showing a video with 7 exercises against osteoarthritis in the hands, we will also give you good advice on self-measures and self-help. This includes the use of specially adapted compression gloves, sleeping with wrist support, training with hand and finger trainer, as well as self-testing with hand dynamometer. Links to product recommendations open in a new browser window.

- Which anatomical structures in the hands and fingers are affected by osteoarthritis?

Hand osteoarthritis involves the breakdown of cartilage and bone tissue in the fingers, wrists and small joints of the hand. It particularly affects:

• Wrist

• 1st metacarpal joint (the base of the thumb)

• Fingertips (PIP joint, outer joint of fingers)

• Middle finger joints (DIP joint, middle joint of fingers)

It is worth mentioning that hand osteoarthritis often starts with arthrosis in the thumb.

In this big guide you will learn more about:

1. Symptoms of osteoarthritis in the hands

2. The cause of osteoarthritis in the hands

3. Self-measures and self-help against hand osteoarthritis

4. Prevention of osteoarthritis in the hands (including video with exercises)

5. Treatment and rehabilitation of osteoarthritis in the hands

6. Diagnosing osteoarthritis in the hands

This is a comprehensive and large guide on hand osteoarthritis written by publicly authorized healthcare personnel Pain clinics Interdisciplinary Health. Remember that you can always contact us if you have questions or are wondering about something.

1. Symptoms of osteoarthritis in the hands

The symptoms and pain the individual experiences vary greatly from person to person. Some people have significant osteoarthritis without having pain or a single symptom - while others, with mild osteoarthritis, experience both aching and joint pain. The symptoms experienced will often be directly linked to the extent and severity of the wear and tear changes.

– 5 stages of osteoarthritis

Osteoarthritis is divided into 5 stages. From stage 0 (no osteoarthritis or joint wear) to stage 4 (advanced, significant osteoarthritis and wear and tear). The various stages give an indication of how much cartilage has been broken down in the hands and how extensive the wear and tear changes are. We point out that stage 4 is very extensive wear and tear changes, which will involve significant deformation of the hands and functional impairment.

Symptoms on osteoarthritis can include:

• Swelling in the knuckles, middle or outermost finger joints

• Light or clear swelling of the affected joints

• Local pressure relief over the joints

• Reduced grip strength

• Redness of the joints

• Feeling of stiffness in hands and fingers

• Pain in hands and fingers

• Crooked fingers

• Cartilage formation in outer finger joints (Heberden's knot)

• Bone spurs in middle finger joint (Bouchard's knot)

• Action in hands during use and load

• Increased occurrence of compensatory complaints in the forearms and elbows

Hands affected by osteoarthritis can also cause an increased incidence of forearm ailments, shoulder problems and tendonitis in the elbow. This is due to the fact that you often begin to stress incorrectly if the hands do not work quite as they should, and thus it affects nearby anatomical structures and areas. This is called for compensation complaints. Osteoarthritis in the hands can, due to wrong loading, even give rise to an increase in neck pain (including stress neck) and shoulder pain.

- Why are my hands extra stiff and sore in the morning? 

There are three main reasons why your hands and fingers are stiffer and more painful when you first stand up:

1. Less synovial fluid

2. Less blood circulation

3. Unfavorable wrist position when sleeping

When we sleep, the heart beats more slowly and the body has less need for frequent circulation of blood circulation and synovial fluid. The only problem is that if we have areas of damage with a lot of wear and tear changes, these will still need this microcirculation to keep going. The result is that the joints in the hands and fingers feel even stiffer and more painful. Some people also like to sleep on their own hands, or with their wrists bent, which in turn can increase morning stiffness. Especially an own measure, namely to sleep with orthopedic wrist support, can help keep the wrist in the correct position when you sleep, and thus maintain good circulation and nerve signals, through, among other things, the carpal tunnel and Guyon's tunnel.

Our recommendation: Try sleeping with an orthopedic wrist support

This is good advice that many people report having a good effect. By sleeping with one orthopedic wrist support as shown above, you want to ensure that the wrist is kept straight (instead of bent) and "open" throughout the night. In this way, we also want to avoid reduced space conditions in the wrist, which can reduce circulation when we sleep. Press here to read more about our recommendation.

2. Reason: Why do you get osteoarthritis in the hands?

The reason why you get osteoarthritis in the hands and fingers is more complex than you might think. It is not just about long-term overload, but also genetic factors, age and risk factors. Having said that, joint wear and tear occurs when the body is unable to repair the joint faster than it breaks down. But it is well documented that hand exercises and grip strength training (with grip trainer) can help maintain good function, strengthen and reduce pain among patients with osteoarthritis in the hands.¹ These risk factors increase the risk of hand osteoarthritis:

• Gender (women are more prone to osteoarthritis than men)

• Higher age (impaired ability to repair)

• Genetics (certain genes carry an increased risk)

• Previous injuries and fractures in the hand

• Repetitive overload

• Weakened stability muscles in the hands and fingers

• smoking (impaired circulation)

• Reduced grip strength

If we take a look at the list above, we see that there are some factors that you can control, and others that you cannot control yourself. Common causes for the development of osteoarthritis include, among other things, overloading over a long period of time, genetic factors and previous injuries. Fractures in the hands and fingers can lead to earlier development of hand osteoarthritis.

- Older age means an increased need for maintenance and good habits

It is poorly done, but it is the case that the ability to repair is weakened as we get older. This means that the body is no longer as good at repairing joint surfaces and cartilage, as well as ligaments and tendons. This is precisely why it is so important that we take care of two of the most important tools we have.

Hand osteoarthritis can lead to calcifications and cartilage lumps

When the cartilage in between the various joints of the fingers, hands and wrists breaks down, repair processes will occur on their part in an attempt to make up for the damage. These processes also mean that bone tissue is formed in the affected areas, which in turn can lead to calcifications, lumps of cartilage and bone spurs.

- Visible, larger bone balls on the fingers can be an indicator of significant osteoarthritis

Such calcifications are visible on x-rays and provide a basis for saying how extensive your osteoarthritis is. When there are visible, larger bone balls on the fingers or wrists, this is a clear indication that there is relatively significant osteoarthritis in a later stage (stage 3 or 4 usually).

Heberdens knots 

When bone spheres and clear calcifications occur in the outer part of the fingers, these are - medically speaking - called Heberden's spheres. Many people often find that they have small distinct balls on the outermost part of the finger joints (DIP joints) and wonder very much what that might be. The truth is that there are calcifications.

Bouchards knots

If similar calcifications and balls occur in the middle finger joint, this is called Bouchard's nodule. This description is thus used if the middle link (PIP link) is affected.

3. Self-measures and self-help against hand osteoarthritis

If you want to take an active approach to slowing down osteoarthritis and reducing the aging process in your hands, this is certainly possible. By strengthening the muscles in the hands, forearms and shoulders, you can relieve the joints, as well as contribute to improved blood circulation and maintenance. Good ways to do this include using grip strength trainer or finger trainer. Many use too specially adapted compression gloves to increase circulation in the hands and provide increased protection. All product recommendations open in a new browser window.

Our recommendation: Daily use of compression gloves

One of the easiest self-measures to get started with and also one of our warmest recommendations. Compression gloves has, in a number of studies, documented a positive effect on grip strength, increased circulation and better function - also for rheumatic patients.² Click here to read more about our recommendation. These can be used daily.

Recommendation for better grip: Grip strength trainer

The best way to train grip strength is through specific training. This is exactly why we recommend this one specific grip strength trainer. You can set the resistance anywhere from 5 to 60 kg. So then you have good opportunities to map your own strength development (you can also use a hand dynamometer to check your strength more accurately - you can read more about these further down in the article). Press here to read more about this recommended grip strength trainer.

4. Prevention of osteoarthritis in the hands (including video with recommended exercises)

In the section above, we mentioned how using smart self-measures can help protect your hands and fingers. And it is somewhat the case that self-measures and prevention overlap a good deal. But here we choose to take a closer look at specific exercises that can help you slow down the development of hand osteoarthritis. The video below shows namely chiropractor Alexander Andorff come up with a recommended training program for you with osteoarthritis in the hands.

VIDEO: 7 exercises against hand arthritis

You can read more about these seven exercises in our article 7 exercises against hand osteoarthritis. There you can read detailed descriptions of how the exercises are performed.

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Recommended training tools: Practice "opening your hand" with this finger trainer

Have you considered that almost every movement we make in everyday life "closes" the hand? It is easy to forget that the fingers should be able to go the other way too! And this is where this hand and finger trainer comes into its own. It helps you train what we call finger extension (i.e. to bend the fingers backwards). Such training can have a positive effect on function and muscle balance in the hands and fingers. Press here to read more about our recommendation.

5. Treatment and rehabilitation of osteoarthritis in the hands

Our clinicians at the Vondtklinikkene Tverrfaglig Helse know that the first step on the way to better hand health always starts with a decision from the patient. A choice to take active measures for better function and less pain in everyday life. Our physiotherapists and chiropractors work daily to help osteoarthritis patients on the way to a better everyday life. We achieve this through an evidence-based combination of physical treatment techniques and specific rehabilitation exercises. Some of the treatment methods used for hand osteoarthritis may include:

• Physiotherapy

• Hand massage techniques

• Intramuscular stimulation (IMS)

• Low-dose laser therapy (therapeutic laser)

• Joint Mobilization

• Trigger point therapy

• Dry needling

Which treatment techniques are used are adapted to each individual patient. But with that said, the physical treatment often consists of massage techniques, therapeutic laser and joint mobilisation. Laser therapy has a documented positive effect against osteoarthritis in the hands - and also when cartilage formations occur in the fingers (Heberden's nodes and Bouchard's nodes).³ Among other things, a larger study showed that it reduces swelling in the fingers and provides effective pain relief with 5-7 treatments. Therapeutic laser is offered at all our clinic departments.

More movement in everyday life

Do you have a job that gives you a lot of repetition and static load? Then we strongly recommend that you take extra care to get enough movement and blood circulation. Join an exercise group, go for a walk with a friend or do exercises at home. The most important thing is that you do something you like and thus manage to motivate yourself to move more in your everyday life.

6. Diagnosis of osteoarthritis in the hands

The process for diagnosing hand osteoarthritis consists of several steps. These include:

• anamnese

• Functional examination

• Imaging examination (if medically indicated)

An initial consultation with a clinician with expertise in muscles and joints will start with a history taking (called an anamnesis). Here the patient tells about the symptoms and pain they are experiencing, and the therapist asks relevant questions. The consultation then moves on to a functional examination where the clinician checks joint mobility in the hand and wrist, examines for cartilage formations and tests the muscle strength in the hand (including grip strength). The latter is often measured with a digital hand dynamometer. This can be used actively to map the development of hand function and grip strength over time in the treatment plan. If you work with physical therapy and rehabilitation, this can be a useful tool to have in your clinic. It may also be suitable for those who want to chart their own development.

For clinicians: Digital hand dynamometer

Et digital hand dynamometer is a clinical examination tool for accurate testing of grip strength. These are regularly used by physiotherapists, doctors, chiropractors, naprapaths and osteopaths to map the development of grip strength in their patients. You can read more about our recommendation here .

If there are symptoms and clinical signs of hand osteoarthritis, a chiropractor or doctor can refer you to an imaging examination of the hands and fingers. When mapping osteoarthritis, it is most common to take an X-ray, as this is best for visualizing such changes.

Summarizeering: Osteoarthritis of the hands (hand arthrosis)

The most important thing to slow down the development of hand osteoarthritis is that you yourself are willing to take active measures. Make changes in your everyday life that gradually help turn the trend in your favor, with both stronger hands and less pain. If you are wondering where to start, we recommend that you seek out an authorized clinician with an interest in the treatment and rehabilitation of osteoarthritis. Feel free to contact us if you are near any of them our clinic departments belonging to the Vondtklinikkene Interdisciplinary Health. We also remind you that you can, completely without obligation, ask us questions if you have any questions.

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Article: Osteoarthritis of the hands (hand osteoarthritis)

Written by: Our publicly authorized chiropractors and physiotherapists at Vondtklinikkene Tverrfaglig Helse

Fact check: Our articles are always based on serious sources, research studies and research journals, such as PubMed and the Cochrane Library. Please contact us if you spot any errors or have comments.

Research and sources

1. Rogers et al, 2007. The effects of strength training among persons with hand osteoarthritis: a two-year follow-up study. J Hand Ther. 2007 Jul-Sep;20(3):244-9; quiz 250.

2. Nasir et al, 2014. Therapy gloves for patients with rheumatoid arthritis: a review. Ther Adv Musculoskeletal Dis. 2014 Dec; 6(6): 226–237.

3. Baltzer et al, 2016. Positive effects of low level laser therapy (LLLT) on Bouchard's and Heberden's osteoarthritis. Lasers Surg Med. 2016 Jul;48(5):498-504.

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Frequently asked questions about osteoarthritis of the hands (FAQ)

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