Rheumatoid Arthritis of the Hand

When rheumatoid arthritis affects your hands, simple tasks such as holding your toothbrush or turning a doorknob can be challenging.

What is rheumatoid arthritis and how does it affect hand function?

Rheumatoid arthritis (RA) is a chronic, autoimmune disease that can affect any part of the body. When the immune system mistakenly attacks the joint tissues found in your fingers, thumb, and/or wrist, it can affect the functionality of your hands.

There are 27 joints in the hand. The ones that most likely show the signs of RA include:

• The metacarpophalangeal joints (large knuckles)
• The proximal interphalangeal (middle knuckles)
• The joints of the wrist

When RA affects the joints of the hands, hand dexterity, grip strength, and ability to pinch objects can be affected.

How does RA develop?

RA occurs when the immune system mistakenly attacks the synovial joint’s delicate membrane. This usually involves the following process:

Invasion of the white blood cells

The body’s immune system sends white blood cells to invade one or more of the hand joints.

Inflammation of the synovium

The white blood cells in the area trigger an inflammatory response in your hand joint’s synovium (the connective tissue that lines the joint capsule).

Formation of pannus

The inflammation of the synovium results in formation of new synovial cells at a rapid pace. These abnormal cells are called pannus.

Damage of the cartilage and bones

Pannus squeezes into the joint space and releases proteins that cause degradation and damage to the joint’s articular cartilage, ligaments, and bones.

Buildup of excess fluid

Pannus formation also leads to production of excess fluid that can contribute to wrist and knuckle swelling.

What are the common signs and symptoms of RA?

The signs and symptoms of hand RA may first appear on the smaller joints.

Some of the common signs and symptoms of RA in the hands include:

• swelling of the finger and wrist joints
• symmetrical inflammation
• difficulty making a fist
• localized pain and stiffness which usually worsens in the morning or after a period of inactivity
• flushing of the skin (it may feel warm to touch as well)
• carpal tunnel syndrome
• formation of rheumatoid nodules
• misalignment of one or more joints

How is RA treated?

Early diagnosis and treatment is important to prevent further degradation and deformity of the joints.

The hand and wrist experts at South Florida Orthopedics & Sports Medicine are ready to care for your specific needs. Whether you need physical or occupational therapy, conservative treatment options, or minimally invasive surgery, our team will work with you to develop the best treatment plan for you.

If RA of the hand is detected early, nonsurgical interventions may help in alleviating the symptoms. This includes giving your hands periodic rests, application of warm or cold compress, occupational therapy, splinting, and medications (anti-rheumatic drugs, biologic drugs).

If these nonsurgical treatments provide very little to no relief, we will consider surgery. We will recommend the surgical procedure that provides long-term pain relief and help you return to your normal functioning.

If you’re dealing with pain or loss of functionality in your hand or wrist, we can help you feel better faster. Call (772) 288-2400 to request an appointment.