Rheumatoid arthritis is a chronic, inflammatory disease in which your immune system mistakenly attacks the lining of the membrane that surrounds your joints. Though RA can affect joints and organs all over the body, it often strikes in smaller joints first — particularly those in your hand and wrist, as well as ones in your feet.
Your hand is one of the most complex structures in the human body. It’s designed to give powerful grip, lift heavy objects, and manipulate small ones (like threading a fine string through a tiny needle eye). Made up of the wrist, palm, and fingers, each hand contains 27 small joints, the same number of bones, and a whole lot of muscles, tendons, and ligaments. All of this complexity also makes the hand a prime target for rheumatoid arthritis (RA).
90 percent of people will RA experience pain, stiffness, or swelling in joints in their hand, and often results in problems performing daily activities.
When your hands are affected by rheumatoid arthritis, you may experience swelling around the affected joint, which leads to pain or tenderness. The joint may feel warm to the touch. Swelling tends to be symmetrical, which means it occurs in the same joints on both right and left hands.
When your hands are affected by rheumatoid arthritis, you may experience swelling around the affected joint, which leads to pain or tenderness. The joint may feel warm to the touch. Swelling tends to be symmetrical, which means it occurs in the same joints on both right and left hands
Symptoms like stiffness and pain are usually worse in the morning, and can last at least 30 minutes or more. Together these hand symptoms can impair function and the ability to go about your daily routine and tasks.
Some specific hand problems and deformities that can be caused or made worse by rheumatoid arthritis include:
- Carpal tunnel syndrome
- Trigger finger
- Ulnar drift
- Swan’s neck deformity
This occurs when the middle joint on the finger bends back more than normal (or hyperextends), and the top joint is flexes, or bends down, resulting in a shape that resembles a swan’s neck.
Sometimes called a buttonhole deformity, the middle finger joint is bent in (toward the palm) and the top finger joint is bent out (away from the palm).
Your thumb’s large knuckle abnormally flexes while the top knuckle hyperextends, resembling a Z-shape.
Some people with RA will develop hard lumps under the skin called nodules, often around pressure points. In the hands, nodules may appear on finger joints and wrists.
There is no cure for rheumatoid arthritis, but there is a lot you can do to relieve symptoms, prevent damage, and maintain function in your hands. To help keep your hands healthy:
- 1. Stick to your prescribed rheumatoid arthritis treatment plan
- 2. See a physical or occupational therapist
- 3. Apply heat or cold
- 4. Modify your movements
- 5. Use assistive devices
- 6. Consider a steroid injection
- 7. Talk to your doctor about surgery options
Surgery may involve removal of inflamed joint linings, tendon repair, joint fusions, or joint replacements. Depending on the joint involved, the degree of damage, and other factors, you hand surgeon will determine the most appropriate treatment to help correct deformities, relieve pain, or improve function.