What is arthritis?
A joint is where two or more bones meet each other. The ends of these bones are covered with a smooth substance called cartilage which allows the bones to slide past each other smoothly. This cartilage layer can be worn away with time or due to other things, and when this occurs the rough bone ends start to rub against each other. This is arthritis. Sometimes arthritis does not cause any problems, but sometimes it can cause pain, swelling, stiffness, and deformity.
What causes arthritis?
The most common causes of arthritis are different for different locations in the body. The normal arthritis that often comes along with age is called osteoarthritis. This is simply arthritis that occurs due to normal wear and tear on the body as we get older. Often this type of arthritis is partially hereditary, meaning that if your parents or grandparents had arthritis, you may be more likely to have it. Other things can cause arthritis as well. These include major joint injuries or infections, and certain medical conditions.
Just because you have arthritis doesn’t mean it’s necessarily a problem. Many people have arthritis that they don’t even know about. Arthritis only needs treatment if it bothers you or causes issues in the body.
My hand arthritis hurts! How can I treat it?
Once arthritis is present, it will always be there. This is because the body can’t regrow the type of cartilage found in the joints. But there is good news: just because arthritis is in the body doesn’t mean it will always cause pain or other issues. Even if arthritis causes pain, the pain may not be there all the time- it can often come and go. There are many things we can do to try to improve arthritis symptoms when they occur. Conservative management of arthritis- meaning treatment without surgery- is almost always the first step. There are many options to try. Usually these treatments work best when they are used all together over several weeks or months.
What if none of these treatments work to improve my arthritis pain?
There are surgeries that can help make hand arthritis pain better. However, most people with hand arthritis never need to move forward with surgery- this is a personal decision that should be made after discussion with a hand surgeon. The safest and best plan is usually to try to maximize all non-surgery treatments to make arthritis feel better. If none of these treatments give you good relief from your arthritis symptoms, see a hand surgeon to discuss whether a surgical procedure could benefit you.
Arthritis of the Hand and Upper Extremity: A Master Skills Publication, SZ Glickel, RA Bernstein (Eds.), American Society for Surgery of the Hand, Rosemont, IL (2011), 442 pages. (2012): 1508-1509.
Heineman, John T., et al. "A Randomized Controlled Trial of Topical Cannabidiol for the Treatment of Thumb Basal Joint Arthritis." The Journal of Hand Surgery (2022).
Spaans, Anne J., et al. "Conservative treatment of thumb base osteoarthritis: a systematic review." The Journal of hand surgery 40.1 (2015): 16-21.
Vanessa Prokuski-Lund is a hand and orthopedic surgeon in Massachusetts. She is an Associate Professor of Orthopaedic Surgery at the Warren Alpert School of Medicine at Brown University.