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Hand Osteoarthritis

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Hand Osteoarthritis

Introduction

Osteoarthritis (OA) is a condition which causes joint pains and is thought to affect about 1 in 4 people aged 50 years and over. It can be diagnosed clinically, without an x-ray. It can make things you are used to doing more difficult and painful, resulting from structural changes in the joints.

Signs & Symptoms

Joint pain occurs frequently in both hands but the pattern of pain and signs of OA can affect each person, and hand, differently. However, the location of finger nodes (swellings) is often similar. You may notice that the affected joints are stiff first thing in the morning and begin to ease with gentle movement.

Causes

There is evidence to say that repetitive hand movements over time and previous hand injuries may make a person more likely to develop symptoms. Being overweight, over 40 years old, being female and having a family history of OA, have also all shown to be prevalent in those diagnosed with hand OA. The condition often coexists with other conditions, such as carpal tunnel syndrome and trigger finger, but no-one knows exactly why some people get OA in their hands and others don’t.

 

Assessment & Diagnosis

Your clinician will take a detailed history of your symptoms and will carry out a thorough physical assessment to help understand your physical limitations and produce a diagnosis. We provide a precise and accurate diagnosis so that the most effective treatment and management can be initiated straight away, helping to produce favourable outcomes.

Self-Management

There are treatments available and lifestyle changes you can make to the way you use your hands and undertake daily activities to help ease pain and swelling, all of which your Physiotherapist at Pure can explain. Making small changes – The 6 P’s can make a BIG difference. Being more aware of how you use your hands in everyday activities helps to identify which movements particularly contribute to pain, aching and joint difficulties (Keele University 2015).

 

Pain: Make a note of your pain and which activities or movements make it worse or better.

 

Positioning: Change your hand position regularly and try to reduce repetitive movements. Be aware of the position of your hands when doing everyday activities and check you are not over stretching. Think about what happens to your fingers when you turn a tap on or open a jar. Are they twisted into a painful position? Can you think of other ways to do these things?

 

Protection: Try to reduce joint strain by adapting lifting, pushing and twisting movements. Think about how you can use your joints differently, e.g. use a tray to carry cups to spread the load, use gadgets to help, use two hands instead of one. When doing DIY or gardening, grip handles less tightly. It may help you to try and to use your palm and fingers only, keeping the thumb out of the way.

 

Pacing: Take regular, short ‘microbreaks’ to stretch your joints. Save your energy by planning activities and swap between tasks to change position. Avoid peaks and troughs, and build up your activity levels slowly. Even out heavier and lighter jobs throughout the day and the week.

 

Problem Solving: Analyse problems and identify possible causes. Identify a range of possible solutions and try these solutions in turn to see which work best for you. Try using stronger and larger joints for activities, e.g. hips to push open doors. Look for help and support if you’re having difficulties at work. Speak to your manager for advice and guidance. Take more frequent breaks consider moving to an area of work where you don’t use your hands as much.

 

Planning: Be more active when you have less or no pain, and try to avoid certain jobs when you have pain. If you can, organise tasks more efficiently by breaking jobs up into smaller tasks, or spread tasks out over a longer period. Remember to take breaks, try to avoid buying clothes with lots of buttons and buy plastic mugs if glass ones are too heavy. It may help you to find out what is going on ‘under your skin,’ by learning more about your condition you could help yourself to better manage it. Remember, a joint can remodel itself. Arthritis is wear and repair, NOT wear and tear.

Physiotherapy

Research by Oppong (2015) shows if you improve your grip and hand strength it will help your hand pain. Stress balls, thumb flexing, using play-dough and doing flexibility exercises in warm water, e.g. the bath or the sink, can all be useful. At Pure Physiotherapy, our clinicians can create an individualised exercise plan based on your physical ability and what is important to you. We will work with you to establish clear goals for you to work towards throughout your rehabilitation journey. With regular re-assessment, your Physiotherapist can make adjustment to your exercise plan so that it remains optimal in developing strength and maintaining flexibility. Your Physiotherapist will provide ongoing advice and support for you to feel confident in managing your symptoms independently and minimise the likelihood of future episodes on increased pain and discomfort.

Resources

References

Keele University Arthritis Research UK Primary Care Centre SMOOTH study — Dziedzic, K., Nicholls, E., Hill, S., Hammond, A., Handy, J., Thomas, E. and Hay, E. (2015). Self-management approaches for osteoarthritis in the hand: a 2× 2 factorial randomised trial. Annals of the rheumatic diseases, 74(1), 108-118.

 

Oppong, R., Jowett, S., Nicholls, E., Whitehurst, D.G., Hill, S., Hammond, A., Hay, E.M. and Dziedzic, K. (2015). Joint protection and hand exercises for hand osteoarthritis: an economic evaluation comparing methods for the analysis of factorial trials. Rheumatology54(5), 876-883.

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