Older woman safely gardening to avoid a flare-up in her arthritis

Arthritis in the Hand: Being Mindful During Home DIYs

By: Nicholas A. Smerlis, MD, FAAOS, CAQSH
Published: May 22, 2020

With more time at home during quarantine, now is a great time to tackle that home to-do list. Working in flower beds, power-washing the driveway, or even finally taking the time to build a new piece of furniture are all great activities to start. But be careful, the possibility of an arthritic flare-up lurks for some projects. 

Be Mindful of Arthritic Flare-Ups

Older woman safely gardening to avoid a flare-up in her arthritis

As spring blooms, we spend time preparing flower beds, weeding, and pruning. Together, these activities can create the perfect opportunity for arthritis in the hand and wrist to flare, leading to swollen joints and painful movements.

Arthritis is the inflammation of a joint, which occurs when the bones of the joint meet and rub together causing pain, swelling, and stiffness. In a normal joint, cartilage covers the bones to serve as a shock absorber to allow smooth, pain-free movement. For those whose joint cartilage has worn down due to age or repetitive movement, coupled with more time outside laboring in the garden or flower beds, an arthritis flare-up that typically shows itself in colder winter months may be making an unwelcome and unexpected spring appearance.  

Symptoms of Arthritis in the Hand

Pain, swelling, and stiffness are the most common symptoms of arthritis. A common form of arthritis in the hand is Basilar Joint Arthritis. As the condition gets worse in the joint at the base of the thumb (basilar joint), a bump develops as the long bone (metacarpal bone) slides out of the saddle joint (joint at the base of the thumb) and causes limited motion and weakness. This limited movement makes the ability to pinch and grasp difficult.

Diagnosing Arthritis

Arthritis of the hand is diagnosed through a review of personal history and a physical exam.  X-ray imaging may be used to confirm the diagnosis by looking for narrowing of the joint space, the formation of bony outgrowths (osteophytes or “spurs”), or the development of dense, hard areas along the bone margins of the joint.

Treating Arthritis of the Hand

The goal of treatment is to reduce pain and improve movement so you can continue to perform everyday activities.

Conservative, non-operative treatment methods:

Activity Modification

  • Brief periods of rest may help if arthritis has flared up. Try taking water breaks while you are working in your flower beds.

Medications

  • Anti-inflammatory or other painkillers may be beneficial in relieving pain.

Heat and Cold

  • A warm compress or using warm wax might help alleviate symptoms. Use ice and other cold treatment options to reduce swelling.

Bracing

  • Bracing may include soft sleeves or rigid splints for support.

Therapy and Hand Exercises

  • Hand therapy is often helpful by utilizing exercises, splints, and other approaches.

Injections

  • A cortisone injection can often provide relief of symptoms but does not cure arthritis.

Surgical Treatment for Arthritis

Surgery is usually only discussed after non-operative treatments fail to provide relief and the patient has too much pain or too little function. The goal of surgery is to restore as much function as possible and to eliminate or reduce the pain to a tolerable level. 

Joint reconstruction is performed by removing the deteriorated joint in order to eliminate bone to bone contact that causes pain and restricts motion. The joint is then reconstructed to support the thumb bone. 

In some cases, the PIP joint (middle knuckle) is replaced by a silicone joint replacement implant. For the DIP joint (top knuckle), joint fusion is performed to eliminate motion from the problem joint. 

Overcoming Arthritic Flare-Ups

If you suffer from arthritis in the hand, just remember there are options to help eliminate pain. To prevent flare-ups of arthritis, try taking regular breaks, and drink plenty of water. Try switching to other tasks to give your joints some rest. Using gardening tools with bigger handles or electric machinery may help offload the power required to operate self-powered tools such as shears. Work at waist level to avoid squatting or bending. Reach out to a hand specialist when your arthritis becomes bothersome. And as always, listen to your body and give it a break when it asks for one!


About Nicholas A. Smerlis, MD, FAAOS, CAQSH

Nicholas Smerlis, MDBoard certified Orthopedic hand surgeon, Nicholas A. Smerlis, MD, FAAOS, CAQSH has over a decade of experience specializing in the surgical and non-surgical treatment of the hand, wrist, and elbow. Although he specializes in surgery of the hand, not all problems need surgery. Dr. Smerlis often uses non-operative treatments such as medications, splints, injections, and hand therapy to restore function to the hand and wrist. Dr. Smerlis joined TPMG Orthopedics in June 2019 and sees patients in the Newport News and Williamsburg offices.