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Rheumatoid Arthritis in Hands and Fingers: What You Need To Know

Updated on March 03, 2021
Medically reviewed by
Diane M. Horowitz, M.D.
Article written by
Laurie Berger

Rheumatoid arthritis (RA), a chronic inflammatory disease, can strike anywhere in the body. Most frequently, RA attacks the small joints of the hand, fingers, and wrists. This makes it difficult to perform daily activities, such as tying a shoelace or gripping a coffee cup.

Approximately 1.5 million people in the U.S. have rheumatoid arthritis. Women are three times more likely than men to develop RA and its complications of the hand and finger joints, which are often the first place RA appears.

More than 5,600 members of myRAteam report crippling joint pain, stiffness, swelling, and deformities in their hands. These symptoms not only hurt them physically, they also affect their self-esteem, work, and overall quality of life.

“My hands hurt so bad they’re useless most days,” said one member. “I can’t make a fist or bend my deformed fingers at all. Not being able to use my hands has taken a toll on me,” another lamented. Yet another member shared, “I've been told I have the hands of a 90-year-old at age 57.”

What Does Rheumatoid Arthritis in Hands and Fingers Feel Like?

RA in hands and fingers affects everyone differently. Members of myRAteam describe their unique experiences of RA symptoms:

  • “Bones feel like they’re twisting inside my fingers.”
  • “Fingers turning sideways on both hands.”
  • “Swollen fingers look like hot dogs.”
  • “Feels like fire ants all over.”

How Does Joint Pain in Hands and Fingers Affect Members?

The symptoms of RA in hands and fingers significantly disrupt myRAteam members’ daily lives in many ways. Many members report that this type of arthritis makes it hard to grip, pinch, or squeeze things with their hands. “It’s frustrating to not be able to turn a doorknob, open jars, or lift heavy cookware,” said one member. “I need both hands to balance a coffee mug,” explained another. “I can’t hold onto my pills without dropping them,” said another.

Loss of hand function can also be dangerous. Members say they’ve dropped a cup of coffee or lost control of a pot of hot water. One member said, “I was changing the toilet paper roll and, because my hands don't work, the holder shot out of my hand and popped me in the eye!”

On the Job

Job performance often suffers for people living with rheumatoid arthritis. According to a 20-year study, one-third of people with RA felt limited at work within one year of diagnosis, and 40 percent were registered as work disabled within three years.

RA in the hands, specifically, has impacted members’ livelihoods. “The tips of my fingers are killing me, and I can’t type very long,” shared one. “My severe RA has made work more difficult,” said another. Others have trouble just getting to work. “I was slow getting dressed today and late again for work. I’m doing my best not to get fired, but no one understands.”

Socializing

Arthritic hands are embarrassing for many myRAteam members and prevent them from engaging in social activities. “I was invited to our neighbor’s house for a BBQ steak supper, but was afraid to go because I might not be able to cut the steak. Embarrassing!” wrote one member.

Relationships

Marriage and family relationships have also been affected. “I've cut myself off from most everyone. They don't understand the pain I deal with every day,” shared one member. Another revealed, “My husband and I have been trying to have intercourse, but it’s so hard. The first time we tried, my hands were in agony. I ended up crying and feeling like a complete failure.”

How Does RA Affect the Hands and Fingers?

Rheumatoid arthritis occurs when the immune system attacks the joint lining or synovium — the tissue that produces fluid to help joints move smoothly. The resulting stiffness, swelling, joint damage, and deformities make it difficult to use the hands. When joint damage becomes severe, it can lead to complete loss of joint function and the need for joint replacement surgery.

RA typically starts in the small joints of the hands. Joints most commonly affected are the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints — better known as knuckles. RA hand symptoms can include:

  • Creaking sounds during movement
  • Swelling of wrist and hand joints
  • A soft lump on the back of the hand that moves when straightening fingers
  • Fingers bending away from the thumb
  • Inability to straighten or bend a finger or thumb (trigger finger or stenosing tenosynovitis)
  • Swelling and inflammation of tendons that cause finger numbness and tingling (carpal tunnel syndrome)
  • Bent middle finger (Boutonniere deformity)
  • Overextended middle joint and bent fingertip (swan neck deformity)
  • Thumb flexing at the MCP joint and hyperextending at the PIP joint (also called Z-shaped deformity or hitchhiker’s thumb)

Other Causes of Hand and Finger Symptoms

RA hand symptoms can mimic those of other conditions, such as osteoarthritis. Some members of myRAteam discovered their hand pain was actually related to secondary Raynaud’s disease, a vascular condition that affects 10 percent to 20 percent of people with RA. Psoriatic arthritis, another autoimmune disease, can also cause hand and finger dysfunction — as can pinched nerves in the neck.

A rheumatologist can diagnose the specific cause of symptoms in the hand with a physical exam and X-rays. X-rays can detect narrowing of joint space or erosions of the bone that could signal RA. Ultrasound and MRI technology has improved the ability to spot joint damage earlier in the course of the disease.

How Is RA in the Hands Treated?

There’s no cure for RA, but treatment can help reduce joint pain and swelling and improve the ability to perform day-to-day activities. For the most part, RA in the hands is managed with the same medications and treatment options used to treat rheumatoid arthritis in general. However, some treatments are specific to hand and finger RA.

See what rheumatologist Dr. Ashira Blazer says about managing pain and stiffness in fingers and wrists.

Nonsurgical Therapies

An occupational therapist can help you design an exercise program and may also prescribe splints to improve function and slow the progression of deformity in the hands.

Splints and orthoses are often recommended to decrease pain, swelling, and deformity from RA. They include resting hand splints, wrist supports, and finger splints. “My RA doctor wants me to wear a splint at night for my trigger finger,” wrote one member. Another said a splint helps prevent her hands from “curling in and creating morning stiffness and pain.”

Members of myRAteam exercise their hands to keep joints loose. “I regularly flex my fingers and hands and lift 5-pound weights,” said one member. Another says he squeezes a “soft spongy ball” while binge-watching TV shows.

A therapist may also suggest RA-friendly assistive devices to avoid stressing painful joints. A kitchen knife with a hand grip, for example, helps protect finger and wrist joints. Tools such as buttonhooks can make it easier to get dressed. One member of myRAteam asked her pharmacist to “put different lids on my medication vials that are easier to open.” Another purchased Fiskars scissors. “You squeeze to cut, then they automatically open back up for you.”

Arthritis gloves may also be recommended — and they are a favorite of myRAteam members. Gloves come in different forms. There are thermal gloves that warm the hand and compression gloves that provide pressure to reduce stiffness and swelling. A 2014 study reported strong improvement in RA symptoms from the use of therapy gloves.

“Compression gloves are the best — I type all day and when my hands are bad, they are such a lifesaver!” said one member. “I wear my compression gloves to sleep at night. They really seem to work really well because I have deformities in my fingers,” said another.

To be effective, therapy gloves must be the right size and worn for at least eight hours. They’re not recommended for people living with carpal tunnel syndrome or Raynaud’s disease. Check with your doctor before purchasing therapy gloves.

Surgical Procedures

If medications or therapy fail to prevent or slow joint damage in your fingers and hands, your doctor may recommend surgery to repair damaged joints. Joint surgery is frequently discussed on myRAteam. Surgery carries a risk of bleeding, infection, and pain. Discuss the benefits and risks with your doctor.

Carpal Tunnel Release

This procedure releases or cuts a ligament in the wrist to relieve pressure on the median nerve, which supplies feeling to the hand. “I had great luck with carpal tunnel surgery. After 45 days, I was able to work cattle and I roped 26 calves,” shared one member. Another added, “I lost all feeling in three fingers. After surgery, the feeling returned, and I haven't had a problem since.” Carpal tunnel release may restore feeling, but it won’t stop RA from progressing.

Trigger Finger Release

If your finger or thumb is stuck in a flexed or bent position, this surgery may help release the blocked tendon to prevent permanent stiffness. “I had tendon release surgery on all fingers. The surgeries are really very minor, and I haven't had much trouble with tendons sticking since,” shared one member.

Joint Replacement

Joint replacement surgery, or arthroplasty, involves removing the damaged parts of your joint and replacing them with a prosthesis made of metal and plastic. “I have had five hand surgeries. I can now move my fingers,” shared one member.

Complementary Therapies for Hand RA

When used along with rheumatoid arthritis medications, myRAteam members reported that these approaches helped manage their hand RA.

Heat or Cold

Heat can help ease pain and relax tense muscles. Cold may dull or numb pain. Some members soak in Epsom salts or ice their swollen hands. One member said, “I run my hand, fingers, or wrist under the hottest water I can stand and flex whatever area hurts.”

Over-the-Counter Topicals

“Arnica (homeopathic) gel applied two to three times a day makes the pain tolerable,” said one member. "Blue Stop, from emu and tea tree oil, helps the aches and pains in my hands,” shared another. “I've gotten a lot of relief from CBD (cannabidiol) salve [where legally available]. My rheumatologist recommended it,” another said.

Paraffin Wax

A wax bath for the hands can provide temporary relief from arthritis pain and sore joints or muscles. You can purchase or rent a paraffin unit to heat the wax. “I do it for 20-30 minutes and it definitely takes the edge off of it,” said one member. “It feels really good, like going to the spa!” said another member.

Curcumin

This supplement has anti-inflammatory and antiarthritic properties. A small 2012 study showed significant improvement in RA symptoms after taking curcumin (turmeric) in conjunction with diclofenac dodium. “I take 1,300 milligrams daily and I was able to reduce my oxycodone levels,” said one member.

You Are Not Alone: Finding Support for RA in the Hands

By joining myRAteam, the social network and online support group for those living with rheumatoid arthritis, you gain a support group more than 144,000 members strong. Hand and finger pain is one of the top 10 most discussed topics.

How does RA in your hands and fingers affect your daily life? Has your rheumatologist found the right medication to manage your symptoms? What helps you successfully get through each day? Share your tips and experiences in a comment below or on myRAteam. You'll be surprised how many other members have similar stories.

All updates must be accompanied by text or a picture.
Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here.
Laurie Berger has been a health care writer, reporter, and editor for the past 14 years. Learn more about her here.

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