From the Guidelines
Yes, there are several effective treatments for hand arthritis, and the most recent guidelines recommend a multimodal approach to manage symptoms and improve quality of life. According to the 2019 EULAR recommendations for the management of hand osteoarthritis 1, treatment should be individualized and consider the unique functionality of the hands compared to large joints.
Treatment Options
- Over-the-counter pain relievers like acetaminophen (Tylenol) at 325-650mg every 4-6 hours as needed, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) at 200-400mg three times daily with food, or naproxen (Aleve) at 220-440mg twice daily
- Topical treatments like diclofenac gel (Voltaren) applied to painful joints 3-4 times daily for localized relief with fewer side effects
- Physical therapy exercises to maintain joint flexibility and strengthen surrounding muscles, along with splinting to support painful joints, especially at night
- Heat and cold therapy to manage pain—warm paraffin baths or heating pads for stiffness, and ice packs for inflammation
- For more severe cases, corticosteroid injections may provide temporary relief, while disease-modifying antirheumatic drugs (DMARDs) might be prescribed for inflammatory arthritis
Lifestyle Modifications
- Using ergonomic tools to reduce strain on the hands
- Avoiding activities that aggravate symptoms
- Maintaining a healthy weight to reduce pressure on the joints
- Engaging in regular exercise to improve joint mobility and strength
The American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee 1 also support the use of nonpharmacologic modalities such as instruction in joint protection techniques, provision of assistive devices, and use of thermal modalities. Additionally, the NICE guidelines for the care and management of osteoarthritis in adults 1 recommend a stepped approach to treatment, starting with core treatments such as education, exercise, and weight loss, and progressing to pharmacologic and surgical options as needed. Overall, a comprehensive treatment plan that incorporates both pharmacologic and nonpharmacologic interventions can help improve symptoms, function, and quality of life for individuals with hand arthritis.
From the Research
Treatment Options for Hand Arthritis
- There are various treatment options available for hand arthritis, including exercise, medication, and lifestyle changes.
- A study published in 2018 2 found that hand exercise probably slightly improves hand function in the medium and long term, but has little or no difference on pain.
- The same study found that exercise compared to usual care has little or no benefit on mean grip strength and pinch strength in the medium and long term.
Medication Options
- Medications such as methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine are commonly used to treat rheumatoid arthritis 3.
- Biologic agents such as anti-TNF, abatacept, and tocilizumab may also be used to treat rheumatoid arthritis, especially if patients have a suboptimal response or are intolerant to traditional disease-modifying agents 3.
- A study published in 2022 4 recommends starting effective treatment immediately with DMARDs to reduce disability and using a treat-to-target strategy to achieve low disease activity or remission.
Safety of Non-Steroidal Anti-Inflammatory Drugs
- A study published in 2011 5 found that the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) with methotrexate appears to be safe, provided appropriate monitoring is performed.
- However, the use of anti-inflammatory doses of aspirin should be avoided due to the risk of adverse effects such as liver and renal dysfunction 5.
Hand Osteoarthritis
- A study published in 2016 6 found that hand osteoarthritis is a prevalent disease that can lead to substantial pain and physical disability.
- Currently, there are no disease-modifying drugs available for the treatment of hand osteoarthritis, but research is ongoing to develop new treatments, including the use of methotrexate 6.