From the Guidelines
Fingers arthritis can be effectively managed with a combination of education, exercises, and topical treatments, prioritizing patient-centered care and minimizing systemic side effects, as recommended by the most recent guidelines 1.
Management Strategies
To manage fingers arthritis, consider the following approaches:
- Education and training in ergonomic principles, pacing of activity, and use of assistive devices, which should be offered to every patient, as it improves function and reduces pain 1.
- Exercises to improve function and muscle strength, as well as to reduce pain, should be considered for every patient, with a focus on gentle finger exercises to maintain mobility 1.
- Topical treatments, such as topical NSAIDs, are preferred over systemic treatments due to safety reasons and should be the first pharmacological topical treatment of choice 1.
Medication and Interventions
For pain relief, the following options can be considered:
- Topical NSAIDs, like diclofenac gel, applied to affected joints 3-4 times daily, providing localized relief with fewer side effects 1.
- Oral analgesics, particularly NSAIDs, should be considered for a limited duration for relief of symptoms, with careful monitoring of side effects 1.
- Intra-articular injections of glucocorticoids may be considered in patients with painful interphalangeal joints, although their use is generally not recommended for hand OA 1.
Lifestyle Modifications
Additional lifestyle modifications can help alleviate symptoms:
- Applying heat for morning stiffness or cold packs for inflammation (15 minutes at a time) can provide comfort 1.
- Wearing compression gloves at night may reduce morning pain and stiffness.
- Maintaining a healthy weight, engaging in regular exercise, and avoiding repetitive strain on the fingers can also help manage symptoms.
From the Research
Fingers Arthritis Treatment Options
- Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to treat fingers arthritis, including trigger finger, with low-certainty evidence showing little to no benefit over glucocorticoid injection 2
- Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfasalazine, and leflunomide may be used to treat rheumatoid arthritis, which can affect the fingers 3, 4, 5
- Biologic agents such as tumor necrosis factor (TNF)-alpha inhibitors, abatacept, and rituximab may be used to treat rheumatoid arthritis, but their effectiveness in treating fingers arthritis specifically is unclear 3, 4, 5
- For osteoarthritis, which can also affect the fingers, treatment options include pain and inflammation control with non-steroidal anti-inflammatory drugs, analgesics, and intraarticular corticosteroids, as well as symptomatic slow-acting drugs such as glucosamine sulfate and chondroitin sulfate 6
Fingers Arthritis Management
- Early aggressive therapy with a combination of drugs or biological agents may be warranted for the effective treatment of rheumatoid arthritis, which can affect the fingers 4
- Treatment of osteoarthritis, which can also affect the fingers, is still a challenge, and no disease-modifying drugs are currently available 6
- Further research is needed to investigate the efficacy of new biologic agents and other potential therapies for osteoarthritis, including those that target the nerve growth factor-β and bone metabolism 6
Fingers Arthritis Treatment Considerations
- The choice of treatment for fingers arthritis depends on the underlying cause, such as rheumatoid arthritis or osteoarthritis, and the severity of symptoms 2, 3, 4, 5, 6
- Potential side effects of treatment, such as infections and infusion or injection site reactions, should be considered when selecting a treatment option 5
- Patients being considered for biologic agents should be screened annually for tuberculosis and should receive pneumococcal, influenza, and hepatitis B vaccinations 5