How do arthritis gloves help reduce pain in patients with arthritis?

How Arthritis Gloves Help Reduce Pain in Arthritis

Arthritis gloves primarily help reduce pain through providing warmth and compression to the joints of the hand, though evidence for their effectiveness is limited and recent high-quality research suggests they may not provide clinically important benefits beyond regular gloves. 1

Mechanisms of Action

Arthritis gloves are believed to work through several mechanisms:

1. Warmth and Compression:

   • Gloves may offer benefit by providing warmth and compression to the joints of the hand 1
   • The thermal qualities and mild compression may help improve blood circulation to the affected joints

2. Joint Support:

   • Gloves can provide mild support to affected joints, potentially reducing pain during movement
   • They may help stabilize joints during daily activities

3. Proprioceptive Feedback:

   • The pressure and tactile sensation may improve joint position awareness
   • This could help patients better control hand movements and reduce strain

Evidence for Effectiveness

The evidence regarding arthritis gloves is mixed and generally limited:

• Recent High-Quality Evidence: The A-GLOVES randomized controlled trial found that arthritis gloves (applying 23-32 mmHg pressure) showed no clinically important effect compared to loose-fitting placebo gloves on hand pain, function, or stiffness 2

• Patient Perceptions: In a nested questionnaire study within the A-GLOVES trial, similar percentages of participants (73%) reported benefits from both arthritis gloves and loose-fitting control gloves, with warmth (54-59%) and comfort (54-62%) being the most commonly reported benefits 3

• Historical Evidence: An older small study (1979) with 23 patients suggested that compression gloves worn during sleep improved hand symptoms including morning stiffness, pain, and swelling compared to loose-fitting gloves 4

Current Clinical Practice

According to the 2019 American College of Rheumatology/Arthritis Foundation guidelines for osteoarthritis:

• Hand orthoses (including gloves) are strongly recommended for patients with first carpometacarpal (CMC) joint OA
• Hand orthoses are conditionally recommended for patients with OA in other joints of the hand 1

The guidelines note that "gloves may offer benefit by providing warmth and compression to the joints of the hand" but acknowledge that "data are insufficient to recommend one type of orthosis over another for use in the hand." 1

Practical Considerations

• Usage Patterns: Current practice involves providing open-finger gloves (commonly Isotoner™) for both day and night wear, with advice to wear them "as and when" for symptom relief 5

• Potential Issues:

  • Patients report problems with gloves being too hot at night
  • Inability to wear gloves for wet or dirty activities during the day 3
  • About 6-7% of patients discontinue glove wear due to adverse effects 2

• Cost-Effectiveness: The A-GLOVES trial found that provision of arthritis gloves cost £129 with no additional benefit over placebo gloves, suggesting they are not cost-effective 2

Recommendations for Patients

For patients with hand arthritis seeking pain relief:

1. Consider that regular gloves may provide similar warmth benefits to specialized arthritis gloves
2. If using arthritis gloves, avoid continuous wear during the day
3. Regularly perform hand exercises while using gloves
4. Monitor for potential adverse effects such as skin discoloration
5. Consult with an occupational therapist for proper fitting and usage instructions

While arthritis gloves continue to be widely prescribed, patients should maintain realistic expectations about their benefits given the limited evidence for their effectiveness beyond the warmth and mild compression they provide.