Degenerative Arthritis of the Hand

What is degenerative arthritis?

Degenerative arthritis is a slowly progressive arthritis of unknown cause which affects several joints. It occurs late in life and mainly affects the hands and large weight-bearing joints. Degenerative arthritis causes pain, deformity, and limitation of motion.

What causes degenerative joint disease?

The cause of degenerative joint disease is largely unknown. However, a number of factors are important in the development and progression of the disorder. Some people inherit the tendency to develop arthritis and often develop it at an earlier age. Mechanical factors, such as joint alignment, laxity of joints, overuse or excessive loading of joints, are also important. Previous injuries may also play a role. A good way to think of degenerative joint disease is as the accumulation of the wear and tear on our joints from a lifetime of heavy usage.

Who is affected by degenerative arthritis?

Degenerative arthritis primarily affects older patients. X-ray studies show that 80 to 90 percent of adults over the age of 75 have arthritis.. Women are more severely affected than men.

What are the symptoms of degenerative arthritis?

Pain is the main symptom of degenerative arthritis. The pain is usually felt at the involved joints (localized). In the early stages of the disorder, the amount of pain may vary. There may be days or weeks without any pain, and then there may be periods of constant pain.

Degenerative arthritis may affect a single joint or many joints. The disorder generally increases slowly over many months. The pain caused by degenerative arthritis may be made worse by a variety of daily activities, and is often relieved by rest.

Other symptoms include:

How is degenerative arthritis diagnosed ?

A physical examination identifies the painful joints, the limited motion, deformity, and instability. An X-ray is used to confirm the diagnosis and to demonstrate the extent of joint involvement.

What is the treatment for degenerative arthritis?

Conservative treatment consists of resting the involved painful joints. This may mean immobilizing (prevent movement) or splinting a joint, and restricting or modifying activities. Anti-inflammatory medication is often helpful. Cortisone injection of a particularly painful joint often can often relieve the pain for a period of time. The injection can be repeated in several months. It is important to gently exercise the joints through the full range of motion daily.

Is surgical treatment available?

Surgical treatment is offered when conservative treatment methods fail. Pain that is inadequately controlled by other means is the main reason for surgery. Joint motion is not improved with reconstruction, but pain can be substantially improved or relieved.

For the joint at the end of the finger, a surgical procedure known as an arthrodesis or fusion is done. This procedure makes that joint permanently stiff in a straight position. Because of the pain relief, overall function is improved.

For the the joint in the middle of the finger, either a joint fusion or a joint replacement procedure is performed. The fusion offers stability and is always done for the index finger.

A joint replacement provides some motion, but less stability. There is some risk of recurrent deformity with this procedure.

The other joint of the hand that's commonly involved in painful arthritis is the joint at the base of the thumb. Reconstructive surgery for this joint involves removing the arthritic bone and replacing it with a piece of rolled-up tendon removed from the forearm of the same arm. This procedure provides excellent pain relief, allows good range of motion, and restores good function to the thumb.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit www.clevelandclinic.org/health/ or www.clevelandclinicflorida.org. This document was last reviewed on: 5/20/2004

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