, Gloucester, MA

February 22, 2013

On the Mend: Tapping into hand pain: Signs may point to arthritis

On the Mend
Joe DiVincenzo

---- — If you’re above the age of 55, there’s a strong likelihood that you have a touch of arthritis in your hands — and that’s no pun.

Osteoarthritis, the most common form of arthritis, affects tens of millions of Americans annually — and as the average age of the population in this country rises, it will be more prevalent than ever before.

While it’s nearly impossible to prevent arthritis, you certainly can slow the process and manage symptoms once it arises — that is, if you know you have it.

Here is a list of the most common signs and symptoms of hand arthritis. If the following descriptions closely match how you feel, schedule an appointment with a hand clinician.

Stiff, achy hands indicate that there may be a problem with the cartilage lining the joints. Cartilage helps joints glide over each other, essentially creating a friction-free environment. In fact, some joints are so smooth, there’s less friction than ice gliding on ice. But if the cartilage wears thin it becomes bumpy and irregularly shaped. These irregularities cause increased joint pressure, altered mechanics and thus, arthritis.

If you feel like your knuckles are grinding when you move your fingers, you probably have significant “bone-on-bone” contact. When the soft and smooth cartilage is damaged or removed, the hard bone underneath is exposed and causes a grinding or rubbing between the two joint surfaces. The more this occurs, the more likely it is to keep happening. So get checked out if your hands are making noise.

Swollen hands could be the result of inflamed cartilage. Damaged cartilage creates pockets of swelling around the corresponding joints. Cartilage bleeds considerably when injured, and because the hand has numerous small compartments, it’s difficult to evacuate the swelling once it’s rooted in — hence the reason why hands can stay swollen for days before improving.

If your knuckles are drifting away from the center of your hand, it’s a sign that you have significant joint damage. Hallmarked by trailing off in the direction of the pinky finger, arthritic knuckles like these can cause severe pain if overused or misused. If your knuckles are adrift and you haven’t yet had them inspected, it’s time to see a hand specialist.

If it looks as if your hands have grown in size, well, it’s quite possible they have. Arthritic knuckles grow outwards over time. In an effort to repair damaged cartilage, bone will grow in its place. However, the new bone has no substantial lining and the resulting situation is ‘bone on bone.’ This causes more stress-related bone growth and perpetuates the arthritic cycle.

If you’ve lost hand strength, it could be because arthritic joints are weaker than normal ones. Once infiltrated with arthritis, the joint will deform and become misshapen. Muscles and tendons are sensitive to both joint destruction deviations from normal anatomical alignment. If any of these variables are out of place, it might be hard for you to open jars, hold heavy plates or grip anything for any length of time.

Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes “On the Mend” weekly. Questions may be submitted by email to