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Arthritis Today

What Your Hands Say About Your Health

Your hands can’t talk, but they can tell you a lot about your health. Find out how.

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Our hands are one of our greatest tools. Their multiple small joints work together with muscles to produce precise motions and strength. They allow us to button a shirt, open a jar, wave to a neighbor, stroke a pet’s fur or provide a comforting touch. But hands also can be prone to arthritis and related problems and, in some cases, provide clues to what’s happening elsewhere in our body. 

Use your hands – and this story – to learn what your hands may be telling you about your health. And be sure to discuss any concerns you have with your doctor or health professional.

Symptoms: Bony outgrowths on the finger joints, which can interfere with hand function and cause fingers to look deformed.
What it may mean: Nodules on the joint closest to the fingertip, known as Heberden’s nodes, or the middle joint, known as Bouchard’s nodes, are characteristic of osteoarthritis, or OA. As the cartilage in the finger joints wears away, the ends of the bones rub together, stimulating the growth of these bony spurs.
Treatments: Rest, pain relievers, splints, heat or ice, physical therapy, and in severe cases, surgery.

Symptoms: Bumps of rubbery tissue on thumbs, knuckles or other pressure points that get a lot of use
What it may mean: Poorly controlled rheumatoid arthritis, or RA. About 25 percent of people with RA have these nodules, which are associated with more aggressive disease.
Treatments: In some cases, corticosteroid injection directly into the nodules. Nodules often disappear with treatment for underlying disease.

Symptoms: Fingers that change colors – first pale, then bluish, then red – in response to cold temperatures or emotional stress. The color changes may be accompanied by numbness, tingling and pain.
What it may mean: Raynaud’s (ray-nohz) phenomenon, a condition in which the small blood vessels in extremeties – fingers, toes, even the tip of your nose – narrow in response to cold or stress, reducing blood supply. As the blood supply is slowed, skin can turn pale and then blue. As it returns, the skin turns red. Raynaud’s often occurs in conjunction with autoimmune diseases such as rheumatoid arthritis, lupus and scleroderma, but it also can occur on its own.
Treatments: Simple measures such as keeping the extremities warm and avoiding tight fitting jewelry, and in more severe cases, oral medications used to treat high blood pressure.

Symptoms: Pitting or crumbling of the nails; separation of the nails from the bed.
What it may mean: Fungal infection, psoriasis or psoriatic arthritis (especially if accompanied by joint pain).
Treatments: If it’s a fungal infection, an antifungal. Topical steroids or vitamin A or D derivatives are applied directly to the nail, ultraviolet light therapy combined with the prescription drug psoralen, and sometimes surgical removal of the affected nails. Systemic treatment for psoriatic arthritis may also improve the nails.  

Symptoms: Tight, thickened skin on the fingers that often appears shiny and can make bending your fingers difficult.
What it may mean: Scleroderma, a condition characterized by a buildup of collagen in the skin, causing skin tightening and thickening.
Treatments: Physical or occupational therapy, if skin thickening makes movement difficult; ointments and lotions to help soften skin. Other problems, including Raynaud’s phenomenon, calcium deposits under the skin and difficulty swallowing, often go along with skin thickening and will require their own treatment.

Symptoms: A finger that gets stuck – especially when your first wake up in the morning – and is painful when you try to extend it; painful clicking or snapping when you try to flex the affected finger.
What it may mean: Trigger finger, a condition that happens when the tendons that move the fingers thicken or become inflamed. Tendons in the hand are like ropes that move the fingers; these ropes run through tunnels, or sheaths, that hold them in place. If the tendon – or the sheath through which it moves – becomes thickened, movement can be difficult. Bending the finger may pull the swollen portion through the narrowed sheath, making a popping or snapping noise and causing pain.
Treatments: Use of a splint to keep the finger straight, or in more severe cases, nonsteroidal anti-inflammatory drugs, or NSAIDs, steroid injections and/or surgery to loosen the tendon sheath.

Symptoms: Painless bending/curling of the fingers toward the palm of the hand.
What it may mean: Dupuytren’s disease, a condition in which the connective tissue under the skin of the palm of the hand becomes thickened, eventually forming tough bands, or cords, of tissue, which can cause the fingers to bend toward the palm. This is called Dupuytren's contracture.
Treatments: Splints, an injection of an enzyme called collagenase to break up the cord, or surgery to cut the cord.

Symptoms: Tingling, numbness, weakness, or pain felt in the thumb, index finger, middle finger, thumb side of the ring finger and/or palm. You may have symptoms in one hand, or if both hands are affected, they may be worse in one hand.
What it may mean: Carpal tunnel syndrome, a condition in which swelling of tissues in the wrist puts pressure on the median nerve, which supplies movement and feeling to the thumb side of the hand. In severe cases the nerve can become irreversibly damaged, permanently affecting hand function.
Treatments: A splint to support the wrist, hot and cold compresses, oral NSAIDs, corticosteroid injections directly in to the wrist and, in some cases, surgery to release the compressed nerve.

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