Hand & wrist condition
Arthritis in the hand concentrates in two places, and they behave quite differently. The joint at the base of the thumb is the workhorse — a saddle-shaped joint that carries many times the force of whatever you are pinching — and it is the commonest site of hand arthritis needing treatment, giving a deep ache with keys, jars and taps. The finger joints tell another story: firm bony bumps and stiffness, usually near the fingernails, often running in families. Those bumps are wear, not rheumatoid — a distinction worth getting right. This page explains both, and why hand arthritis is far more treatable than “it’s just age” suggests.
Tap any that apply to you — this is guidance, not a diagnosis, but it helps tell joint wear from the other causes of hand pain.
That fits hand arthritis — and there is a good deal that helps. Base-of-thumb wear responds well to joint protection, a supportive splint, hand therapy and, where needed, a targeted injection, with reliable surgery in reserve. One pattern is worth separating out promptly: soft, boggy swelling of the knuckles in both hands with prolonged morning stiffness suggests inflammatory arthritis rather than wear, and that needs treatment aimed at the disease itself, started early.
If your thumb-side pain sits higher, at the wrist rather than at the joint itself, it may be an irritated tendon sheath rather than arthritis. De Quervain’s causes pain around the watch-strap line and bites when lifting with the thumb held out, while thumb-base arthritis grinds lower down with pinching. They are readily told apart. More: De Quervain’s
Hand arthritis concentrates in particular joints, and which one is affected shapes everything:
The most useful change is not doing less with the hand, but doing it differently. Spread load across the whole hand instead of pinching: use jar openers and lever taps, hold a pen with a fatter barrel, carry bags on the forearm rather than pinched between finger and thumb, and swap tight pinch grips for whole-hand grips wherever a task allows. A supportive splint for the base of the thumb, worn for provoking activities or overnight, settles a painful joint well. What to avoid is the instinct to stop using the hand altogether — the muscles that stabilise the thumb weaken quickly, grip declines, and the joint typically becomes stiffer and more painful, not less. Keep the hand active within comfortable limits. And if the picture is soft, swollen knuckles in both hands with morning stiffness lasting well over an hour, that is a different problem from wear and worth having assessed promptly, because inflammatory arthritis does best when treatment starts early.
The plan differs by which joints are involved — tap the one that fits:
Base-of-thumb arthritis responds well, and most people avoid surgery. Joint protection, a supportive splint for provoking tasks or overnight, and hand therapy to strengthen the stabilising muscles relieve a great many. A targeted injection settles a stubborn flare. Where wear is advanced and pain persists, surgery at this joint is reliable and long established.
Bony bumps at the finger joints are wear, not rheumatoid — and often less troublesome than they look. Many settle into stiff but manageable joints, helped by hand therapy, adapting grips and treating flares. It is still worth confirming the diagnosis, mainly to separate it from inflammatory arthritis, which needs an entirely different approach.
When arthritis is limiting everyday tasks, it is worth a proper look at all the options. Struggling with jars, keys, buttons and taps is not something to simply accept. Hand therapy and joint protection often restore a surprising amount, injections help flares, and surgery for a badly worn thumb base reliably relieves pain and restores useful pinch.
Thumb and finger arthritis treatment climbs gradually, and most people are helped well before the top:
Tap each card to reveal the truth:
Two places above all. The joint at the base of the thumb is the commonest site needing treatment, because it is a saddle-shaped joint built for mobility that takes enormous force every time you pinch — grip something between thumb and finger and the load through that joint is many times the force at your fingertips. The other is the finger joints, particularly the small joints nearest the fingernails and, less often, the middle joints. Arthritis in those tends to show as firm bony bumps and stiffness. The knuckles at the base of the fingers are less commonly affected by wear, and when they are prominently involved it raises the question of inflammatory arthritis instead.
A deep ache at the base of the thumb, right where it meets the wrist, provoked by pinching and twisting rather than by resting. The classic triggers are turning a key, opening a jar, twisting a tap, pinching a clothes peg and holding a pen. People often notice grip weakness, or that they have started opening jars differently without consciously deciding to. Over time the joint can develop a squared-off, more prominent look at the base of the thumb, and some feel a grinding or crunching sensation as it moves. It is distinct from De Quervain’s, which sits higher, at the wrist itself.
Usually the opposite. Firm, bony bumps on the small joints near the fingernails, and sometimes the middle joints, are the classic appearance of osteoarthritis — wear — and they often run in families. Rheumatoid and other inflammatory arthritis behaves differently: it tends to affect the knuckles at the base of the fingers and the wrists, often symmetrically in both hands, with soft, boggy swelling rather than hard bumps, and prolonged morning stiffness lasting well over an hour. The distinction matters a great deal, because inflammatory arthritis needs medical treatment aimed at the disease itself, and the earlier that starts the better.
Not in the way people fear. Sensibly protecting the joints — spreading load, using larger grips and jar openers, avoiding sustained hard pinching — genuinely reduces pain and strain. But avoiding use altogether is counterproductive: the muscles that stabilise the thumb and hand weaken, grip declines, and the joints become stiffer and more painful, not less. The goal is to change how you load the hand rather than to stop loading it. Guided hand therapy is valuable precisely because it teaches that distinction and builds the supporting muscles that take pressure off the worn joint.
A great deal, and base-of-thumb arthritis in particular is one of the more satisfying problems to treat. Most people improve substantially without surgery: joint protection and adapting how you grip, a supportive splint worn for activities or at night, hand therapy to strengthen the muscles that stabilise the joint, and a targeted injection to settle a painful flare. Where the joint is badly worn and the pain persists despite all that, surgery is reliable — removing the small worn wrist bone at the base of the thumb relieves pain well and is a long-established operation. For finger joints, fusion or joint replacement is available depending on which joint and what you need from it.
Same-day appointments are usually available. Call or book online — our team will take it from there.
