If you’ve been experiencing persistent pain in your hands, you may be wondering if arthritis could be to blame. But which type of arthritis in your hands might be the issue? The answer isn’t always obvious.
The two most common forms of arthritis — osteoarthritis (OA, or degenerative arthritis caused by wear and tear on the joints) and rheumatoid arthritis (RA, an inflammatory type of arthritis caused by inflammation in the joint) — share many symptoms in common. Plus, there are other, less common forms of inflammatory arthritis that affect the hands that your doctor will need to consider as well.
Types of Arthritis in the Hands
Both osteoarthritis and inflammatory arthritis can cause pain, stiffness (particularly in the morning), swelling, and tenderness of the joints in the hands. But people with inflammatory forms of arthritis like rheumatoid arthritis may display additional symptoms that aren’t seen in those with OA.
“OA patients lack the warmth and redness in the hands that patients with inflammatory arthritis have,” says Kevin Wayne Byram, MD, assistant professor of medicine, division of rheumatology and immunology and director of the Vanderbilt Vasculitis Clinic at Vanderbilt University Medical Center. “In addition, both hands are usually affected in those with inflammatory arthritis, while symptoms of OA are typically worse in the patient’s dominant hand.”
How long morning stiffness lasts can be revealing in determining which kind of hand arthritis you may have, he adds. People with inflammatory arthritis usually experience prolonged stiffness that lasts an hour or longer, while stiffness often eases in just five to 15 minutes in those with OA.
If your hand arthritis symptoms suggest inflammatory arthritis, Dr. Byram says the most likely culprit is rheumatoid arthritis (which often begins in the hands) but it could also be psoriatic arthritis (PsA), which commonly affects the hands too. Other symptoms of PsA include having puffy fingers and toes that resemble sausages (a condition called dactylitis), skin plaques, and pitted nails.
Your doctor will also need to consider whether your symptoms are due to palindromic rheumatism (PR), an episodic form of inflammatory arthritis (though palindromic rheumatism is rare). PR can attack any joint, but most commonly affects the hands.
Gout, a type of arthritis caused by high levels of uric acid in the body, could also be the culprit. However, while gout can affect the wrist and fingers, it is most likely to attack your big toe.
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