Rheumatoid arthritis (RA) is a chronic autoimmune disorder primarily affecting the synovial joints and known for causing pain, swelling, and deformity, particularly in the hands and wrists. The condition was first described by Alfred Baring Garrod in 1800, highlighting its long history in medical literature. Key symptoms include joint stiffness, often worse in the mornings or after periods of inactivity, along with fatigue, fever, and loss of appetite. Initially, RA tends to affect smaller joints, like those in the fingers and toes, before progressing to larger joints such as the wrists and knees.
One common complication of RA is hand deformity, which can manifest in various forms such as boutonniere and swan-neck deformities, hitchhiker’s thumb, ulnar deviation, and the formation of nodules. The more than 25 joints in the hands and wrists are particularly susceptible to RA’s damaging effects, with early signs often including stiffness and swelling in the wrists and knuckles. Over time, prolonged joint damage and inflammation can lead to significant deformity.
Occupational therapy, including exercises and splinting, can play a crucial role in managing RA. These interventions can slow the progression of hand deformities and improve hand function. For those with severe hand disease, an occupational therapist can design a tailored exercise program and splints to enhance function and potentially slow the progression of deformity.
Another aspect of RA in hands includes the appearance of soft lumps over the back of the hand, which move when lifting the fingers, and a creaking sound during finger movement. These symptoms are indicative of the chronic pain, swelling, and deformity caused by RA.
For more detailed information on RA hand deformities and management strategies, visit Healthline, Verywell Health, StatPearls – NCBI Bookshelf, Mayo Clinic, The Hand Society, Arthritis Foundation, Medical News Today, and WebMD for more information.
