Functional Implications of Rheumatoid Arthritis in the Hands

This article is the second in a series of articles that aim to simplify the confusing world of living with arthritis. Have a look at the first article in the series to read about the difference between Rheumatoid Arthritis, Osteoarthritis and Osteoporosis.

Rheumatoid arthritis (RA) in the hands can present in many different ways (symptoms). You might have a few symptoms or many of them. Each person is different and everyone’s symptoms can differ. These symptoms can be felt and seen in the hand, specifically in the joints of the hand (if you want to know why, read about it in the first article in this series).

These symptoms can include:

• Swelling of joints – on both the left and right hand (symmetrical inflammation)
• Pain and reduced mobility (stiffness) – difficulty making a fist
• Joints can feel warm and appear red
• Nodules (rounded bumps under the skin) near the joints that are affected
• Malalignment/Misalignment – deviation (movement) of the bones attached to the damaged joints
  • This can result in hand deformities such as:  Boutonniere deformity, Swan’s neck deformity, Hitchhiker’s thumb, Trigger finger and Ulnar deviation (we won’t go into these today though).

The above mentioned presentations all have consequences and these consequences are felt in the way you are able to use your hands (functional ability). Let’s refer to these symptoms as functional implications. To understand the functional implications we need to, however, understand a little about how the hand works.

The problems experienced with regards to hand function (functional implications) are the result of joint damage that is caused by RA. Deviation (movement) of the bones attached to the damaged joints is caused by tendon weakness. Tendons are the ‘tissue bands’ that move the joints and as a result the fingers of the hand. Tendons are attached to muscles – some muscles originate (start) in the hand and others originate in the forearm.

Therefore damage caused to one part (the joints) has a consequence on other parts (tendons) which have an effect on functional ability (the ability to use all the structures together for the desired hand movement).

Functional implications of RA in the hands may involve the following:

• Fine motor skills and Hand dexterity (having dexterous hands means that you don’t have any hand pain or discomfort, and you can perform most tasks reasonably easy and comfortably)
• Grip strength (Power grips)
•  Ability to pinch objects between the thumb (Precision grips)

The picture below demonstrates aspects of hand dexterity by isolating the different grips we use every day.

Looking at the pictures above, can you think about how your hand function (dexterity and grip strength) has been influenced by RA or even any other injury/diagnosis? – Tell us by leaving a comment below.

It is important to know that a significant amount of joint damage happens early on in rheumatoid arthritis. This is why it is extremely important and beneficial to you to go to your doctor early on for possible diagnosis and treatment. Don’t wait!

In the next article we will discuss management of RA.

Chanel McCabe

(Netto AP. Hand Pain and Rheumatoid Arthritis (RA). https://www.arthritis-health.com/types/rheumatoid/hand-rheumatoid-arthritis-ra Accessed 10:30am, 2020/09/05)