Rheumatoid Arthritis (RA) of the Hand: Everything to Know

Medically Reviewed By Stella Bard, MD

Rheumatoid arthritis (RA) is an autoimmune condition characterized by joint pain, swelling, and stiffness. Rheumatoid arthritis of the hand can affect the joints of the fingers and thumbs. RA can also cause fingers to swell and appear “sausage-shaped.” Fingers may also begin to drift away from the thumb.

This article examines the symptoms of RA of the hand in more detail. It also details causes, treatment options, when to contact a doctor, and more.

What are the symptoms of RA of the hand?

Closeup of a person holding their fingers.
Lupe Rodríguez/Stocksy United

The main symptoms of RA of the hand include:

  • stiffness
  • swelling
  • pain

You may find that some joints in your fingers and thumbs are more swollen than others.

Other symptoms you may experience with RA of the hand include:

  • creaking sounds when you move your fingers
  • ulnar drift, which is when fingers drift away from the thumbs
  • numbness or tingling from carpal tunnel syndrome
  • inability to bend or straighten certain fingers
  • a soft lump at the back of your hand that moves when you straighten your fingers
  • Boutonnière deformity, which is when the finger’s middle joint is bent, and the end joint is hyperextended

Learn more about RA.

What causes RA of the hand?

RA is an autoimmune condition. This means that the immune system attacks the healthy body tissue surrounding the joints.

When this happens, the synovium that covers your joints becomes inflamed.

While experts do not know exactly why this happens, they have identified certain factors that may increase your risk of developing RA.

Risk factors include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • genetics, as the condition can run in families
  • being assigned female at birth, as the hormone estrogen may increase your risk
  • smoking
  • stress
  • infection
  • gingivitis

More research into these risk factors and the likelihood of developing RA is necessary.

Learn more about RA and genetics.

What are the treatments for RA of the hand?

Treatments for RA of the hand include medications, physical and occupational therapy, and surgery.

Medication

Medications to reduce inflammation in RA of the hand can include:

  • disease-modifying antirheumatic drugs (DMARDs)
  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • corticosteroid injections

NSAIDs are available as oral or topical medications. DMARDs are available as oral or injectable medications.

Your doctor may recommend corticosteroids only if your symptoms do not respond to other treatments.

Your doctor may also recommend pain relief medication to help you to manage pain.

Learn more about drugs commonly prescribed for RA.

Physical therapy

Your doctor may refer you to a physical therapist to teach you strengthening and stretching exercises.

Hand exercises can help to maintain dexterity while helping to alleviate pain. It may also help you maintain a good grip level as the condition progresses.

Learn about some exercises for RA here.

Occupational therapy

An occupational therapist can help you make adaptations to your daily routine and around your home. They will teach you how to perform certain tasks while putting less stress on your hands. They will also inform you about assistive devices to help you to perform daily tasks, such as opening jars and using cutlery.

Your occupational therapist may also recommend that you wear a hand splint or brace. This can help to prevent deformity. It is important to follow the directions of your occupational therapist or doctor when wearing a hand splint, as prolonged use can cause muscles in your hand to waste away.

Learn more about occupational therapy and independent living.

Surgery

Surgery for RA of the hand is rarely Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source necessary.

However, your doctor may recommend surgery in some instances. Types of surgery include:

  • arthrodesis or joint fusion
  • arthroplasty or joint replacement
  • synovectomy
  • tendon realignment
  • tenosynovectomy
  • tendon transfer

Your doctor will let you know if they recommend surgery and answer any questions you may have.

Learn more about other treatment options for RA.

When should I see a doctor?

Contact your doctor as soon as you have concerns about RA of the hand.

Receiving an accurate diagnosis and beginning treatment as early as possible can help to reduce the risk of more severe deformity or disability.

Our RA appointment guide can help you to prepare for your appointment.

How do doctors diagnose RA of the hand?

To diagnose the cause of your symptoms, your doctor may perform a physical examination and take a full medical history.

They may order tests to confirm the diagnosis and rule out other possible causes. Tests can include:

Your doctor can explain why they have ordered certain tests and answer any questions you may have beforehand.

Learn about what an MRI can tell you about RA.

What are the possible complications of RA of the hand?

Various complications may develop as a result of RA of the hand. These can include:

Contact your doctor if you have concerns about the complications of RA of the hand.

Learn more about the complications of RA here.

Can I prevent RA of the hand?

As the exact cause of RA is unclear, preventing it may not be possible.

However, there are steps that you can take that may help to lower your risk of RA of the hand. These include:

  • avoiding smoking or quitting smoking if you currently smoke
  • getting enough regular exercise
  • eating a nutritious, well-balanced diet that includes fruits, vegetables, legumes, and fish
  • avoiding excess alcohol consumption

Following your treatment plan can also help to prevent complications such as joint deformity and disability.

Learn more about the best and worst foods for RA.

Summary

RA is an autoimmune condition that can cause joint pain, stiffness, and swelling. When it affects the hands, it can cause the fingers and thumbs to become painful and swollen. It may also cause deformity.

To treat RA of the hand, your doctor may recommend DMARDs, NSAIDs, and corticosteroids. They may also refer you to an occupational and physical therapist.

Contact your doctor as soon as you have concerns about RA of the hand. They will be able to carry out tests to reach an accurate diagnosis and advise on treatments to help you to manage pain and reduce the risk of complications.

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Medical Reviewer: Stella Bard, MD
Last Review Date: 2022 Dec 23
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