Private hand osteoarthritis clinic in London, same-day physiotherapy.

Where it occurs

• Base of the thumb — the commonest and most disabling site. Pain gripping, pinching, opening jars, turning keys and using a phone.
• End finger joints — bony swellings called Heberden's nodes. Often painful for a period while they form, then settling into painless deformity.
• Middle finger joints — Bouchard's nodes, less common.
• Stiffness that is worst in the morning but lasts only minutes, easing with movement.
• It is strongly hereditary, more common in women, and often begins around the menopause.

What helps

• Hand exercises — a structured programme of range-of-movement and strengthening work, done daily. This has the best evidence of anything.
• A thumb base splint for thumb arthritis, worn during aggravating activities and sometimes at night. Effective, and often the single most useful intervention.
• Joint protection — use larger joints where possible, spread load across both hands, avoid sustained tight pinch grips.
• Adapted equipment — chunky-handled tools, jar openers, tap turners, key grips, lever door handles. Cheap, and they transform daily tasks.
• Topical anti-inflammatory gel, which is recommended ahead of tablets for hand osteoarthritis and works well because the joints are superficial.
• Heat before activity and exercises; some prefer cold after.

If that is not enough

• Oral anti-inflammatories, at the lowest effective dose for the shortest period, with stomach protection where appropriate.
• Steroid injection into the thumb base — useful for a painful flare, ideally under ultrasound guidance given how small the joint is. Relief typically lasts weeks to months.
• Hand therapy with a specialist therapist for a tailored programme and custom splinting.
• Surgery — trapeziectomy for thumb base arthritis is effective for pain in well-selected people, with a recovery of around three months. Fusion or joint replacement is used for some finger joints.
• Mucous cysts at the end joints can be removed if they are troublesome or grooving the nail.

What does not help

Glucosamine and chondroitin have no meaningful evidence in hand osteoarthritis and are not recommended. Nor are copper bracelets or magnetic devices. Cracking your knuckles does not cause arthritis. Diet has little direct effect, though maintaining a healthy weight and staying generally active help overall.