Osteoarthritis of the Hands (cont.)

For another type of dietary supplementation, it should be noted that fish oils have been shown to have some anti-inflammation properties. Moreover, increasing the dietary fish intake and/or fish oil capsules (omega-3 capsules) can sometimes reduce the inflammation of arthritis.

Obesity has long been known to be a risk factor for osteoarthritis of the knee. I recommend weight reduction for patients with early signs of osteoarthritis of the hands who are overweight, because they are at a risk for also developing osteoarthritis of their knees.

Pain medications that are available over the counter, such as acetaminophen (Tylenol), can be very helpful in relieving the pain symptoms of mild osteoarthritis and I recommend these as the first medication treatment. Studies have shown that acetaminophen, given in adequate doses, can often be equally as effective as prescription anti-inflammatory medications in relieving pain in osteoarthritis of the knees. Since acetaminophen has fewer gastrointestinal side effects than nonsteroidal anti-inflammatory drugs (NSAIDS), especially in elderly patients, acetaminophen is generally the preferred initial drug given to patients with osteoarthritis. If symptoms persist, then I recommend trials of over-the-counter anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, Nuprin), ketoprofen (Orudis), and naproxen (Aleve). Many patients do best when they take these medications along with their glucosamine and chondroitin.

Some patients get significant relief of pain symptoms by dipping their hands in hot wax dips in the morning. The wax can often be obtained at local pharmacies or medical supplies stores. It can be prepared (melted) and kept in a crock pot (electric cooker). The hot wax hardens on the hands and thereby provides a warm covering over the hands. The hardened wax then can be reused by peeling it off the hands and placing it back into the melted wax. Warm water soaks and nighttime cotton gloves (to keep the hands warm during sleep) can also help ease hand symptoms. Gentle range of motion exercising regularly can help to preserve function of the joints. These exercises are easiest to perform after early morning hand warming.

Pain-relieving creams that are applied to the skin over the affected joints can provide relief of daytime minor arthritis pain. Examples include capsaicin (Arthricare, Zostrix), salycin (Aspercreme), methyl salicylate (Bengay, Icy Hot), and menthol (Flexall). For additional relief of mild symptoms, local ice application can sometimes be helpful, especially toward the end of the day. Occupational therapists can assess daily activities and determine which additional techniques may help patients at work or home.

Arthritis quackery

Like many people with chronic ailments, sufferers of chronic arthritis are potentially vulnerable to proponents of heavily marketed "cure-all" treatments. These "quick fix" treatments are promoted as having great benefits, but in reality they have no right to such claims. For a listing of examples of bogus arthritis medications, see MedicineNet.com's arthritis quackery article.

Conclusion

Finally, when arthritis symptoms persist, it is best to seek the advice of a doctor who can properly guide the optimal management for each individual patient. Many other prescription medications are available for the treatment of osteoarthritis for patients with chronic, annoying symptoms. And if you are concerned that osteoarthritis could be associated with injury to internal organs, don't be. This disease does not cause internal organ damage or blood test abnormalities.

In addition to the steps described above, you should pay attention to joint problems elsewhere in your body if you develop signs and symptoms of osteoarthritis of the hands. Be on the lookout in the future for persistent, unexplained joint symptoms and see your doctor if you notice them.

Previous contributing editor: Leslie J. Schoenfield, MD, PhD

REFERENCE:

Klippel, John H., et al., eds. Primer on the Rheumatic Diseases. 13th ed. New York: Springer and Arthritis Foundation, 2008.


Last Editorial Review: 2/14/2012