Rheumatoid Hand

Rheumatoid arthritis is a long-term inflammatory condition that can affect the joints in the hand and wrist.

Over time, ongoing inflammation can damage the joints, tendons and supporting structures in the hand. This may lead to pain, stiffness, weakness and, in some cases, visible changes in the shape of the fingers or wrist.

The pattern of involvement in rheumatoid arthritis is often different from wear-and-tear arthritis. It commonly affects multiple joints and can lead to progressive changes if not managed appropriately.

Early and ongoing care is important to control symptoms, maintain function and reduce the risk of long-term joint damage.

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Diagnosis is based on a combination of clinical assessment, blood tests and imaging.

Assessment may include:

• Examination of joint swelling, movement and function
• Blood tests to look for markers of inflammation or autoimmune activity
• X-rays or ultrasound to assess joint damage and disease progression

Care is often coordinated between rheumatology and hand surgery teams.

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Management of rheumatoid arthritis in the hand is usually part of a broader treatment plan.

Non-surgical treatment may include:

• Medication to control inflammation and disease activity (managed by a rheumatologist)
• Hand therapy to maintain movement and strength
• Splints to support joints and improve function
• Activity modification to reduce strain

Surgical treatment may be considered when symptoms are not controlled or when structural problems develop. This may include:

• Tendon repair or reconstruction
• Joint stabilisation procedures
• Joint replacement (in selected cases)
• Correction of deformity

The aim of treatment is to reduce pain, improve function and maintain independence.

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Surgical treatment is tailored to the individual, depending on the pattern and severity of involvement.

Procedures may involve repairing or reconstructing tendons, stabilising joints, or replacing damaged joints to improve alignment and function.

Surgery is usually planned carefully alongside medical treatment to ensure the condition is well controlled.

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Recovery depends on the type of procedure performed.

In general, this may include:

• A period of splinting or support
• Hand therapy to restore movement and function
• Gradual return to daily activities

The aim is to improve function and reduce pain, while maintaining as much independence as possible.

Long-term management of rheumatoid arthritis remains important alongside any surgical treatment.

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As with any surgical procedure, there are potential risks, although these are uncommon.

Possible complications include:

• Infection (around 1%), usually treated with antibiotics
• Swelling or stiffness, which may take time to settle
• Scar sensitivity
• Nerve irritation or injury (rare)
• Ongoing symptoms or incomplete symptom relief
• Recurrence or progression of deformity over time
• Tendon rupture (related to the condition itself or following surgery)

Very rarely, a condition known as complex regional pain syndrome (CRPS) can occur, leading to prolonged pain and sensitivity.

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You should seek medical advice if you have persistent pain, swelling or stiffness in your hands, particularly if symptoms affect both sides or last for several weeks.

If you have already been diagnosed with rheumatoid arthritis, further assessment may be helpful if you notice increasing pain, loss of function or changes in the shape of your hand.

Early and coordinated care can help prevent progression and maintain hand function.

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