WHEN TO SEE YOUR DOCTOR
* See your doctor as soon as you perceive that your fingers are beginning to look twisted and out of shape.
What Your Symptom Is Telling You
Those bumpy, knobby knuckles are just a sign of time passing—and of the osteoarthritis that inevitably comes to aging joints.
Osteoarthritis is often called wear-and-tear arthritis and is often simply the result of years and years of microinjuries. Usually, these gnarly bumps won't prevent you from carrying out your normal activities, though they may hurt from time to time, doctors say.
If your hands begin to feel distorted and quite painful as early as your thirties, however, you may be showing signs of rheumatoid arthritis—a potentially debilitating form of the disease that may require ongoing medical treatment. The joints are held together by ligaments, which become stretched out when rheumatoid inflammation fills the joints with fluid. Gradually, the ligaments may deteriorate to the point that they can no longer hold the finger joints stable. The fingers may then start to "drift" out of position, sometimes quite severely.
For reasons no one yet understands, rheumatoid arthritis tends to strike more women than men, usually between the ages of 35 and 45.
Nothing, short of surgery, is going to untie the knots or smooth out the bumps once fingers have become gnarled. But you can reduce the pain.
Start with OTCs. If osteoarthritis hurts, take over-the-counter pain relievers. Try acetaminophen first, then enteric-coated aspirin or ibuprofen, suggests Sidney Block, M.D., a rheumatologist in private practice in Bangor, Maine.
Get help from your doctor. A variety of prescription medicines can help to control the damage that rheumatoid arthritis causes, says Earl Marmar, M.D., an orthopedic surgeon at Einstein Medical Center, director of the Einstein/Moss Joint Replacement Center and assistant clinical professor of orthopedic surgery at Temple University in Philadelphia. The first line of defense is anti-inflammatory drugs, followed by gold, methotrexate and steroids, he says.
Try a wax bath. Your favorite offering from a physical therapist is likely to be the paraffin bath, Dr. Marmar says. Your hand is placed in very warm paraffin, which soothes your joints wonderfully as it dries.
Consider surgery. If your rheumatoid deformities are so severe that you feel disabled, don't despair. Advances in reconstructive surgery can restore a great deal of function, says Dr. Marmar. A reconstructive hand surgeon can rebalance joints, remove inflamed tissues, repair destroyed tendons and even insert rubber spacers to support the joints. Often the surgery is a combination of procedures and may include treatment of the wrist joints, where arthritic changes may have contributed to deformity in the fingers.
See also Joint Inflammation; Joint Pain