Arthritis Archive

Your hands perform countless small and large tasks each day—from pouring coffee, brushing teeth, and buttoning shirts to raking leaves or kneading bread.

But aching hands can transform the simplest task into a painful ordeal. Hands can hurt for a variety of reasons, from the mechanical to the neurological. Arthritis—which affects one in five American adults—and other persistent joint problems are by far the most common cause of hand pain and disability.

News briefs

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Exercise is considered the most effective pill-free treatment to cope with the pain and stiffness of arthritis. And more people are getting advice from their health care providers about how to stay active, according to a study published online Jan. 5, 2018, by the CDC's Morbidity and Mortality Weekly Report. Researchers looked at national health surveys gathered from 2002 to 2014. In that period, there was an increase in the proportion of people with arthritis (osteoarthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia) who said their clinician suggested physical activity to help reduce symptoms — from 52% in 2002 to about 60% in 2014. But by 2014, about 40% of arthritis sufferers still said they weren't getting exercise counseling. That's significant, considering that 91 million people ages 18 or older are affected by arthritis, according to a study published online Nov. 27, 2017, by Arthritis & Rheumatology. You don't have to wait for a doctor to suggest exercise as an arthritis treatment. Try something gentle, like walking, tai chi, or modified yoga. For more ideas, check out the Harvard Special Health Report The Joint Pain Relief Workout (www.health.harvard.edu/jprw).

Understanding risk and modifying your activities can cushion your joints from damage.

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Joints are a little bit like couch cushions. Over time, the padding between your bones, called cartilage, gets worn out and flattens down — a condition known as osteoarthritis. Unfortunately, dealing with worn joints is not as simple as fixing or replacing a couch. And whether your joints wear out may not be entirely in your control.

"Unfortunately, a lot of your risk depends on your genes," says Dr. Scott Martin, an orthopedic surgeon and associate professor of orthopedic surgery at Harvard Medical School. "If you have a history of arthritis in your family, you may get arthritis in your lifetime. That's one factor you can't control." Dr. Martin is the faculty editor for the Harvard Special Health Report Knees and Hips (www.health.harvard.edu/knees).

Inflammation is a key component of arthritis and other chronic joint diseases. Gout, a painful and potentially debilitating form of inflammatory arthritis, develops when tiny, needle-shaped crystals of uric acid (a biological waste product) accumulate in the joints. The presence of these uric acid crystals triggers the release of cytokines, and these inflammatory messengers attract neutrophils and other white blood cells to the scene. Gout usually affects one joint at a time, most often the big toe, but sometimes it occurs in a knee, ankle, wrist, foot, or finger. 

Early on, gout flare-ups tend to be intermittent. If gout persists for a long time, the joint pain can be ongoing and mimic other types of arthritis. After several years, uric acid crystals may collect in the joints or tendons. They can also collect under the skin, forming whitish deposits. They are called tophi, lumps of tissue that form under the skin of fingers, knuckles, and elsewhere. 

Arthritis is a painful problem that can interfere with your ability to do the things you enjoy. But you can take steps to manage arthritis by protecting your joints, reducing discomfort, and improving mobility.

Physical or occupational therapists can be very helpful in teaching you how to modify activities and accomplish daily tasks more easily in order to manage arthritis. But there are simple things you can do for yourself, starting today. Here are five of them:

Physical therapy may be an effective alternative to surgery in relieving joint and back pain.

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Exercising may be the last thing you want to do when you have a sore knee or aching back, but it might be the first thing you should do. Physical therapy has long been recommended following surgery. But for some, trying physical therapy before opting for surgery may be the better choice.

"You may be able to spare yourself the expense, pain, and recovery time of surgery," says physical therapist Karen Weber, clinical supervisor at Harvard-affiliated Spaulding Rehabilitation Outpatient Centers in Braintree and Quincy, Mass.

In the journals

Corticosteroid injections are used to ease short-term knee osteoarthritis pain, but a new study in the May 16, 2017, Journal of the American Medical Association suggests the treatment may not help in the long term.

Researchers recruited two groups of 70 people, average age 58, with knee osteoarthritis. One group received 40 milligrams of the steroid triamcinolone (Kenacort, Kenalog, Artistocort) every three months for two years, while the other group got placebo injections. By the end, pain scores — measured on a scale from zero for no pain to 20 for extreme pain — had dropped by only 1.2 points among the steroid group, while the placebo group's score dropped by 1.9 points, neither of which was clinically significant.