Can anything ease my arthritic hands?
QAFTER years of arthritic pain, painkillers including meloxicam and three keyhole surgeries, I had both knees replaced.
However, I am now beginning to struggle with arthritis in my hands, particularly my right thumb. The knuckle has swollen to three times its original size, I drop things and picking up anything with even the slightest
weight is very painful. I don’t want to go back on the meloxicam — can you suggest any alternatives?
ALinda Johnson, by email. These problems are common and will be of interest to many readers. Osteoarthritis, the main symptoms of which are joint pain and stiffness, is the most common form of arthritis. sufferers can also experience the swelling that you mention, as well as tenderness and a grating sound when they move the affected joints.
Once thought of as simple degenerative wear and tear, we now know it is a complex process that culminates in the production of enzymes called proteases.
These degrade the cartilage — the springy material that cushions our joints from the stress and the strain of bending, lifting, gripping and kneeling.
The exact cause isn’t known but age, previous injuries, obesity and genetics all feed into a person’s risk. hormones may also be involved.
Interestingly, while the osteoarthritis of the hands and knees you have experienced is more common in women, hip arthritis occurs equally in both sexes.
I appreciate it is distressing for you to have developed arthritis in your hands after years of coping with knee pain, but there are alternatives to meloxicam, a powerful nonsteroidal antiinflammatory drug (nsaId), which is the mainstay of arthritis medication.
While there is no doubt that meloxicam can help with pain and swelling, it can also cause a range of sideeffects, from stomach ache and heartburn to allergies and wheezing — and many patients are reluctant to take it long term.
I suggest you ask your GP for a referral to an orthopaedic specialist or rheumatologist with a particular interest in hand problems. They will carry out a thorough assessment
before recommending treatment — likely a combination of drugs and nonpharmacological therapies.
When osteoarthritis affects the base of the thumb, using a splint for pain relief can be very effective as this enforced rest allows some natural recovery.
a physiotherapist will fit you with the splint and show you how best to use it. hand exercises, also taught by the physiotherapist, improve both function and strength, and are helpful in reducing pain.
I respect your reluctance to start taking meloxicam again and suggest you ask your GP about topical nsaId treatments, such as gels and creams. These cause fewer sideeffects than pills and can be helpful in arthritis of the hand. diclofenac gel is the classic example.
You may also be offered an injection of corticosteroids into the base of your thumb and any other severely affected joints.
If such a procedure is recommended, do accept it. These injections are widely used and can be beneficial. and while improvement is usually shortlived, they are relatively free of sideeffects.
You describe yourself as fit and active, and I hope you will soon be able to take part in yoga and the other activities you enjoy without being thwarted by hand pain.