Arthritis in the knuckles occurs when the knuckle joint becomes swollen and stiff, leading to pain. It can happen for many reasons, but it becomes more common with age. This is because the joints become worn down over time.
Your knuckles are the joints where your fingers join the palm of the hand. The bony part of the knuckle joint sticks out when you close your hands, making a fist. The knuckles allow you to bend and flex your fingers, as well as spread them.
If you have arthritis in the knuckles, you may experience pain, difficulty bending your hands, or cysts.
Sex and gender exist on spectrums. This article uses the terms “female” and “women” when discussing people who are assigned female at birth to reflect language that appears in source materials.
Types of arthritis that can affect the knuckles
In medical terms, the knuckles are known as metacarpophalangeal (MCP) joints. They allow us to use our hands in a variety of ways. Three types of arthritis can usually affect the knuckles the most.
Osteoarthritis (OA)
Also known as degenerative or wear-and-tear arthritis, OA is the most common type of arthritis, affecting about 32.5 million adults in the United States. Because it gets worse with time, symptoms will go through stages that vary in severity.
OA usually occurs in older adults — and more often in women — as the tissues of the joint begin to break down, leading to pain and stiffness. OA commonly affects the joints of the hands, including the knuckles.
Psoriatic arthritis (PsA)
PsA is a chronic autoimmune condition. This means it happens because your immune system mistakenly attacks healthy cells. It causes swelling, redness, and pain in the joints, as well as scaly and itchy skin in the affected areas.
People who develop PsA will usually already have psoriasis, although some develop arthritis first, followed by psoriasis. Nearly 8 million people have psoriasis in the United States, and 30% of them develop PsA. PsA can affect the hands and fingers, including the knuckle joints.
Rheumatoid arthritis (RA)
RA is also an autoimmune condition in which the immune system mistakes healthy cells and attacks them. This causes inflammation and pain in the joints, particularly the small joints of the fingers and hands.
Research from 2023 points out that RA particularly affects the MCP joints—the knuckles. RA affects about 1.5 million people in the United States.
Causes
The cause of arthritis is not exactly known. There are several factors that come into play, from genetics, age, and sex to environmental factors. Some of these factors may have more of a role depending on which type of arthritis is causing knuckle pain.
For example, genetics play a role in the development of both PsA and RA, which are both autoimmune conditions. About 40% of people with PsA have a close family member with the condition.
RA, according to a 2020 study, has a heritability estimate of 60%. This means there’s a 60% chance that RA is caused by genes and only a 40% chance that it’s caused by environmental factors.
OA happens mainly due to aging and the wear and tear your joints go through over the years. But other factors can also contribute to the development of OA, PsA, and RA.
- Sex: Females tend to experience OA and RA more than males, while PsA affects both sexes equally. According to the Arthritis Foundation, the exact reason for this is unknown.
- Age: OA and RA tend to develop in people older than 50 years, while PsA tends to appear in people in their 30s.
- Environmental factors: Factors such as injury, diseases, infections, and stress can trigger the development of arthritis.
- Coexisting health conditions: Some health conditions like diabetes and obesity increase the risk of developing arthritis.
Symptoms
Symptoms of arthritis of the knuckles include:
- pain
- inflammation and swelling
- stiffness
- redness
- scaly and itchy skin on the knuckles in the case of PsA
- reduced range of motion
- difficulty bending, folding, or opening your hand
In some cases, people with arthritis in the knuckles may experience structural changes in the joint as well as cysts and nodules in the area. You may also experience fatigue, fever, and nausea.
Treatments
There’s no cure for the types of arthritis mentioned above. Yet you can manage the condition and try to minimize the symptoms.
Treatment for arthritis in the knuckles will depend on which specific type of arthritis you have. Treatment may consist of medication, medical interventions, and lifestyle measures.
Medications used to treat these types of arthritis aim to reduce symptoms, relieve pain, and reduce inflammation. Some medications include:
- pain relievers like acetaminophen (Tylenol)
- nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil) or naproxen (Aleve)
- corticosteroids like prednisone (Rayos)
- for OA, glucocorticoid injections like triamcinolone acetonide (Zilretta) and hydrocortisone (Cortef)
- disease-modifying anti-rheumatic drugs like leflunomide (Arava), methotrexate (Trexall), and sulfasalazine (Azulfidine)
- biologics like adalimumab (Humira), apremilast (Otezla), certolizumab (Cimzia), etanercept (Enbrel), risankizumab (Skyrizi), and tofacitinib (Xeljanz)
- therapies, such as light therapy for PsA and physical and occupational therapy for people with RA
- surgery
Certain lifestyle strategies can help improve symptoms and promote overall health to keep your immune system strong and help reduce the risk of developing the conditions or worsening symptoms. Some lifestyle measures include:
- eating a balanced diet to maintain a moderate weight and reduce the strain on the joints
- taking anti-inflammatory supplements, such as curcumin and omega-3
- doing regular exercise, about 30 minutes per day for 5 days per week
- performing hand exercises to strengthen hand muscles and improve flexibility
- doing heat and cold therapy
- reducing stress with practices such as meditation and yoga
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Summary
Arthritis in the knuckles can cause pain, swelling, redness, and stiffness in the joints that connect your fingers to the palms of your hands.
Three common types of arthritis tend to affect the hands and the knuckles the most: OA, PsA, and RA.
The causes for these types of arthritis range from genetics to environmental factors, such as illness, stress, and injury.
There’s no cure for these types of arthritis, but different treatment options can help you manage symptoms. These include medications, therapy, surgery, and lifestyle measures.
Talk with a healthcare professional if you experience pain, stiffness, and swelling in the knuckles. They can help determine what’s causing the symptoms and which type of arthritis you have in order to figure out the best treatment course.
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