Not only are these some of the hardest working in our body (performing delicate operations such as tying shoelaces and tension-based tasks such as brushing our hair), but they’re also some of the most fragile joints in the skeleton.
It’s probably therefore, no surprise that one of the first manifestations of PsA-related joint pain and discomfort can be in the hands. So what exactly happens to trigger the symptoms?
Put simply, PsA symptoms can occur anywhere in the body when an imbalance of proteins in the blood stream causes the body’s immune system goes into overdrive. For people living with PsA, this overdrive can often result in a condition known as entheseal inflammation or enthesitis, which is the inflammation of entheses, the site where ligaments or tendons insert into the bones. Enthesitis can make the tissues in the affected area become ropey (known as fibrosis) or solid (known as ossification or calcification), and results in pain, swelling and tenderness. It doesn’t occur in other forms of arthritis such as rheumatoid arthritis or osteoarthritis.2
Another condition linked with PsA that affects the hands is dactylitis, or ‘sausage fingers’ as it’s commonly known. Dactylitis impacts around 40-50% of people living with PsA4 and is the result of inflammation of the entire tendon that runs along the fingers or toes.3 It’s a non-symmetrical condition, so can affect differing fingers on the two hands (which can be a key to diagnosis, so be sure to mention this in any medical appointments!)3 Similarly to enthesitis, the most common symptoms are swollen, painful digits, and difficulty moving the affected areas.3
The world we live in means it’s impossible to get by ‘hands free’ – they’re pretty vital for everyday tasks and chores. But what’s important to remember is that PsA symptoms in our hands can be made worse by doing lots of repetitive tasks such as typing on a keyboard (including on phones!), gripping a knife and chopping vegetables or sewing.
If you’re experiencing hand pain and stiffness on a regular basis, be sure to speak with your doctor at your next appointment, and let them know the specific areas in which you’re experiencing pain. Your doctor may be able to refer you to a physiotherapist to help create a bespoke exercise regime designed to combat your specific areas of pain and discomfort. They may also recommend wearing splints or, in some cases, prescribe injections to help alleviate the pain. In the meantime, make sure you rest your hands as much as possible, and share any hints or tips you have for reducing pain on our social channels!
1Sharp JT, et al. How many joints in the hands and wrists should be included in a score of radiologic abnormalities used to assess rheumatoid arthritis? Arthritis Rheum 1985; 28(12): 1326-35
3Veale D, Rogers S, Fitzgerald O. Classification of clinical subsets in psoriatic arthritis. Br J Rheumatol1994;33:133–8.
4Ritchlin CT et al. N Engl J Med. 2017;376(10):957-970
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