Osteoarthritis in the Hands

This is a documentary review of published trial evidence and national guidance rather than a treatment plan for your hands. Around a dozen approaches commonly recommended for hand osteoarthritis were considered, including the five here plus arthritis compression gloves, paraffin wax baths, oral anti-inflammatories, glucosamine and chondroitin, corticosteroid injection, acupuncture, ultrasound, and surgery at the thumb base.

Three criteria decided the order: how much difference each makes to everyday hand function, the quality of the evidence behind it, and how easily it fits into a normal day.

The sources read were NICE guideline NG226 on osteoarthritis, the 2017 Cochrane review of exercise for hand osteoarthritis by Østerås and colleagues, and the A-GLOVES randomised trial of arthritis gloves, run across 16 NHS rheumatology departments in England and Scotland.

Arthritis gloves were excluded on the strength of that last trial, which compared compression gloves with looser placebo gloves offering warmth alone and found no clinically important effect on hand pain, function or stiffness, concluding that routine provision should cease. That is worth knowing before spending money on them, and it does not mean a warm glove is useless: warmth is what participants valued, and an ordinary glove supplies it. Evidence checked in August 2026.

What could not be checked: the evidence base across hand osteoarthritis is generally low quality, several of the interventions here rest on clinical practice rather than trials, and no study has ranked these five against each other. Joints that are hot, red and swollen, morning stiffness lasting well over an hour, or several joints flaring together point at inflammatory arthritis and need a GP.

Start with the task, not the hand. Write down the three things that hurt most in a normal day. Almost always they are jars, keys, taps, secateurs or a kettle, and almost always there is a tool that removes the load entirely.

Separate the joint that hurts. The base of the thumb, the middle knuckles and the fingertip joints behave differently and respond to different things. Thumb base pain is the one that most rewards a splint.

Do the warmth before the exercise, not instead of it. Warmth makes the session easier and does nothing lasting on its own.

Give anything twelve weeks. The hand exercise trials run for three months or more, and hands respond slowly because they are used constantly.

What it is

Changing how a task is done and what it is done with, so the arthritic joints are not the part doing the crushing.

Best for

Anyone whose hands hurt during specific daily tasks, which is nearly everyone with hand osteoarthritis.

What it involves

An electric or lever jar opener. A key turner that gives a bigger lever. Ratchet secateurs instead of standard ones. Wide-handled cutlery, pens and kitchen tools. Carrying bags over the forearm rather than hooked on the fingers. Using two hands for a kettle. Pushing doors with a flat palm rather than gripping handles.

What the evidence supports

Joint protection is a standard component of hand therapy and sits within the self-management approach NICE describes. The direct trial evidence for it in isolation is thin, and the mechanism is not in doubt: a joint that is not being loaded to its limit twenty times a day hurts less.

Limits and cautions

It changes symptoms rather than the joint. It also feels like giving in to some people, which is the main reason it gets skipped, and it is the single highest-value change on this page.

Why it ranks first

It is bought once, it requires no daily discipline, and it removes the peaks of load that produce most of the day’s pain.

What it is

A short daily programme of tendon gliding, gentle grip work, thumb stabilisation and finger movement.

Best for

Grip strength, finger range, and hand function generally. It helps pain less reliably than it helps what the hand can do.

What it involves

Tendon glides, a gentle sponge or putty squeeze, a thumb web-space hold, finger table lifts and thumb opposition rings. Twice daily, about ten minutes, ideally after warming the hands. Our hand and finger exercise guide sets out the doses and progressions.

What the evidence supports

The 2017 Cochrane review pooled trials in hand osteoarthritis and found low-quality evidence of small to moderate benefits on pain, function and finger stiffness, with a small to moderate improvement in grip strength across five studies covering 362 people. NICE makes therapeutic exercise a core treatment for osteoarthritis at any joint.

Limits and cautions

Hard spring grippers load exactly the thumb joint that hurts. Gentle pulses with a sponge do the job. During a flare of a hot swollen joint, drop the resistance work and keep the movement.

Why it ranks second

It has the best trial evidence on this page and it demands the most from you daily, which is the trade-off that puts it second rather than first.

What it is

Warming the hands for five to ten minutes before exercises or before a demanding task.

Best for

Morning stiffness, and getting more range out of the same exercise session.

What it involves

A bowl of comfortably warm water, warm water over the hands in the shower, a wheat bag, or simply a pair of gloves in a cold house. Five to ten minutes is enough, and the effect lasts long enough to get through the exercises or the task.

What the evidence supports

Warming raises tissue temperature and makes the joint capsule and tendons more extensible, which is why hand programmes routinely start with it. This is physiology and standard practice rather than a trial finding, and it should be treated as a way of making the exercise easier rather than a treatment on its own.

Limits and cautions

The effect is temporary, lasting the length of the session. A joint that is hot, red and visibly swollen is the exception, where cooling is more comfortable and where the pattern needs checking with a GP.

Why it ranks third

It is cheap, immediate and pleasant, and it is a multiplier on the exercise rather than a substitute for it.

What it is

A neoprene or rigid support that holds the base of the thumb steady, worn for specific tasks rather than all day.

Best for

Pain at the base of the thumb, which is the most common and most disabling site of hand osteoarthritis.

What it involves

Wearing it for the tasks that provoke the pain: opening jars, gardening, prolonged writing, heavy pinching. A soft neoprene version is enough for most people. Some find a rigid version helpful at night during a bad spell.

What the evidence supports

Splinting for thumb base osteoarthritis is widely used in hand therapy and the trial evidence is limited and mixed. The rationale is sound: the joint is unstable under pinch load, and supporting it during exactly those tasks reduces the peaks.

Limits and cautions

All-day, everyday wear over months is worth avoiding, because the muscles supporting the thumb weaken and the joint is less protected once the splint comes off. Task-specific is the way to use it.

Why it ranks fourth

It helps one joint rather than the whole hand, and it works best paired with the strengthening rather than in place of it.

What it is

A non-steroidal anti-inflammatory applied to the skin over the painful joints rather than taken as a tablet.

Best for

Painful joints that sit close to the surface, which describes every joint in the hand.

What it involves

Applying the gel over the affected joints several times a day as directed. Because the finger joints sit directly under thin skin, the drug reaches them with far less circulating through the rest of the body than a tablet produces.

What the evidence supports

NICE offers a topical NSAID for knee osteoarthritis and says to consider one for osteoarthritis affecting other joints, with oral NSAIDs reserved for where topical treatment is ineffective or unsuitable. The evidence NICE reviewed for hands specifically came from one hand study and showed no clinically important difference, and the committee noted that uncertainty, so the case for hands is weaker than the case for knees.

Limits and cautions

Topical NSAIDs are medicines with real cautions, particularly alongside other anti-inflammatories or with kidney problems, so a pharmacist or GP conversation is worthwhile. This is symptom relief, and it changes nothing about the joint.

Why it ranks fifth

It is easy to try and the hand-specific evidence is the weakest of the five, so it belongs alongside the others rather than as the first thing reached for.

The last row is included deliberately, because arthritis gloves are one of the most heavily marketed products in this area and the trial that tested them properly did not support them.

If jars, keys and taps are the problem, buy the tools first. It is the fastest improvement available and it needs no discipline.

If pain sits at the base of the thumb, combine a task-specific thumb splint with web-space strengthening, and expect twelve weeks.

If mornings are the worst part, put five minutes of warm water before the exercises rather than trying to push through cold, stiff hands.

If your grip is what you are losing, the exercise programme is the part with the evidence. Our hand and finger exercise guide is the place to start.

If you were about to buy arthritis gloves, buy warm ordinary gloves instead and spend the difference on a decent jar opener.

If several joints are hot, swollen and stiff for more than an hour each morning, that is not osteoarthritis. See a GP, and read our guide to exercising with rheumatoid arthritis.

Hand osteoarthritis is a bigger part of the caseload here than it would be in most towns, and the reason is demographic. Wealden has a markedly older age profile than England as a whole: 26.5 per cent of the district’s population is aged 65 or over, and the median age rose to 49 at the 2021 Census against 40 for England. Hand osteoarthritis rises steeply with age, so a district shaped like this produces a great deal of it, much of it never mentioned to anyone because people assume nothing can be done.

The clinical point is that the assumption is half right and expensively so. Nothing reverses the bony changes at a finger joint, and the things people are actually losing, grip strength and the ability to manage a jar, a key or a kettle, respond well. The two highest-value interventions cost about the price of a takeaway and take one afternoon: a lever jar opener and a key turner. The exercise programme adds to that rather than replacing it. What gets bought instead, more often than not, is a pair of compression gloves that the best randomised trial found no better than a loose placebo glove.

Where hand or thumb joints have been painful for months and nobody has looked at them properly, booking an assessment is what turns a general diagnosis into a specific plan.

What are the hard bumps on my finger joints?
Heberden’s nodes on the joints nearest the fingertips, and Bouchard’s nodes on the middle knuckles. They are bony growths formed at the edges of joints where cartilage has thinned. Once formed they are permanent, though the redness, throbbing and tenderness that often accompany their formation usually settle over a year or two, leaving a knobbly but far less painful joint.

Do arthritis compression gloves work?
The best evidence says no. The A-GLOVES trial ran across 16 NHS rheumatology departments in England and Scotland and compared proper compression gloves with looser placebo gloves that provided warmth but no compression. It found no clinically important difference in hand pain, function or stiffness, and concluded that provision of arthritis gloves in routine practice should stop. What people valued was the warmth, which a cheap ordinary glove provides.

What helps pain at the base of the thumb?
A combination rather than any single thing. Strengthen the muscles that hold the thumb out and away from the palm, use a supportive thumb splint for high-pinch tasks such as opening jars and turning keys, and change the tools so the thumb is not doing the crushing. Ratchet secateurs, an electric jar opener, a key turner and wide-handled utensils change the load more than any exercise does.

Should I use warm water or ice for hand arthritis?
Warmth, in almost all cases. Warm water for five to ten minutes before exercises or before a demanding task makes the joints and tendons move more easily, which is why most hand programmes start there. Ice is for the uncommon situation where a joint is hot and visibly inflamed, and repeated hot swollen joints point towards inflammatory arthritis rather than osteoarthritis.

Does exercise help hand osteoarthritis?
Yes, modestly. A 2017 Cochrane review found low-quality evidence of small to moderate benefits on hand pain, function and finger stiffness. The honest reading is that exercise helps and it is not dramatic, which is a good reason to run it alongside joint protection rather than instead of it.

Is topical anti-inflammatory gel worth using on my hands?
It is reasonable to try. NICE offers a topical NSAID for knee osteoarthritis and says to consider one for osteoarthritis affecting other joints. For the hand specifically, the evidence NICE reviewed came largely from knee studies with one hand study, which showed no clinically important difference, so the recommendation for hands is weaker than it is for knees. Finger joints sit close to the surface, which is the argument in its favour.

Will hand osteoarthritis keep getting worse?
Not necessarily, and not steadily. Symptoms typically fluctuate over months and many people find that a painful joint settles into a stiffer but far less painful state over a year or two, particularly the fingertip joints. Grip strength and hand function are what respond to what you do, and those are what most people are actually losing.