Deformed hands and crooked fingers should not be ignored

15 Nov 2023 12:00pm
Symptoms include stiffness and joint pain that causes instability of the hands before exacerbating into deformation with sideways deviation of joints and growth of bony spurs called osteophytes - FILE PIX
Symptoms include stiffness and joint pain that causes instability of the hands before exacerbating into deformation with sideways deviation of joints and growth of bony spurs called osteophytes - FILE PIX
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KUALA LUMPUR - Whilst deformed hands and crooked fingers are commonly found especially among older individuals, they should not be ignored as it may be a sign of a medical condition known as hand osteoarthritis.

Hand and Microsurgery Consultant at Sunway Medical Centre, Sunway City, Dr Liew Siew Khei said the condition, which affects approximately 600 million individuals worldwide, is caused by progressive degeneration and inflammation of joints in the hands.

She said the symptoms include stiffness and joint pain that causes instability of the hands before exacerbating into deformation with sideways deviation of joints and growth of bony spurs called osteophytes.

"The condition may also lead to weakness in gripping and it causes patients to face difficulties in carrying out activities in their daily lives as well as simple tasks such as twisting a door knob or opening a jar lid,” she told Bernama recently.

Dr Liew added osteoarthritis may affect anyone, but it peaks after 50 years of age and risk increases as age advances, for example, the condition is found in 80 per cent of those aged 75 years and above.

Manual workers who use a lot of repetitive pinching or gripping motions in their line of work, and those with previous hand fractures, family history, and obesity are also at higher risks of developing the condition.

"Women are also three times more susceptible compared to men. This condition is not purely a biomechanical problem like in knee or hip joint, and it is closely related with inflammation and metabolic regulation.

"...women suffer a significant fluctuation of oestrogen levels when they reach their perimenopausal phase, around the age of 50, and hormonal changes causes them to be more prone to inflammation and have increased pain sensitivity,” she said.

Dr Liew said the occurrence of hand osteoarthritis is severely underreported in Malaysia (7.05 cases for every 100,000 population, as according to the journal Frontiers in Medicine 2022) as there is a lack of awareness among the public who often dismiss the symptoms as merely an unavoidable part of aging.
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"Perhaps, there could be more reporting and awareness to encourage patients to seek medical attention. As it stands, Malaysia doesn’t have many hand surgeons, there are less than 100 of us in the whole country,” she said.

She also noted that it is concerning how a lot of patients especially elderlies tend to ignore the symptoms and delay their treatment, while adding that deformities and costly surgeries to correct the condition could be prevented if patients seek early medical attention.

"Once osteoarthritis sets in, usually it can’t be reversed but what we can do is manage the symptoms such as using splints to correct the alignment of joints and alleviate pain, steroid injection to reduce inflammation or hyaluronic acid injection that will act as lubricants to reduce friction in the affected joints,” she said.

Dr Liew said patients could also manage the early onset of hand osteoarthritis by using hot or cold compress to alleviate pain, reducing their body weight to reduce pro-inflammatory cells in the body, as well as through lifestyle modification such as replacing door knobs with handles, not wearing buttoned pants and shirts, and doing simple hand strengthening exercises.

She added that if all fails, doctors will resort to surgery, such as keyhole (arthroscopic) surgery, alignment correction surgery, or by replacing with artificial or prosthetic joints.

"In early thumb osteoarthritis, we can do a keyhole surgery to clean the joints to reduce inflammation and pain. But if the fingers are already deformed, we will have to resort to alignment correction surgery or fuse the affected joints. Fusion of joints will result in the joints being unable to bend anymore.

"All things considered, my advice is to seek early treatment if you have stiffness, pain, nodules or swelling on your hands, even those that are painless. By seeking early medical treatment, deformities can be prevented and perhaps prevent costly surgeries,” she said - BERNAMA