Rheumatoid Arthritis: hands are significant
You’ve probably heard me say that Rheumatoid Arthritis is not a hand disease – principally. So many books and websites give particular emphasis to hands in the RA diagnosis process. However, I’m wondering whether it is clear what to look for.
Usually, involvement of particular hand joints such as the metacarpophalangeal joints (MCP) and proximal interphalangeal joints (PIP) is required. Many go so far as to state that involvement of the distal interphalangeal joints (DIP), next to the fingernail, is not even possible with RA. I’ve actually had a couple of rheumatologists tell me that. A few rheumatology docs also told me that my own hands were RA-free because there was not obvious swelling during the visit. By obvious I mean visible from across the room.
Does it matter whether doctors or researchers really understand Rheumatoid Arthritis hands? Does it impact the way the disease is presented to the public? Could it have anything to do with the mistakes that are so frequently made with diagnosis and treatment of RA? Should we worry that there are no tests which objectively measure the activity of Rheumatoid Arthritis in hands?
Handful of RA hand battles
- If you visited our RA Warrior Facebook page last week, you would have seen a post by a lady describing her recent visit to a hand specialist. She described wincing with his death grip handshake as they greeted. What upset her most, though, was that after a long consultation, he repeated the favor. Did he not hear her explanation of her pain? What was the problem?
- A friend of mine had surgery on one hand at Christmas. Her other hand will be done soon. She had extremely severe carpel tunnel syndrome which caused her to lose feeling in her hands for the last year. The Rheumatoid Arthritis in her wrists created nerve compression, which caused numbness and painful burning. Fortunately for her, both her rheumatologist and hand specialist recognized that RA was the cause and accelerated her treatment plan over usual carpel tunnel treatment. People frequently comment about similar symptoms. Maybe it’s more common than thought.
- I never even knew about it way back then, but my grandfather had his knuckles replaced when his RA hands got bad enough. Check out this fantastic page explaining knuckle replacement on Hand University. The animations are “don’t miss” if you like cool stuff like that.
- I sighed last week when I got an email about exercises for RA hands, advertising ways to have “limber and pain-free hands.” After I regained composure, I opened the link. The article described a technique of gently exercising every finger joint. The movements appeared harmless – if one’s RA would allow them to be performed. However, “pain free hands” with RA? Only if your Rheumatoid Arthritis hasn’t gotten to the hands yet. I’m sorry if being blunt is offensive, but exercise cannot moderate Rheumatoid Arthritis pain or damage. RA is like battery acid eating away at living tissues. People say these things because they have no clue what RA does to hands or what it feels like.
The actual information in the article is pretty solid. There are even cautions about joint protection and avoiding painful movements. They just need a new headline writer. Wouldn’t it be great if an RA’er were hired to proofread some of these things?
Postblog: I’ve had hands on the brain because mine hurt more than ever right now. Every joint in both hands is painful, stiff, and increasingly weak. I’ll leave off the long list I cannot do right now. I type at about 25 percent of my usual rate. I’m so glad I can type at all – at least until RA hands are clearly understood.
- Ultrasounds for Rheumatoid Arthritis, Part 2
- Should Rheumatoid Arthritis Patients Exercise, Part 2
- Rheumatoid Arthritis Joint Protection