Hand osteoarthritis is a common joint condition that causes pain, stiffness and sometimes knobbly swelling in the finger joints and at the base of the thumb. Thumb-base osteoarthritis affects the joint where the thumb meets the wrist and makes pinching and gripping painful. Information, hand exercises, thumb splints and adapted tools are the main treatments, with surgery for a small number of people.
Also known as thumb CMC arthritis, basal thumb arthritis, hand arthritis, Heberden's nodes
Symptoms
- Aching at the base of the thumb or in the finger joints, worse with use
- Pain when pinching, turning keys, opening jars or writing
- Stiffness, usually easing within 30 minutes of getting up
- Bony swellings on the finger joints (Heberden's and Bouchard's nodes)
- Reduced grip or pinch strength
- Flare-ups where a joint becomes warm and swollen for a while
Causes and risk factors
- Age-related changes in the joint, with the body's repair processes not keeping pace
- Being female, with symptoms often starting around the menopause
- Family history of hand osteoarthritis
- Previous injury to the joint
- Higher body weight and metabolic factors such as high blood pressure
- Heavy, repeated use of the hands over many years
What the evidence says helps
- NICE guidance recommends that everyone with osteoarthritis is offered information and tailored exercise as core treatment. Joint pain may increase at first, and the greatest benefit comes from sticking with it.1
- Hand exercises give small improvements in pain, function and finger stiffness, based on low-quality evidence. The benefits may fade if exercises are stopped.3
- European guidance recommends education, assistive devices and hand exercises for everyone with hand osteoarthritis, and suggests considering long-term use of a thumb splint for thumb-base osteoarthritis.2
- Updated reviews found a moderate long-term effect of thumb splints on pain and a moderate effect of assistive devices, such as jar openers and thicker pens, on everyday function.46
- Topical anti-inflammatory gels may be considered, although NICE notes the evidence for the hand is uncertain. NICE does not recommend manual therapy for hand osteoarthritis because the evidence covers only hips and knees.1
Things you can try at home
- Do a short set of hand exercises most days, such as gentle fist making, thumb movements and grip work
- Use tools that reduce strain: jar openers, thicker pen grips, lever taps and electric can openers
- Try a thumb splint for painful tasks or during flare-ups
- Use warmth, such as a warm water soak, to ease morning stiffness
- Pace heavy hand tasks such as gardening and DIY, and switch between activities
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Seek same-day advice from NHS 111 or your GP if a joint becomes hot, red and very swollen, especially if you feel feverish
- See a GP urgently if several joints swell at once with morning stiffness lasting more than an hour, as this may be inflammatory arthritis
- Go to an urgent treatment centre if a joint is suddenly deformed or very painful after a fall or injury
- See a GP if pain is severe and constant or stopping you sleeping
How Apollo can help
We can assess your hand, explain osteoarthritis in plain terms and help you build a hand exercise and daily activity plan. We offer advice on splints and helpful gadgets, and on keeping the rest of your body strong and active, which NICE recommends for all osteoarthritis. Our supervised clinical exercise and Reformer Pilates sessions can support general strength and confidence. If symptoms are severe or not improving, we will suggest you see your GP about medication or a hand surgery opinion.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Do hand exercises really help arthritis?
Research suggests hand exercises give small improvements in pain, stiffness and function. NICE recommends exercise for everyone with osteoarthritis. It works best when done regularly over the long term.
Should I wear a thumb splint for thumb arthritis?
Thumb splints are recommended in European guidance for thumb-base osteoarthritis. Reviews suggest they can reduce pain over months of use. Many people wear one for painful tasks or at night, and it is worth trying different types for comfort.
Will I need surgery for thumb arthritis?
Most people manage well without surgery. An operation is usually considered only when pain remains severe and limiting despite exercise, splints and medication. Your GP can refer you to a hand surgeon to discuss this.
References
- National Institute for Health and Care Excellence (2022). Osteoarthritis in over 16s: diagnosis and management (NG226). NICE. View source
- Kloppenburg M, et al. (2018). 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Annals of the Rheumatic Diseases. View source
- Østerås N, Kjeken I, Smedslund G, Moe RH, Slatkowsky-Christensen B, Uhlig T, Hagen KB (2017). Exercise for hand osteoarthritis. Cochrane Database of Systematic Reviews. View source
- Kjeken I, et al. (2025). Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review. RMD Open. View source
- Marshall M, et al. (2013). Subsets of symptomatic hand osteoarthritis in community-dwelling older adults in the United Kingdom: prevalence, inter-relationships, risk factor profiles and clinical characteristics at baseline and 3-years. Osteoarthritis and Cartilage. View source
- Bühler M, et al. (2019). Effectiveness of splinting for pain and function in people with thumb carpometacarpal osteoarthritis: a systematic review with meta-analysis. Osteoarthritis and Cartilage. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
