Can hand arthritis be treated without surgery?

Yes — most hand arthritis is managed without surgery, often for many years. Changing how you use the hand, a splint for flare-ups and heavier tasks, hand therapy to keep movement and strength, simple pain relief, and an occasional corticosteroid injection into a specific joint all help. These do not regrow worn cartilage, but they control symptoms. Surgery is considered when pain or stiffness keeps limiting daily life despite them — for finger joints, typically after three months or more of simple treatment that has not settled it.

What operations are there for thumb arthritis?

The main options are removing the worn bone at the base of the thumb (a trapeziectomy), replacing the worn joint with an artificial joint, or resurfacing it with a smooth carbon implant. Each aims to remove the painful grinding surfaces; they differ in recovery time and in how they preserve thumb length, pinch and grip. Which suits you depends on how much of the joint is worn, your hand demands and your goals, and the consult works through the trade-offs.

What can be done for arthritis in the finger joints?

For the middle finger joint (PIP), the options are a joint replacement, which aims to keep movement, or a fusion, which reliably removes pain by stiffening the joint in a useful position. For the fingertip joint (DIP), fusion is the usual operation and gives a stable, pain-free tip. Knuckle joints (MCP) worn by osteoarthritis or rheumatoid arthritis can be replaced.

Are the bony lumps on my fingers arthritis?

Firm bony lumps at the fingertip joint, called Heberden's nodes, are a common sign of arthritis there. They are not dangerous, though the joint can be painful while they form. A soft, fluid-filled lump near the nail is more likely a mucous cyst growing from the arthritic joint beneath — worth having assessed, because it often returns after draining and can affect the nail.

When should I see a specialist about hand arthritis?

Reasonable triggers are pain that wakes you at night, pinch or grip that is weakening, a finger that is drifting, stiffening or can no longer straighten, a lump near the nail, or arthritis your GP and hand therapist have been managing without enough relief. A GP referral is needed for a Medicare rebate. Seeing a specialist does not commit you to surgery — much of the value is confirming which joints are involved and mapping the options. A hand that becomes hot, red, swollen and painful, especially with a fever, needs the emergency department the same day.

Hand condition

Hand and finger arthritis
in Rockhampton

Arthritis in the hand causes pain, stiffness, swelling and a weakening pinch and grip — most often at the base of the thumb and in the finger joints. Most of it is managed without surgery for a long time; when it is not, there are operations that remove pain while keeping the hand working. Patients are seen at Mater Private Hospital Rockhampton from across Central Queensland.

About the condition

What is hand arthritis

Each joint of the hand is lined with smooth cartilage that lets the bones glide. Arthritis is the loss of that lining, so bone loads against bone — bringing pain on use, stiffness, swelling, and a pinch and grip that weaken and tire. Tasks that need a firm pinch usually suffer first: keys, jars, buttons, pens, taps.

What matters is which joints are affected and why. Wear and tear at the thumb base and the finger joints behaves very differently from inflammatory arthritis such as rheumatoid arthritis, and each joint has its own treatment options. The consult confirms the diagnosis on examination and X-ray and sets out a pathway that runs from splinting, hand therapy and injection through to surgery when — and only when — symptoms justify it.

Where it occurs

The joints it affects

"Hand arthritis" covers several joints, each with its own pattern of symptoms and its own best treatment.

Base of the thumb

The commonest hand arthritis seen in practice. The pain sits at the base of the thumb, in the fleshy part near the wrist, and is brought on by pinching and gripping — turning a key, opening a jar, holding a pen, picking up a kettle. Pinch strength often goes before overall grip, so fine tasks like threading a needle or pulling up a zip become hard while carrying shopping is still possible. How much it hurts does not always match how worn the joint looks on X-ray.

Read about basal thumb arthritis → Thumb joint replacement in Rockhampton →
Fingertip joint (DIP)

Arthritis of the joint closest to the nail causes pain right at the end of the finger, often with swelling, tenderness and firm bony lumps called Heberden's nodes. Fine fingertip tasks — buttons, coins, keys, writing — become hard, and the finger can stiffen and drift out of line. A small fluid-filled lump near the nail (a mucous cyst) can grow from the joint beneath, which is why it often returns after draining.

Read about dip joint arthritis →
Middle finger joint (PIP)

The joint in the middle of the finger — the one you bend to make a fist — becomes painful, stiff and sometimes swollen, worse when straightening against resistance. Pinching loads the index finger joint sideways, so buttons, keys and small objects hurt, and the finger may sit crooked or not bend or straighten fully. It can follow an old sprain or dislocation of that knuckle.

Read about pip joint arthritis → Finger joint replacement in Rockhampton →
Knuckle joint (MCP)

The knuckles where the fingers meet the hand can be worn by osteoarthritis or damaged by rheumatoid and other inflammatory arthritis. When the joint surface is badly worn and other treatment has not helped, the knuckle joint can be replaced.

Read about knuckle joint replacement → Finger joint replacement in Rockhampton →
Inflammatory arthritis

Rheumatoid arthritis and related conditions attack the joint lining rather than wearing the cartilage mechanically, and often affect several joints of the hand and wrist at once. Medical treatment of the underlying disease, usually with a rheumatologist, comes first. Surgery is directed at joint damage that can still follow, and at tendons the disease puts at risk.
Arthritis of the wrist

Pain across the wrist rather than in the thumb or fingers is a different set of conditions — often following an old ligament injury or fracture — with its own pathway and operations.

Wrist arthritis in Rockhampton →

The pathway

From splint to surgery

Treatment escalates only as far as the symptoms require, and most patients never reach the end of the ladder:

Non-operative first. Changing how you use the hand, a splint for flare-ups and heavier tasks, hand therapy to keep movement and strength, simple pain relief, and a corticosteroid injection where one joint is the pain source.
Thumb base surgery. Removing the worn trapezium bone (trapeziectomy), replacing the joint with an artificial one, or resurfacing it with a smooth carbon implant.
Finger joint replacement. For a worn middle finger joint or knuckle, aiming to relieve pain while keeping movement.
Joint fusion. Joining a worn finger joint solid in a useful position — the usual operation for the fingertip joint, and an option for the middle joint — reliably removes pain at the cost of that joint's movement.

Which option suits you depends on the joint, how worn it is, your work and hobbies, and what you need the hand to do — the trade-off between movement and pain relief is the substance of the discussion, not an afterthought.

At the practice

How a hand consult works

The consult runs through a structured history (which joints, how long, what makes it worse, how it affects pinch, grip and daily tasks), an examination of the thumb and finger joints, and a review of any X-rays you bring. It ends with a diagnosis (or a clear plan to confirm it) and an itemised treatment plan — hand therapy, splinting, injection, further imaging, or surgery — written for the GP.

Hand therapy is coordinated on-site through Ruby Doolan's practice (Extend Rehabilitation), which keeps splinting and pre- and post-operative therapy in one place. Fees, Medicare rebates and the quote process are on the fees page. Not sure it is arthritis? The hand pain and thumb pain guides triage the common causes.

Hand consultations at the practice are run by Dr Kieran Hirpara, fellowship-trained hand, wrist and upper-limb surgeon at Mater Private Hospital Rockhampton. Sub-specialty fellowship training in orthoplastic hand surgery (BSSH Advanced Training Programme, Manchester) and in hand and upper-limb surgery in Brisbane.

Patients travel from

Across Central Queensland

Patients are seen for hand arthritis from Rockhampton and the wider region. Drive time and scheduling notes are on each catchment page:

Frequently asked

Patient questions we hear most

Can hand arthritis be treated without surgery?

Yes — most hand arthritis is managed without surgery, often for many years. Changing how you use the hand, a splint for flare-ups and heavier tasks, hand therapy to keep movement and strength, simple pain relief, and an occasional corticosteroid injection into a specific joint all help. These do not regrow worn cartilage, but they control symptoms. Surgery is considered when pain or stiffness keeps limiting daily life despite them — for finger joints, typically after three months or more of simple treatment that has not settled it.
What operations are there for thumb arthritis?

The main options are removing the worn bone at the base of the thumb (a trapeziectomy), replacing the worn joint with an artificial joint, or resurfacing it with a smooth carbon implant. Each aims to remove the painful grinding surfaces; they differ in recovery time and in how they preserve thumb length, pinch and grip. Which suits you depends on how much of the joint is worn, your hand demands and your goals, and the consult works through the trade-offs.
What can be done for arthritis in the finger joints?

For the middle finger joint (PIP), the options are a joint replacement, which aims to keep movement, or a fusion, which reliably removes pain by stiffening the joint in a useful position. For the fingertip joint (DIP), fusion is the usual operation and gives a stable, pain-free tip. Knuckle joints (MCP) worn by osteoarthritis or rheumatoid arthritis can be replaced.
Are the bony lumps on my fingers arthritis?

Firm bony lumps at the fingertip joint, called Heberden's nodes, are a common sign of arthritis there. They are not dangerous, though the joint can be painful while they form. A soft, fluid-filled lump near the nail is more likely a mucous cyst growing from the arthritic joint beneath — worth having assessed, because it often returns after draining and can affect the nail.
When should I see a specialist about hand arthritis?

Reasonable triggers are pain that wakes you at night, pinch or grip that is weakening, a finger that is drifting, stiffening or can no longer straighten, a lump near the nail, or arthritis your GP and hand therapist have been managing without enough relief. A GP referral is needed for a Medicare rebate. Seeing a specialist does not commit you to surgery — much of the value is confirming which joints are involved and mapping the options. A hand that becomes hot, red, swollen and painful, especially with a fever, needs the emergency department the same day.