Common Ailments of the Aging Hand

The manifestations of aging vary among the body, especially the hands.

America is aging. The current average age in American is slightly less than 50 years old and by 2022 the average age is projected to reach 65. As no surprise, aging brings time-induced cellular changes that affect one’s overall health and vitality.

The manifestations of aging vary among the body’s different tissue types. In bone, density decreases making it less structurally sound and more susceptible to fracturing. Furthermore, we shrink at the rate of one centimeter every 10 years after the age of 40. Between the ages of 25 to 50, there is an annual four percent decrease in muscle mass.  After the age of 50, muscle mass loss can increase to as much as 10% per year. As joints age, cartilage thins and begins to fragment leading to joint collapse, joint enlargement and joint misalignment. These changes manifest as joint stiffness, pain and eventual loss of motion. Aging soft tissues lose strength and elasticity. Tendons become stiff and lose strength, increasing their susceptibility to degenerative breakdown and tearing.

The hand is not immune to aging. As a result, there are a number of ailments which will likely affect our hands as we age. While many of these conditions cannot be prevented, some can be cured and others mitigated with early intervention. Perhaps the most obvious sign of aging in the hand is the skin cover, which thins and wrinkles over time. Aging skin is most affected by genetics and decreasing hormone levels—particularly in women. Skin aging can be accelerated by sun exposure, smoking, the use of corticosteroids and malnutrition. Excessive sun exposure is the most common cause of skin cancers.

Another very visible sign of aging in the hand is arthritis. The most common type of arthritis affecting the hand is osteoarthritis or degenerative arthritis. Onset is age related, increasing in frequency after the age of 40. Osteoarthritis tends to be more accelerated and frequent in females than males. The symptoms of osteoarthritis initially are morning stiffness and pain with or after use. As the condition progresses, there is joint enlargement, loss of joint motion and poor joint alignment. The most frequently affected hand joints are the distal interphalangeal joints—the last joints of the fingers closest to the nail bed. The second most commonly affected joint is the basilar joint of the thumb, which is the joint closest to the palm. Possible, but less common, is osteoarthritis in the remaining joints of the fingers and selected joints of the wrist.

While osteoarthritis cannot be prevented, the negative impact on hand function can be reduced with conservative treatment. First and foremost, it is necessary to maintain motion in arthritic joints in order to maintain hand function. This can be accomplished with gentle range of motion exercises on a frequent basis. Use of heat, such as hot tub temperature water or paraffin bath, can aid in easing morning stiffness and joint discomfort at any time. When discomfort and loss of motion flare up, immobilization in protective splints and short-term use of anti-inflammatory medicines can be helpful. If a 10 to 21-day course of anti-inflammatory medicine proves to be ineffective, the medicine should be discontinued. Often, selective joint injections with steroids are helpful in temporary relief of acute joint pain.

When conservative measures fail for osteoarthritis, surgical intervention may be necessary. For degenerative arthritis at the distal phalangeal joint, a joint fusion is typically performed. This takes away the joint motion, but it is very effective in restoring joint stability and alleviating pain. For the thumb’s basilar joint, a procedure known as a resection arthroplasty is very effective in maintaining joint motion and alleviating pain.

Another common condition affecting aging hands is a mucous cyst—a mass or blister-like lesion which develops near the nail complex of the fingers or thumb. It can be thought of as a hernia of the joint capsule and is always seen in association with degenerative changes occurring within the joint. When a mucous cyst presents as a blister-like lesion, there is often a temptation to drain or lance the blister. This treatment is ineffective because it does not destroy the source of the fluid. Typically the lesion recurs and can result in a serious joint infection and loss of the joint, should it become infected. When diagnosed early, mucous cysts may be treated with aspiration and/or rupture performed sterilely. A more predictable treatment is surgery to destroy the fluid source and to remove any associated bone spurs.

Tips to make your hands look younger: