Dec 16, 2014 3 min read

DEAR DOCTOR K: I have osteoarthritis in my hand. Could you recommend some drug-free treatments to relieve the pain?

DEAR READER: Osteoarthritis causes stiffness and pain in the joints. It develops when cartilage — the connective tissue that covers the ends of bones — deteriorates. In a joint, the ends of two or more bones come together. The softer and more flexible cartilage that covers the ends of the bones acts as a cushion. If the cartilage were not there, the hard bones would grind against each other.

Over time, the space between bones narrows and the surfaces of the bones change shape. This can eventually damage the joint. In the hand, the most common places for osteoarthritis are the joint at the base of the thumb and the last joints before the tip of the fingers.

Here are some non-drug treatments you can try instead of, or in addition to, more traditional treatments:

n HEAT. Moist heat can help raise your pain threshold and decrease muscle spasms. Simply apply a warm, moist towel to your sore joint. You can also buy gel packs that can be warmed up in the microwave.

n TOPICAL TREATMENTS. Many topical creams and gels, such as Bengay and Aspercreme, can be rubbed directly onto affected joints to temporarily reduce inflammation and pain. These products often contain salicylate, a relative of aspirin, plus menthol or eucalyptus. Creams and lotions containing capsaicin (an extract of pepper) can also help relieve pain. The capsaicin produces a slightly unpleasant sensation that “distracts” the brain from paying attention to the pain signals from your arthritic joint. You need to use these products several times a day, because their effects are temporary.

n SPLINTS. Hand splints can provide pain relief, improve function and realign the joint of your hand if needed. Splints come in a wide range of materials and forms.

n EXERCISES AND JOINT PROTECTION. An occupational therapist (OT) can recommend devices that can help if your hand has lost some strength or function. Examples include long-handed grippers, electric can openers or doorknob turners. An OT can also suggest exercises to improve your function. (I’ve put an illustration on my website, AskDoctorK.com, of an exercise that may help to improve range-of-motion in your hands.) When possible, try to move your hand when you’re feeling less pain or are pain-free, and rest it when pain intensifies.

n PARAFFIN WAX BATH AND HEAT TREATMENTS. Sometimes therapists recommend a warm paraffin wax bath to temporarily relieve symptoms of hand osteoarthritis. You dip your hands into wax melted in an electric appliance that maintains a safe temperature. After the wax hardens, the therapist wraps the treated area in a plastic sheet and blanket to retain the heat. Treatments take about 20 minutes, after which the wax is peeled off. Paraffin bath kits are also available for home use.

If these non-drug treatments don’t give you sufficient relief, consider over-the-counter pain medicines. Particularly if hand pain is reducing the amount of time you can spend at something you love — like gardening or playing the piano — take action. Above all, don’t just do nothing!

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)