Gout Impairs Hand Dexterity, Grip Endurance Comparable to RA, Study Finds

A study found that individuals with gout experience impaired hand function, including grip strength and manual dexterity.1

Research has shown that gout can cause structural changes in the hand joints and surrounding tissues, leading to joint damage, inflammation, tophus formation, and alterations to tendons or ligaments that impair task performance.2 These changes weaken grip strength and grip endurance.1 Gout flares and the fatigue that often follows also impede a person’s ability to participate in daily activities, contributing to functional losses.

Investigators sought to compare the hand function of participants with gout or rheumatoid arthritis (RA) versus healthy controls. Both RA and gout have a large impact on hand function, but no studies have compared the hand function of these rheumatology conditions.

In a case-controlled, single-center study conducted at the Ankara Etlik City Hospital Rheumatology Clinic between March and August 2024, the team assessed grip strength and grip endurance via a hand dynamometer (Jamar Hand-Dynamometer, USA), manual dexterity via the Nine-Hole Peg Test, and perceived hand functional disability via the Duruöz Hand Index. Participants with gout met the 2015 ACR-EULAR Gout classification criteria, and those with RA met the 2010 ACR/EULAR RA classification criteria.

“We…found that gout had worse dexterity than [healthy controls],” wrote investigators, led by Oguzhan Mete, from the University of Health Sciences, Gülhane Faculty of Physiotherapy and Rehabilitation in Turkey. “Additionally, except for the non-dominant removing time, it was as poor as RA. It was surprising that, although RA mainly affects the hand joints and worse manual dexterity was well-known, participants with gout also experience manual dexterity impairments that are nearly equivalent to RA. It is an important issue that needs to be addressed.”

Participants with gout and healthy controls had similar grip strength (P > .05), but those with gout had lower dominant (P = .008) and non-dominant (P = .001) grip endurance. Individuals with gout had greater dominant placing (P = .001), removing (P < .001), and total Nine-Hole Peg Test (P < .001) time than controls, indicating that it takes them longer to complete tasks with the dominant hand. Those with gout also had greater non-dominant placing (P = .002), removing (P = .004), and total Nine-Hole Peg Test (P = .002) time than controls.

“It is an important issue that needs to be addressed,” investigators wrote. “Manual dexterity involves skillful hand and arm movements that rely on strong sensorimotor functions that are important to perform daily living activities properly. Therefore, the causes, including clinical, kinetic, and kinematic analyses of impairment in hand dexterity in gout, should be further investigated.”

Additionally, participants with gout had a greater Duruöz Hand Index (range, 0 – 90) than healthy controls (2 vs 0) but lower than in patients with RA (2 vs 10) (P = .008).

“The perceived hand function was impaired in gout, although not as severely as in RA,” investigators wrote.

The team said the lack of ultrasound or X-ray findings limited the findings. They could not assess the extent of the structural damage in the joints and had to rely on other measures, like the dynaometer. Investigators said future studies should examine the relationship between structural damage and hand function.

“These results provide valuable insights into the characteristics of hand function in gout. Assessing hand function during clinical examinations of patients with gout should be considered…it is clinically important to address these issues collaboratively with rheumatologists, physicians, and hand therapists.”

References

1. Mete O, Apaydin H, Varol F, Gülöksüz EGA, Pamukcu M. Hand function in gout: a comparative study with rheumatoid arthritis and healthy. Rev Assoc Med Bras (1992). 2025 Jul 7;71(6):e20250054. doi: 10.1590/1806-9282.20250054. PMID: 40638474; PMCID: PMC12245048.

2. Xu H, Qin H, Hua Y, Dalbeth N. Contributions of joint damage-related events to gout pathogenesis: new insights from laboratory research. Ann Rheum Dis. 2023;82(12):1511-1515. doi:10.1136/ard-2023-224679