Special arthritis gloves are no more effective than looser-fitting alternatives in reducing hand pain and stiffness, new work has shown. The researchers say that healthcare professionals should not recommend special gloves; the cheaper alternatives are just as effective.
Rheumatoid arthritis is a common condition which causes painful joints. Special gloves can be prescribed for hand pain; they are usually given out by occupational therapists. However, there is no strict guidance on when gloves should be given.
When the researchers reviewed the available research, they found little evidence that the gloves are effective in reducing hand pain and stiffness. They then set up a large trial and found that the special gloves were no more effective than looser-fitting alternatives.
The researchers say that healthcare professionals should not recommend special gloves, and the NHS should stop buying them. The main benefit of gloves was warmth; and ordinary gloves could be just as effective. The results suggest that professionals should advise people to try ordinary fingerless gloves or buy their own gloves from high street shops or online.
What’s the issue?
Rheumatoid arthritis causes pain and inflammation at the joints, and can restrict movement. Around 400,000 people in the UK live with the condition. Most are over 40 but children and young people can also have rheumatoid arthritis.
Undifferentiated arthritis is an umbrella term for arthritis that does not fit a specific diagnosis, often because it developed recently. For many people, symptoms resolve without treatment. But 1 in 3 go on to develop rheumatoid arthritis.
Treatments typically include medication, physiotherapy, occupational therapy and surgery. In addition, since the 1980s, special gloves have been widely prescribed for rheumatoid arthritis and other common types of arthritis.
Special gloves are believed to work by exerting pressure and so help reduce swelling. This is thought to reduce pain and stiffness. The gloves are prescribed for daytime wear to improve function and for night-time use to improve sleep.
The gloves are considered low cost at up to £25 per pair. The NHS usually provides people with one pair only, which need to be replaced after 4 – 6 months. Many people therefore need to buy the gloves themselves after that, and the cost mounts up.
Despite their widespread use, there is little evidence to show that they are effective. One small study found that people generally liked the comfort, warmth and gentle support the special gloves gave. It showed some small improvements in hand pain, stiffness and function. However, there was no comparison group which meant there was no way to tell whether the gloves or other aspects of care led to improvements.
In the current study, researchers discussed what type of gloves should serve as a comparison. People with arthritis were involved in the design of the study. They said the alternatives should be loosely fitted and apply no pressure but still provide similar warmth.
The study included 163 people with rheumatoid arthritis or undifferentiated arthritis. They were aged 59 years on average and were being treated at 16 NHS sites in England and Scotland.
Everyone in the study received three-quarter-length gloves that leave fingers free. They were either special arthritis gloves that apply pressure, or loose-fitting alternatives. Both types kept hands warm and both were fitted by occupational therapists.
Participants completed a survey before they received the gloves and again 12 weeks later, after the trial. They rated pain in their dominant hand during activities such as housework, DIY and gardening. They also gave their opinion about the gloves.
People in both groups reported similar, but only small, improvements in hand pain. Most people (73%) in both groups found the gloves beneficial.
Study participants said that:
- gloves give warmth (74% with arthritis gloves; 80% with the alternatives)
- gloves give comfort (85% with arthritis gloves; 75% with the alternatives)
- gloves improve sleep (41% of people in both groups).
Both groups expressed had similar views about the gloves. A participant with loose-fitting gloves said: “They were fab. They actually made my joints warm and… as soon as your joints get a bit warmer, the pain actually eases”. Most people (72%) in both groups said they would continue to wear them.
The most common problem in both groups was sleep disturbance, when gloves made hands hot and itchy. More people wearing the arthritis gloves reported downsides (51% compared to 36% with the alternatives). People wearing specialist gloves were more likely to have pins and needles, or numbness. Similar numbers in both groups stopped using gloves (6% using arthritis gloves; 7% using alternative gloves).
Overall, the trial shows that specialist arthritis gloves are no more effective than looser-fitting alternatives. Cheaper, non-specialist gloves had similar benefits.
Why is this important?
Arthritis gloves are commonly prescribed, but there is little evidence to support their use. This research found that they are no more effective at reducing symptoms than looser-fitting gloves. It showed that arthritis patients found the warmth most comforting about using gloves.
This means that cheaper alternatives would give the same benefits. This could save money for the NHS and for patients. Patients could decide to buy ordinary fingerless gloves for themselves.
The research sheds light on the way gloves might work. They were thought to address hand pain and stiffness by exerting pressure. This study suggests that benefits to people with painful hands are more likely to be due to warmth and comfort.
Wearing gloves might also remind people to take care of their hands. It could encourage them to subtly change the way they use their hands. The researchers recommend that people with arthritis try for themselves wearing ordinary light-weight fingerless gloves.
Since special gloves are no more effective than loose-fitting alternatives, healthcare professionals should not prescribe them to patients. Future research should look at whether even cheaper gloves are effective for arthritis than the looser-fitting gloves used in this work.
The researchers believe that similar results would be found in people with different types of hand arthritis. However, more research is needed to test this.
People in both groups reported some benefits from wearing gloves. They generally felt this was due to comfort and warmth but further work could explore how and why the gloves make a difference.
You may be interested to read
This NIHR Alert is based on: Hammond A, and others. Clinical and cost effectiveness of arthritis gloves in rheumatoid arthritis (A-GLOVES): randomised controlled trial with economic analysis. BMC Musculoskeletal Disorders 2021;22:47
Another summary of this research paper by Kudos - Arthritis gloves: are they effective and cost-effective?
A summary of previous work highlighting the lack of evidence into arthritis gloves: Do arthritis gloves work?
A video summary of this study: Prof Alison Hammond talks about the Arthritis Gloves Trial
Funding: This paper presents independent research funded by the NIHR under its Research for Patient Benefit (RfPB) Programme.
Conflicts of Interest: The study authors declare no conflicts of interest.
Disclaimer: NIHR Alerts are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that views expressed in NIHR Alerts are those of the author(s) and reviewer(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.