What People Hope They Do
The promise attached to arthritis gloves is specific and appealing. Gentle, graduated pressure squeezes fluid out of swollen finger joints. Better circulation carries away whatever is causing the ache. You wake up with hands that open instead of hands that have to be prised open. The gloves cost twenty dollars, need no prescription, and have no side effects worth mentioning.
That story is repeated almost word for word across the entire category, including by sellers who have clearly never looked at a trial. We wanted to know how much of it survives contact with the research, so we read the published evidence rather than the marketing — the randomised trials, the systematic review, the economic analysis, and the interviews with the people who wore the gloves.
The answer is more interesting than either "they work" or "they're a scam", and it is genuinely useful if you are deciding whether to spend money. If you have already settled the question and just want the product landscape, our compression gloves buying guide covers sizing, materials and what is actually on the shelves. This page is about whether to buy any of them at all.
What the Research Actually Found
For decades, arthritis gloves were supported by a handful of very small studies. Then somebody ran the trial properly.
The A-GLOVES trial (2021) is the one that matters
Hammond and colleagues recruited 206 adults with rheumatoid or undifferentiated inflammatory arthritis and persistent hand pain across 16 NHS sites in the UK, and randomly assigned them 1:1 to one of two things. The intervention group got genuine three-quarter-finger Isotoner arthritis gloves, which the manufacturer rates at 23–32 mmHg of pressure. The control group got Jobskin classic oedema gloves — deliberately fitted at least one size too large, so they applied essentially no pressure while looking similar and, crucially, providing similar warmth.
That control is the clever part, and it is why this trial can answer a question the earlier ones could not. If compression is the active ingredient, the tight gloves should win. If it is warmth, comfort or expectation, the two groups should be indistinguishable.
They were indistinguishable. After 12 weeks, dominant-hand pain during daily activities fell from 6.3 to 5.3 in the compression group and from 6.3 to 5.1 in the placebo group, on a 0–10 scale. The adjusted mean difference between groups was 0.10 points (95% CI −0.47 to 0.67; p = 0.72). For context, the smallest change patients typically notice on that scale is about 1.1 points — so not only was the difference not statistically significant, it was an order of magnitude below the threshold of being perceptible.
The secondary outcomes told the same story. Hand stiffness improved slightly in both groups, with no meaningful difference. Morning stiffness duration fell by about 70 minutes in the compression group and about 45 minutes in the placebo group — a difference that was not statistically significant, and one that ran in the direction of the gloves rather than emphatically. Hand function scores moved similarly in both arms.
The economic analysis was blunter still. Providing the gloves cost £129 per participant and produced 0.003 quality-adjusted life-years, giving an incremental cost-effectiveness ratio of roughly £83,700 per QALY — far outside any threshold a health service would fund. The authors' stated conclusion was that the trial "provides evidence of no clinically important effect of arthritis gloves on any of the trial outcomes", and that the results support ceasing routine provision of arthritis gloves in NHS practice. Their suggested alternative was telling: if patients want gloves, they could simply buy ordinary three-quarter-finger gloves from a shop.
What came before it, and why it looked better
The 2016 systematic review in Clinical Rehabilitation, by the same research group, pooled the four randomised trials that existed at the time. Their combined sample was 74 people. Almost all tested full-finger gloves worn overnight. The review's conclusion was that evidence for night-worn compression gloves is "inconclusive", that finger joint swelling was significantly reduced in rheumatoid arthritis but findings for pain and stiffness were not consistent, and that there were no improvements in grip strength or dexterity. It also noted that one of those studies had already found similar effects from compression gloves and thermal placebo gloves — the warmth signal was visible fifteen years before A-GLOVES confirmed it.
The most-cited positive study is older and smaller: McKnight and Kwoh's 1992 randomised trial in Arthritis Care & Research, with 39 patients wearing Isotoner or Futuro gloves for seven nights. It reported reduced pain and stiffness, reduced swelling of the proximal interphalangeal joints, and increased range of motion and grip strength. It is a real result and we are not dismissing it — but seven nights, 39 people, and no warm-but-loose control arm is not a foundation on which to build a category.
The trap the older evidence fell into
The clearest illustration is the C-GLOVES feasibility study from 2021, which gave Isotoner compression gloves to 41 people with inflammatory arthritis and 32 with hand osteoarthritis, with no control group at all. Hand pain on activity and at night, stiffness, joint swelling, finger flexion and hand function all improved significantly. Read on its own, it looks like proof.
It isn't, and A-GLOVES is exactly why. People join studies when their symptoms are bad, and symptoms that are unusually bad tend to drift back toward average regardless of treatment. Add the warmth of a glove, the attention of a therapist and the expectation of relief, and a single-arm study will report improvement whatever you put on the hands. That is not a criticism of C-GLOVES — it was explicitly designed as a feasibility study to size the real trial, which is precisely what it did. It is a criticism of every article that cites studies like it as evidence that compression works.
Claims vs Evidence
Every claim below is one we found being made in marketing copy for compression gloves. Here is what the published research actually supports.
| The claim | What the evidence shows | Confidence |
|---|---|---|
| "Compression gloves reduce arthritis hand pain" | Partly. Pain fell about 1 point on a 0–10 scale over 12 weeks in A-GLOVES — but it fell just as much in the loose placebo group, and both fell short of the ~1.1-point threshold for a noticeable change. | Moderate — a small improvement is real; attributing it to the gloves specifically is not supported. |
| "The compression is what does the work" | Not supported. Gloves fitted a size too large, applying no pressure, matched gloves rated at 23–32 mmHg. The 2016 review had already flagged similar effects from a thermal placebo. | High confidence this is wrong. |
| "They reduce finger joint swelling" | Plausible but poorly established. The 2016 review found finger joint swelling significantly reduced in RA across four small trials (74 people total, moderate-to-high risk of bias). A-GLOVES did not measure swelling objectively. | Low to moderate. |
| "They ease morning stiffness and night pain" | Unproven. The 2016 review called nocturnal pain and morning stiffness findings inconclusive. In A-GLOVES morning stiffness fell in both arms (~70 vs ~45 minutes) with no significant difference. | Low. |
| "They improve grip strength and dexterity" | Not supported. The 2016 review found no improvement in grip strength or dexterity. The 1992 trial did report grip gains, but over seven nights in 39 people without a warm control. | Low, and leaning negative. |
| "People who wear them say they help" | True — and this is the finding people misread. Over 70% of both the compression and the no-pressure placebo groups reported benefit and wanted to continue. Interviews attributed relief chiefly to warmth. | High — but it happens with non-compressive gloves too. |
| "They protect your joints / slow the disease" | No evidence whatsoever. No trial has tested or shown any effect on disease activity, joint damage or deformity. UK therapists surveyed did not expect gloves to prevent deformity either. | High confidence this is false. Treat it as a red flag on any seller who claims it. |
| "They work for hand osteoarthritis" | Barely studied. The 2016 review found a single hand-OA study of five people, with no differences. The larger A-GLOVES trial did not include osteoarthritis at all. | Very low — essentially untested in the condition many buyers have. |
| "They're completely harmless" | Mostly, not entirely. Adverse events: 51% of the compression group vs 36% of placebo, 6–7% stopping wear; more pins and needles, numbness and fingertip discolouration with compression. In 1992, 12 of 13 people with bilateral carpal tunnel syndrome worsened after one night. | Moderate — minor issues are common, and carpal tunnel is a genuine caution. |
What They Plausibly Do Help With
Take the verdict seriously in both directions. "Compression is not the active ingredient" is not the same statement as "wearing gloves does nothing", and the trial does not support the second one. Here is what survives.
- Warmth, which is the leading candidate. Interviews with 19 A-GLOVES participants, published separately in Rheumatology Advances in Practice in 2022, came back to temperature repeatedly — one participant summarised it as pain easing once the joints got warmer. Both glove groups described the same thing. If cold hands make your joints ache, a glove is a direct answer to that, and it does not need to be a medical one.
- Subjective comfort and a sense of support. The A-GLOVES authors suggested the tactile feedback of wearing something on the hand contributes to reported comfort, and may subtly change how people use their hands. That is not a placebo in the dismissive sense — feeling better is the outcome most people are actually buying.
- Morning stiffness, possibly. Stiffness duration did fall substantially in both arms of A-GLOVES. We cannot credit the compression for it, and we cannot rule out that simply having warm hands overnight helps.
- Swelling, tentatively. This is the one mechanism with a plausible physical basis and some supporting signal: the 2016 review found finger joint swelling significantly reduced in RA. The trials were small and at risk of bias, so treat it as a reasonable hypothesis rather than a settled fact.
- Being cheap enough to try. A pair of gloves costs less than a co-pay. When the downside is twenty dollars and some itchy hands, "the evidence is weak" is a reason to lower your expectations, not necessarily a reason not to try.
What they do not do is unambiguous, and it deserves a sentence of its own. Compression gloves do not treat arthritis. They have never been shown to affect disease activity, slow joint damage, prevent deformity, or reduce your need for medication. Rheumatoid and other inflammatory arthritis are conditions where the underlying disease process is treatable and where delay costs you joints. A glove addresses symptoms at best, and mostly by keeping your hands warm.
Who Is Most Likely to Get Something Out of Them
Given what the evidence shows, the honest targeting is narrower than the marketing suggests — and it is mostly about warmth and comfort.
- People whose hands are cold and stiff and feel better warm. This is the group the evidence actually points at. If your hands ache in a cool room or first thing in the morning, gloves are a reasonable, low-cost response.
- People with visible finger swelling. The weakest-but-real swelling signal applies here, and this is where a therapist would traditionally have reached for gloves.
- People who have already tried a pair and found they help. If it works for you, it works for you — the trial result does not overrule your own experience, it just tells you the mechanism is probably not the squeeze, so a cheaper or looser glove may serve you equally well.
Less likely to be worth it: anyone hoping for grip strength gains, anyone with hand osteoarthritis expecting the same evidence base as inflammatory arthritis (it does not exist), and anyone buying gloves in place of seeing a clinician about new or worsening joint symptoms.
And if the underlying problem is that daily tasks have become painful or impossible, gloves are the wrong tool entirely. Reducing how much force your hands have to generate does more than padding them does — that is the reasoning behind our guides to arthritis-friendly kitchen tools, opening jars with arthritic hands, easy-grip and spring-loaded scissors and dressing with limited hand strength.
If You're Going to Try Them, Choose and Fit Them Sensibly
The trial evidence changes the shopping advice in a specific and useful way: stop chasing compression numbers. Higher pressure has not been shown to buy a better result, and it does buy more side effects. Optimise for warmth, comfort and staying on your hands.
Compression level
The gloves used in A-GLOVES were rated at 23–32 mmHg by the manufacturer, and they lost to gloves applying nothing. Most consumer gloves do not publish a pressure figure at all, and given the results, that turns out to matter less than the category would like you to think. If a listing leads with a big mmHg number as its main selling point, it is selling you the ingredient the trial ruled out.
Fit
Snug, warm, and never numb. Follow the manufacturer's hand-measurement chart rather than guessing from your usual glove size, and use these as stop signs: tingling, numbness, throbbing, deep indentation marks, or fingertips going pale, white or blue. Any of those means the glove is too tight — size up. This is one of the rare occasions where the research explicitly supports going looser, because the loose gloves worked just as well.
Open fingertips vs full finger
Open-fingertip (three-quarter-finger) designs are the practical default for daytime, and they were what UK rheumatology occupational therapists mostly stocked. You keep sensation and friction for coins, buttons, keys and touchscreens. Full-finger gloves cover more and suit sleeping, and they are the design used in the older night-wear trials — but participants in the A-GLOVES interviews specifically complained that gloves were too slippery for driving and had to come off for anything needing firm grip or wet hands.
Day wear, night wear, or both
Neither schedule has beaten a warm loose glove. The UK therapist survey found practice had moved to recommending gloves "as and when" symptoms warrant, with explicit advice against wearing them continuously through the day. Wear them when your hands are cold, stiff or sore; take them off when they stop earning their place.
Replacement
Elastic fabric fatigues. In the therapist survey, day-wear gloves lasted around 5.7 months, night-wear around 7.9, and combined day-and-night use about 4.5 months before replacement. Whatever compression a glove started with, an old pair has less of it — and given the trial result, that may matter less than the fact that a worn-out glove is also a less warm and less comfortable one.
Current listings, if you want to look: open-fingertip arthritis compression gloves, or — following the A-GLOVES authors' own suggestion — plain fingerless wool gloves for warmth, which cost less and, on this evidence, may do the same job. Our compression gloves guide goes through the sizing charts and materials in detail.
When to See a Doctor Instead of Buying Gloves
This is the part of the article we would most like you to act on, and it is why an honest read of the evidence matters. This page is general information, not medical advice. Compression gloves address symptoms at best. Arthritis — particularly inflammatory arthritis — involves an underlying disease process that is treatable, and where the treatment works better the earlier it starts.
The NHS is direct about why this matters: diagnosing rheumatoid arthritis quickly is important because early treatment can prevent it getting worse and reduce the risk of joint damage. No glove does that. If there is a window in which disease-modifying treatment protects your hands, spending it on compression gloves is the most expensive thing about them.
It is also worth a conversation with a clinician before wearing compression on your hands overnight if you have carpal tunnel syndrome — in the 1992 trial, 12 of 13 participants with bilateral carpal tunnel syndrome had worse symptoms after a single night in compression gloves — or if you have Raynaud's, diabetes, peripheral neuropathy, reduced sensation, or any circulatory problem in your hands.
Alternatives With Better Evidence Behind Them
If your goal is hands that hurt less and work better, several things have stronger support than compression gloves do. None of them are exotic.
Warmth, delivered any way you like
This one follows straight from the trial. If warmth is the plausible active ingredient, you can get it from ordinary gloves, fingerless mittens, a warm room or a hot drink held between both hands. The A-GLOVES authors made this recommendation themselves: ordinary three-quarter-finger gloves are widely available, cost patients very little, and would save health services money.
Heat therapy and paraffin wax
Better studied than gloves, and specifically endorsed for hand osteoarthritis. The 2019 American College of Rheumatology and Arthritis Foundation guideline for osteoarthritis of the hand, hip and knee conditionally recommends paraffin bath therapy for hand OA. A 2026 systematic review and meta-analysis in the Journal of Rehabilitation Medicine pooled nine randomised trials covering 627 people and found heat therapy significantly reduced pain (SMD −0.60) and improved grip strength (SMD 0.43), at moderate certainty of evidence, with no significant effect on stiffness or function. That is a modest, short-term benefit — but it is a better-evidenced modest benefit than the gloves have. If you want to try it: paraffin wax baths for hands.
Hand exercise, which has the best evidence of anything here
The SARAH trial (Lamb and colleagues, The Lancet, 2015) randomised 490 adults with rheumatoid arthritis and hand pain or dysfunction to usual care, or usual care plus a tailored strengthening and stretching hand programme. At 12 months, hand function improvement in the exercise group was roughly double that of usual care (7.9 vs 3.6 points on the Michigan Hand Outcomes Questionnaire function subscale). It caused no increase in joint pain, stiffness or flares, it was cost-effective, and the benefit was still detectable more than two years after randomisation. Ask a hand therapist or physiotherapist about it by name.
Splints and orthoses, where they're indicated
Also better supported than gloves for one specific problem: the 2019 ACR guideline strongly recommends hand orthoses for arthritis at the base of the thumb (the first carpometacarpal joint), and conditionally recommends them for other hand joints. If your pain is concentrated at the thumb base, that is a different piece of equipment and a much stronger recommendation.
Reducing the load on your hands in the first place
Joint protection technique — using larger joints, avoiding sustained tight grips, spreading load across both hands, and swapping tools for versions that need less force — is the least glamorous item on this list and often the most useful day to day. Practical starting points: jar openers and jar-opening technique, kitchen tools designed for arthritic hands, spring-loaded and easy-grip scissors, and dressing aids for limited hand strength. If a task hurts, changing the tool usually beats padding the hand.
Frequently Asked Questions
They probably help a little, but the compression itself does not appear to be the reason. The A-GLOVES randomised controlled trial, published in BMC Musculoskeletal Disorders in 2021, gave 206 people with rheumatoid or inflammatory arthritis either genuine Isotoner compression gloves rated at 23 to 32 mmHg or deliberately loose placebo gloves fitted at least one size too large. After 12 weeks, hand pain fell by 1.0 points in the compression group and 1.2 points in the placebo group on a 0 to 10 scale — an adjusted mean difference of 0.10, with a p value of 0.72. Over 70 percent of both groups said the gloves helped and wanted to keep wearing them. The authors concluded that the benefit people feel is more likely to come from warmth and comfort than from pressure. Our compression gloves guide covers what to look for if you still want to try a pair.
Night wear has the longer history, day wear has the larger trial behind it, and neither has been shown to beat a warm non-compressive glove. The four small trials in the 2016 Clinical Rehabilitation systematic review all tested full-finger gloves worn overnight and returned inconclusive results for pain and stiffness. The much larger A-GLOVES trial tested three-quarter-finger gloves worn in the daytime and found no advantage over placebo. A survey of UK rheumatology occupational therapists found practice had shifted to recommending gloves as and when symptoms warrant rather than continuously, and therapists specifically advised against wearing them all day. The practical answer is to wear them when your hands feel cold, stiff or sore, and to take them off when they stop feeling useful.
Snug enough to stay put and feel warm, and never tight enough to cause tingling, numbness or colour change in your fingertips. This is one place where the trial evidence is genuinely reassuring about going looser: the A-GLOVES placebo gloves were fitted at least one size too large and delivered the same symptom improvement as gloves rated at 23 to 32 mmHg. Higher compression is not buying you a better result, but it is buying you more side effects — 51 percent of the compression group reported adverse events against 36 percent of the placebo group, and pins and needles, numbness and fingertip discolouration were reported far more often in the compression arm. If a glove leaves deep marks, throbs, or makes your fingers pale or blue, it is too tight.
Open-fingertip gloves are the more practical choice for daytime wear, and no trial has shown either design to be clinically superior. Open-fingertip designs, sometimes sold as three-quarter-finger gloves, leave your fingertips free so you keep the sensation and friction you need to pick up a coin, fasten a button or use a touchscreen — and they are what UK occupational therapists mostly stocked. Full-finger gloves cover more of the hand and are the design used in the older night-wear trials, which suits sleeping but makes most daytime tasks harder. Participants in the qualitative study nested inside the A-GLOVES trial complained that gloves were too slippery for driving and had to be taken off for anything needing a firm grip or wet hands, which is an argument for the open design if you plan to wear them while doing things.
They will not worsen the underlying arthritis, but they can cause problems of their own, and there is one specific group who should be careful. In the A-GLOVES trial, adverse events were reported by 51 percent of the compression group and 36 percent of the placebo group, with 6 to 7 percent of each group stopping glove wear altogether; the most common complaint was hands becoming hot and itchy and disturbing sleep. The compression group also reported markedly more pins and needles, numbness and fingertip discolouration. The clearest warning comes from the 1992 McKnight and Kwoh trial: of 13 participants who also had bilateral carpal tunnel syndrome, 12 had worse symptoms after a single night in compression gloves. If you have carpal tunnel syndrome, Raynaud's, poor circulation, diabetes or reduced sensation in your hands, ask a clinician before wearing compression on your hands overnight.
Bottom Line
We went looking for evidence that compression gloves help arthritis, and what we found instead was a well-designed trial showing that the compression is not the part that helps. Real gloves rated at 23–32 mmHg and placebo gloves fitted a size too large produced the same modest improvement in hand pain, stiffness and function over 12 weeks — and left both groups equally convinced their gloves had worked. The most likely explanation is warmth, comfort and expectation, which is a real benefit but a much cheaper one than the category is priced at.
That is not a reason to throw yours away. If gloves make your hands feel better, they make your hands feel better, and that was always the outcome you were buying. It is a reason to lower your expectations, ignore mmHg ratings, buy at the affordable end, and take seriously the possibility that a warm pair of ordinary fingerless gloves does the same job. It is also a firm reason to disbelieve anyone claiming these gloves protect your joints or affect the disease — nothing in the literature supports that.
The thing we would most want you to take from this: gloves are a symptom aid, and arthritis is a treatable disease. Persistent joint pain, swelling in the small joints of the hands, or morning stiffness lasting three quarters of an hour or more should be assessed by a doctor, and soon — inflammatory arthritis responds better the earlier treatment begins, and normal blood tests do not rule it out. Alongside that, hand exercise and heat therapy both have stronger evidence than gloves do. If you still want to try a pair, our compression gloves guide has the sizing and material detail — go in with the right expectations and they are a reasonable twenty-dollar experiment.
Sources
These are the papers and authority pages we read in researching this article. Where we have quoted a figure, it comes from one of these.
- Hammond A, Prior Y, Cotterill S, et al. "Clinical and cost effectiveness of arthritis gloves in rheumatoid arthritis (A-GLOVES): randomised controlled trial with economic analysis." BMC Musculoskeletal Disorders 2021;22(1) — 206 participants randomised; Isotoner compression gloves (23–32 mmHg) vs loose Jobskin placebo gloves; hand pain fell 1.0 vs 1.2 points, adjusted difference 0.10 (95% CI −0.47 to 0.67; p = 0.72); no clinically important effect on pain, stiffness or function; adverse events 51% vs 36% with 6–7% discontinuing; ICER ≈ £83,700/QALY; authors recommend ceasing routine provision.
- Hammond A, Jones V, Prior Y. "The effects of compression gloves on hand symptoms and hand function in rheumatoid arthritis and hand osteoarthritis: a systematic review." Clinical Rehabilitation 2016;30(3):213–224 — four randomised trials, 74 participants total, mostly night-worn full-finger gloves; finger joint swelling significantly reduced in RA, but pain and stiffness findings inconclusive and no improvement in grip strength or dexterity; one study found similar effects from compression and thermal placebo gloves; only one hand-OA study (n = 5), showing no differences.
- McKnight PT, Kwoh CK. "Randomized, controlled trial of compression gloves in rheumatoid arthritis." Arthritis Care & Research 1992;5(4):223–227 — 39 patients, seven nights of Isotoner or Futuro gloves; reduced subjective pain and stiffness, reduced PIP joint swelling, increased range of motion and grip strength; 12 of 13 participants with bilateral carpal tunnel syndrome had worse symptoms after one night's wear.
- Prior Y, et al. "Does wearing arthritis gloves help with hand pain and function? A qualitative study into patients' views and experiences." Rheumatology Advances in Practice 2022;6(1):rkac007 — 19 A-GLOVES participants interviewed; benefit attributed chiefly to warmth in both the compression and placebo groups; practical complaints included gloves being too slippery for driving, unusable with wet hands, hard to take on and off, and durability problems.
- Hammond A, Prior Y. "Compression gloves for patients with hand arthritis (C-GLOVES): a feasibility study." Hand Therapy 2021 — 41 inflammatory arthritis and 32 hand osteoarthritis participants, all given Isotoner gloves with no control group; pain, stiffness, swelling, finger flexion and hand function all improved significantly, illustrating why uncontrolled studies overstate glove benefit.
- Hammond A, Prior Y. "Arthritis glove provision in rheumatoid arthritis and hand osteoarthritis: a survey of United Kingdom rheumatology occupational therapists." Hand Therapy 2022;27(1):3–13 — 97% of respondents provided arthritis gloves; open-finger Isotoner designs dominant; gloves recommended "as and when" needed rather than continuously through the day; typical replacement at ~5.7 months (day wear), ~7.9 months (night wear), ~4.5 months (both); therapists did not expect gloves to prevent deformity.
- Kolasinski SL, et al. "2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee." Arthritis & Rheumatology 2020;72(2):220–233 — hand orthoses strongly recommended for first carpometacarpal (thumb base) OA and conditionally recommended for other hand joints; paraffin and thermal modalities conditionally recommended for hand OA.
- "The short-term efficacy of heat therapy for osteoarthritis of the hands: a systematic review and meta-analysis." Journal of Rehabilitation Medicine 2026;58:45883 — nine randomised trials, 627 participants; significant reduction in pain (SMD −0.60) and improvement in grip strength (SMD 0.43) at moderate certainty; no significant effect on stiffness or function.
- Lamb SE, et al. "Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial." The Lancet 2015;385(9966):421–429 — 490 adults randomised; hand function improvement roughly double usual care at 12 months (7.9 vs 3.6 points on the MHQ function subscale), no increase in pain, stiffness or flares, and cost-effective.
- NHS — Rheumatoid arthritis — see a GP if you think you have symptoms; diagnosing rheumatoid arthritis quickly matters because early treatment can prevent it getting worse and reduce the risk of joint damage. Also NHS — Rheumatoid arthritis symptoms, on morning stiffness lasting longer than the ~30 minutes typical of osteoarthritis, and joints that become swollen, hot and tender.
- NHS Greater Glasgow and Clyde — Suspected rheumatoid arthritis, referral guidance — refer if symptoms persist beyond six weeks even with normal CRP and negative anti-CCP or rheumatoid factor; features include new synovitis of more than one joint (especially small joints of hands and feet), morning stiffness over 45 minutes, and symmetrical symptoms.
Evidence changes. The A-GLOVES trial is the largest and most rigorous study in this area at the time of writing, but it enrolled people with rheumatoid and undifferentiated inflammatory arthritis only — hand osteoarthritis remains close to untested, and a future trial could reasonably reach a different conclusion there.