How Simple Mittens Can Help With A Lifelong Disease: Mittens and Osteoarthritis

By: Ahaana Chaddha

Reviewed By: Saisha Sikka

Reference Research Paper: Cecilie Bartholdy, et al. “Effect of Heated Mittens on Physical Hand Function in People with Hand Osteoarthritis: Randomised Controlled Trial.” BMJ, 17 Dec. 2024, pp. e078222–e078222, www.bmj.com/content/387/bmj-2023-078222, https://doi.org/10.1136/bmj-2023-078222.

---

This research paper evaluates the effects of heated versus unheated mittens on patients with osteoarthritis.

Osteoarthritis is a degenerative disease characterised by the degeneration of joint cartilage, which is the smooth connective tissue that wraps around the ends of bone at joints, along with the bone itself. It is a serious disease that causes severe pain and stiffness and is most commonly seen in the hip, knee and hands. 

Source: Mandal, Ananya. “What Is Cartilage?” News-Medical.net, 23 Aug. 2018, www.news-medical.net/health/What-is-Cartilage.aspx.

Effects of Osteoarthritis

On the hands, it primarily affects the first carpometacarpal (CMC) joints of the second and fifth fingers. These are synovial ellipsoidal or condyloid joints, meaning that they are of one oval-shaped bone end connecting with an oval-shaped hollow of another, allowing for biaxial movement (as in the movement that lets humans flex and extend their fingers, along with moving them from side to side and in a limited circular manner). It has hyaline joint cartilage, a bluish-white cartilage that works as an articular cartilage ,meaning that it allows the joints to move without friction. Osteoarthritis also affects the distal interphalangeal (DIP) joints of the second to fifth fingers. These joints connect the middle and end of the fingers like a hinge, allowing for flexing and extending, also hyaline. 

Hand osteoarthritis affects 16% of women and 8% of men from middle to old age but treatments which have been developed for years, like surgery, drugs, etc, have proved only to give small outcomes. Oral non-steroidal (without steroids), anti-inflammatory drugs were even considered, to some extent, toxic amongst the elderly having comorbidities (when two or more diseases exist in a body at once). 

For a long time, heat therapy has proved to be a particularly viable option, as it increases blood flow and the supply of oxygen and nutrients to the surrounding tissue of the diseased region. It is a good symptom moderation tool.  

Mittens are common wear for most people living in regions where it tends to get cold. That is no exception to the suffering of people with osteoarthritis. 

The Study

A research study conducted in Denmark aimed to connect the two and observe the effects of using electrically heated mittens versus non-heated or control mittens on the function, stiffness and overall condition  in those with the disease. 

A randomised controlled trial (RCT) was conducted in which participants in the commonly affected age range were monitored for 2, 4, and 6 weeks using the hand mittens in two groups (one for heated and one for non-heated mittens). The participants were instructed to wear the mittens for fifteen minutes every day when they felt that the symptoms of osteoarthritis were worse.

• Steroids are artificial hormones created to mimic the ones that your body produces, usually to reduce inflammation and swelling.

•  An RCT is a scientific experiment that assigns participants to two groups- a control group and an intervention group to test the effects of a treatment.

Source: Cecilie Bartholdy, et al. “Effect of Heated Mittens on Physical Hand Function in People with Hand Osteoarthritis: Randomised Controlled Trial.” BMJ, 17 Dec. 2024, pp. e078222–e078222, www.bmj.com/content/387/bmj-2023-078222, https://doi.org/10.1136/bmj-2023-078222.

The Results

Osteoarthritis severity is measured using the AUSCAN questionnaire. This is the Australian/Canadian Osteoarthritis Hand Index, which  assesses the pain during daily activities, joint stiffness after inactivity (such as after waking up) and the level of physical function difficulties while performing daily tasks with hands like lifting or gripping. As a result of the experiment, changes were primarily seen with the AUSCAN chart. 

While both groups displayed improvement in their AUSCAN points, the group using the heated mittens displayed a greater improvement in hand function as compared to the group using the control mittens, however it was proven to not be statistically significant.

Despite that, the improvement in pain and stiffness with heated mittens was greater than with non-heated mittens (this research was statistically significant), and researchers evaluated that while undergoing long-term osteoarthritis treatment, using electrically heated mittens could benefit the patient as they provide a greater level of comfort and relief from stiffness.

By the end of 6 weeks, 26% of the heated mittens group and 24% of the control group met the OMERACT-OARSI responder criteria. This criterion is a checklist to see whether the patient has improved in at least ⅔ of the three domains- pain, physical function and overall health of the patient with at least a 20% improvement. This is because the heat in the mittens regulate and improve blood flow around the tissue due to the vessels expanding. This will also allow improved transport of oxygen and nutrients. It also relaxes the surrounding muscles which eases the chronic (long-term) pain and loosens stiff muscles.

Conclusion

In conclusion, participants using the heated mittens reported significantly less pain and stiffness (symptom relief) than those using the control mittens without heat. However, it would be advisable to note that the patients became aware of the type of mittens they were using and may have experienced the placebo effect, which could have affected the results.

Overall, it can be concluded that, in terms of patient comfort and relief, electrically heated mittens are the preferred option.

Works Cited

1. Allen, K. D., et al. “Validity and Factor Structure of the AUSCAN Osteoarthritis Hand Index in a Community-Based Sample.” Osteoarthritis and Cartilage, vol. 15, no. 7, July 2007, pp. 830–36, https://doi.org/10.1016/j.joca.2007.01.012. Accessed 5 Dec. 2021.

2. “Arthritis Pain Relief: Ice or Heat? | Mass General Brigham.” Massgeneralbrigham.org, 17 Sept. 2025, www.massgeneralbrigham.org/en/about/newsroom/articles/arthritis-pain-relief. Accessed 30 Oct. 2025.

3. Bingham, C. O., et al. “Responder Analysis and Correlation of Outcome Measures: Pooled Results from Two Identical Studies Comparing Etoricoxib, Celecoxib, and Placebo in Osteoarthritis.” Osteoarthritis and Cartilage, vol. 16, no. 11, Nov. 2008, pp. 1289–93, https://doi.org/10.1016/j.joca.2008.04.009. Accessed 1 July 2022.

4. “Carpometacarpal Joint - an Overview | ScienceDirect Topics.” Www.sciencedirect.com, www.sciencedirect.com/topics/medicine-and-dentistry/carpometacarpal-joint.

5. Cecilie Bartholdy, et al. “Effect of Heated Mittens on Physical Hand Function in People with Hand Osteoarthritis: Randomised Controlled Trial.” BMJ, Dec. 2024, pp. e078222–22, https://doi.org/10.1136/bmj-2023-078222.

6. ---. “Effect of Heated Mittens on Physical Hand Function in People with Hand Osteoarthritis: Randomised Controlled Trial.” BMJ, Dec. 2024, pp. e078222–22, https://doi.org/10.1136/bmj-2023-078222.

7. Cleveland Clinic. “What Are Comorbidities?” Cleveland Clinic, Cleveland Clinic, 15 Mar. 2024, my.clevelandclinic.org/health/articles/comorbidities.

8. Hariton, Eduardo, and Joseph J. Locascio. “Randomised Controlled Trials - the Gold Standard for Effectiveness Research.” BJOG: An International Journal of Obstetrics & Gynaecology, vol. 125, no. 13, 2018, p. 1716, https://doi.org/10.1111/1471-0528.15199.

9. Mayo Clinic. “Osteoarthritis.” Mayo Clinic, 8 Apr. 2025, www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925.

10. Nahornyi, Denys. “Interphalangeal Joints of the Hand.” Physiopedia, www.physio-pedia.com/Interphalangeal_Joints_of_the_Hand.

11. NHS website. “Steroids.” Nhs.uk, June 2025, www.nhs.uk/medicines/steroids/. Accessed 26 June 2025.

12. OrthoInfo. “Articular Cartilage Restoration - OrthoInfo - AAOS.” Aaos.org, 2009, orthoinfo.aaos.org/en/treatment/articular-cartilage-restoration/.

13. “Osteoarthritis of the First Carpometacarpal Joint – Causes, Symptoms, and Treatment.” Bauerfeind-Group.com, 22 Sept. 2025, www.bauerfeind-group.com/en/health/osteoarthritis-joint-wear/osteoarthritis-of-the-first-carpometacarpal-joint-causes-symptoms-and-treatment. Accessed 24 Oct. 2025.

14. Pham, T., et al. “OMERACT-OARSI Initiative: Osteoarthritis Research Society International Set of Responder Criteria for Osteoarthritis Clinical Trials Revisited.” Osteoarthritis and Cartilage, vol. 12, no. 5, May 2004, pp. 389–99, https://doi.org/10.1016/j.joca.2004.02.001.