My hands didn't worsen during the summer, probably because I was swimming A LOT, a few times daily. (they didnt improve either, but I could live with that, and I had no pain whatsoever, which was wonderful). They only got worse last week when I went to a mineral springs spa resort, it did feel like an inflammation. Hot water made them worse. Does that point to something? The neurologist I've seen today wouldn't even listen to such information