Arthritis in the Hand and Wrist

What is Hand and Wrist Arthritis?

Arthritis is a condition that involves the breakdown of the protective cartilage around the joints, which results in pain, stiffness, and inflammation. Several forms of arthritis affect the joints in the wrist, hand, and fingers. Over time, if the arthritis is not treated, the bones that make up the joints can lose their normal shape. This causes more pain and further limits the range of motion. 

Causes and Types of Hand and Wrist Arthritis

The most common causes of arthritis of the hand and wrist are disease and trauma. 

Disease

When arthritis occurs due to disease, the onset of symptoms is gradual and the cartilage slowly deteriorates. Osteoarthritis, also known as “wear and tear” arthritis, is a degenerative joint disease in which the cushioning cartilage that covers the bone surfaces at the joints begins to wear out. It develops in a predictable pattern in certain joints. 

Rheumatoid arthritis is a chronic disease that can affect many parts of your body. It causes the joint lining (synovium) to swell, which causes pain and stiffness in the joint. Rheumatoid arthritis of the hand is most common in the wrist and knuckles. It usually affects the same joints on both sides of the body. 

Trauma

Fractures, particularly those that damage the surface of the joints, and dislocations are among the most common injuries that lead to arthritis. Even when properly treated, an injured joint is more likely to become arthritic over time. 

Symptoms of Hand and Wrist Arthritis

If you have arthritis in your hand and wrist, you will likely experience pain, stiffness, and associated swelling. Other common symptoms include: 

• A burning sensation
• Pain after periods of increased joint use
• Pain and stiffness in the morning 
• Pain with rainy weather
• Warmth to the touch
• A grating or grinding sensation

In addition, when arthritis affects the end joints of the fingers (DIP joints), small cysts (mucous cysts) may develop. The cysts can cause ridging or dents in the nail plate of the affected finger.

How is Hand and Wrist Arthritis Diagnosed?

Your doctor can diagnose hand and wrist arthritis by conducting a physical examination of the hand and imaging tests, such as an x-ray. Specialized testing, including MRI, is usually not needed unless Keinbock’s disease is present or suspected. In some cases, a bone scan may be performed to help your doctor diagnose arthritis at an early stage, even if x-rays look normal. 

Treatment for Hand and Wrist Arthritis

It is important to seek help early for hand and wrist arthritis so that treatment can begin and you can return to doing what you love most. Optimal care and treatment involve a multidisciplinary approach, including the patient, physicians, and therapists. Treatment for hand and wrist arthritis depends on a variety of factors, such as:

• How far arthritis has progressed
• How many joints are involved
• Your age, activity level, and other medical conditions
• If the dominant or non-dominant hand is affected
• Your personal goals, at-home support, and ability to understand the treatment and comply with a therapy program

Nonsurgical Treatment

Nonsurgical treatment options for hand and wrist arthritis include: 

• Activity Modification. Limiting or stopping activities that worsen the pain is the first step in relieving symptoms.

• Medications. Anti-inflammatory medications, such as ibuprofen and naproxen, can help to reduce joint swelling and pain.

• Injections. Injections for hand and wrist arthritis contain a long-lasting anesthetic and a steroid that can provide pain relief for weeks, or even months. 

• Splinting. Injections are usually combined with splinting to the affected joint. The splint helps to ease the stress placed on the joint from frequent use and activities. They should be small enough to allow functional use of the hand when worn to avoid muscle deterioration. 

• Physical Therapy. Your doctor or a physical therapist can help develop an exercise program to improve the range of motion and function in your hand and wrist. 

Surgery

If other methods fail to provide relief, surgery may be recommended. Your Raleigh Orthopaedic doctor will discuss your options and help you decide which surgical procedure is best for you. If the damage has progressed to a point that the surfaces will no longer work, a joint replacement or fusion is performed. 

After any joint reconstruction surgery, there is a period of recovery. Length of recovery time varies by individual and depends on the extent of the surgery performed. However, patients can typically return to most, if not all, normal activities in about three months after the procedure. 

Hand and Wrist Specialists at Raleigh Orthopaedic

Raleigh Orthopaedic Clinic is committed to providing patients across Wake County with the highest quality care for all manner of hand and wrist injuries and conditions, including arthritis of the hand and wrist. We will work closely with you to understand your symptoms and develop a comprehensive treatment plan, tailored specifically to your needs. Contact us today for more information or to schedule an appointment near you.