Wrist + Hand

Arthritis in the Wrist and Hand

Overview

Arthritis is common in the small joints of the wrist and hand. The symptoms of arthritis vary depending on which joint is affected. In many cases an arthritic joint will be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There can be other symptoms as well, including:

Dull or burning sensation
Swelling and warmth
Increased pain and stiffness, especially in the morning
Activities that once were easy, such as opening a jar, become difficult due to pain
Sensation of grating or grinding in the affected joint (crepitation)
Joint may appear larger than normal
When arthritis affects the end joints of the fingers, small cysts may develop

Diagnosis

The diagnoses can be made by a physical examination and x-rays. Specialized studies, such as an MRI, are usually not needed except in cases where Keinbock's disease (a condition where the blood supply to one of the small bones in the wrist, the lunate, is interrupted) is suspected. Sometimes a bone scan is helpful. A bone scan may help the doctor diagnose arthritis when it is in an early stage even if x-rays look normal.

Treatment Options

As with other arthritic conditions, initial treatment of arthritis of the wrist or hand is nonsurgical. Your doctor may recommend making some lifestyle modifications help relieve the pain and slow the progression of the disease. Medications treat symptoms but cannot restore joint cartilage or reverse joint damage. The most common medications for arthritis are anti-inflammatories which stop the body from producing chemicals that cause joint swelling and pain. Injections and splinting may also be recommended to relieve pain but are not a long-term solution due to possible side effects.

If your pain from arthritis causes disability and is not relieved with nonsurgical treatment, your doctor may recommend surgery. As with all surgeries, there are some risks and possible complications with different procedures. Your doctor will discuss the possible complications with you before your operation.

Arthrodesis (Fusion)

Arthrodesis fuses the bones of the joint completely making one continuous bone out of two or more bones. The goal of the procedure is to reduce pain by eliminating motion in the arthritic joint.

Joint Replacement (Arthroplasty)

In a joint replacement, your doctor removes the damaged cartilage and bone and then positions new metal or plastic joint surfaces to restore the function of the joint. Most of the major joints of hand and wrist can be replaced.

Proximal Row Carpectomy

In this procedure, the three carpal bones in the row of bones that is closest to the forearm are removed. The procedure is designed to reduce your pain while maintaining some wrist motion.

Physical Therapy

Your doctor may recommend physical therapy to help you regain strength and to restore range of motion. You may need to use a splint or cast for awhile after surgery to protect the hand while it heals.