Hand & Wrist Arthritis
What Is Hand & Wrist Arthritis?
Arthritis is painful inflammation and stiffness of the joints that can significantly impact hand and wrist function. Although there are over one hundred types of arthritis, rheumatoid arthritis and osteoarthritis are the most common forms affecting the hand and wrist. These conditions can cause progressive joint damage, pain, and loss of function if left untreated.
Rheumatoid arthritis is an autoimmune disorder in which the body's immune system mistakenly attacks its own joint tissues. This condition characteristically causes joints on both sides of the body to develop chronic inflammation—for example, both wrists or both hands are typically affected symmetrically. The exact cause remains unknown, though current research suggests that exposure to bacteria or viruses may trigger the immune system to attack the joints in genetically susceptible individuals. While rheumatoid arthritis can affect children and the elderly, it most commonly develops in middle-aged people, with approximately 75 percent of sufferers being women.
Osteoarthritis, also known as degenerative joint disease, is the most common form of arthritis. This condition develops when the protective cartilage cushioning the ends of bones gradually breaks down and wears away, causing painful bone-on-bone contact. Osteoarthritis is often caused by normal wear and tear associated with aging, but it can also be accelerated by obesity, repetitive stress to joints, previous injuries, and genetic factors. Basal joint arthritis (also called thumb arthritis) is the most common type of osteoarthritis in the hand, occurring at the base of the thumb where it meets the wrist. This joint experiences tremendous forces during pinching and grasping activities and is particularly susceptible to degenerative changes.
Symptoms of hand and wrist arthritis vary somewhat between the two main types but share many common features. Osteoarthritis typically causes pain and swelling from bones rubbing together due to cartilage loss, soreness and stiffness after periods of inactivity, and visible bone enlargement in the finger joints. Rheumatoid arthritis symptoms include persistent stiffness, pain, and swelling in multiple joints that often worsens after periods of inactivity, such as first thing in the morning. Some patients with rheumatoid arthritis develop firm bumps under the skin near joints called rheumatoid nodules. Both types of arthritis can cause decreased strength, reduced range of motion, and difficulty with activities requiring gripping, pinching, or fine motor control. These symptoms can develop quickly or progress gradually over several years.
Nonsurgical Treatments
Many patients with hand and wrist arthritis can effectively manage their symptoms without surgery. Our doctors offer comprehensive nonsurgical treatments to reduce pain, preserve joint function, and slow disease progression.
Lifestyle Modifications
Activity modification plays an important role in managing arthritis. Avoiding activities that aggravate symptoms while maintaining appropriate activity levels helps preserve joint function. For rheumatoid arthritis specifically, resting joints during inflammatory flare-ups while remaining physically active during less symptomatic periods helps maintain range of motion and muscle strength. Weight management can reduce stress on joints. Using adaptive equipment and ergonomic tools can make daily tasks easier and less painful.
Medications & Injections
Anti-inflammatory medications can help reduce pain and swelling associated with both types of arthritis. For rheumatoid arthritis, disease-modifying medications may be prescribed to suppress the immune system and slow disease progression. Corticosteroid injections into affected joints can provide significant but temporary relief from inflammation and pain. Patients should consult with their pharmacist before purchasing anti-inflammatories, as these medications may be contraindicated or may interact with other medications and medical conditions.
Physical & Occupational Therapy
Physical and occupational therapy are valuable components of arthritis treatment. Therapists design customized exercise programs to maintain or improve strength, flexibility, and range of motion. Hand exercises, stretching routines, and strengthening activities can help preserve function and reduce stiffness. Occupational therapists can teach joint protection techniques, recommend adaptive equipment, and suggest modifications to daily activities that reduce joint stress.
Supportive & Assistive Devices
Splinting or bracing the thumb, hand, or wrist can provide support, reduce pain, and protect affected joints during activities. Splints may be worn during specific activities or at night to rest the joints. Hot and cold compresses can provide symptomatic relief—heat therapy helps reduce stiffness while cold therapy can decrease acute inflammation and pain. Various assistive devices and adaptive tools are available to help with daily tasks, reducing stress on arthritic joints.
Surgical Treatments
When nonsurgical treatments no longer provide adequate relief and arthritis significantly impacts quality of life or hand function, surgical intervention may be recommended. The right surgical approach depends on which joints are affected, the severity of arthritis, and your activity requirements and goals.
Joint Debridement & Synovectomy
In earlier stages of arthritis, particularly with rheumatoid arthritis, removing inflamed synovial tissue (synovectomy) or cleaning out the joint (debridement) may provide relief and slow disease progression. These procedures can often be performed arthroscopically through small incisions, reducing recovery time.
Joint Fusion (Arthrodesis)
For severely arthritic joints, particularly in the wrist or finger joints, fusion surgery may be recommended. This procedure permanently joins bones together, eliminating painful motion while providing stability. While fusion reduces mobility at the fused joint, it can offer substantial pain relief and improved overall hand function. Wrist fusion is particularly effective for severe wrist arthritis, allowing patients to regain grip strength and perform daily activities with less pain.
Joint Replacement
For certain joints, particularly the base of the thumb (basal joint), joint replacement may be an option. In basal joint replacement, the arthritic bone is removed and the joint is reconstructed, often using a tendon graft for stabilization. This procedure can reduce pain while maintaining motion and function. Artificial joint implants may be used in select cases for finger joints, though these are less common than fusion procedures.
Removing Joint Fluid
In some cases, particularly with inflammatory arthritis, aspiration (removal) of excess fluid from swollen joints can provide temporary relief and may be combined with corticosteroid injection. While not a permanent solution, this procedure can be part of a comprehensive treatment plan.