What is Arthritis of the Hand and Wrist?
Arthritis is an inflammatory condition of the joints. There are several types of arthritis, the most common type being osteoarthritis or wear-and-tear arthritis. Arthritis affects various joints in the body. Arthritis in the hand most commonly affects the joint at the base of the thumb. Arthritis may also affect the joints of other digits.
What are the Causes of Arthritis of the Hand and Wrist?
Arthritis is often seen in people aged over 40 years; however, it may affect people of all ages. The most common cause is wear-and-tear, and as you age, you are more prone to develop arthritis. Also, traumatic injuries, fractures and joint dislocation make you more susceptible to develop arthritis. Certain types of arthritis are more common in women than men, as in thumb arthritis.
What are the Types of Arthritis?
There are over several types of arthritis. The most common are:
Osteoarthritis: Also called degenerative joint disease, this is the most common type of arthritis that often occurs in older people. This disease affects the cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge or stick out at the end of a joint to form bone spurs.
Osteoarthritis causes joint pain and can limit your normal range of motion (the ability to freely move and bend a joint). When severe, the joint may lose all movement, causing disability.
Rheumatoid arthritis: This is an auto-immune disease in which the body's immune system (the body's way of fighting infections) attacks healthy joints, tissues and organs. Occurring most often in women of child-bearing age (15-44), this disease inflames the lining (or synovium) of joints. It can cause pain, stiffness swelling, and loss of function in the joints. When severe, rheumatoid arthritis can deform or change a joint. For example, the joints in a person's finger can become deformed, causing the finger to bend or curve.
Rheumatoid arthritis mostly affects the joints of the hands and feet, and tends to be symmetrical. This means the disease affects the same joints on both sides of the body at the same time and with the same symptoms. No other form of arthritis is symmetrical. About two to three times as many women as men have this disease.
Post-traumatic arthritis: Arthritis that develops following an injury to the hand, wrist or elbow is called post-traumatic arthritis. The condition may develop years after the trauma such as a fracture, severe sprain or ligament tears.
Psoriatic arthritis: This form of arthritis occurs in some persons with psoriasis, a scaling skin disorder, and affects the joints at the ends of the fingers and toes. It can also cause changes in the fingernails and toenails. Back pain may occur if the spine is involved.
What are the Symptoms of Arthritis of the Hand and Wrist?
The symptoms of arthritis include swelling, pain, stiffness and deformity, all of which interfere with the use of the hand.
How is Arthritis of the Hand and Wrist Diagnosed?
Your doctor can usually make the diagnosis based on a detailed history and physical examination. X-rays of the joint may be taken to know the severity of the disease and determine any bone spurs or calcium deposits.
What are the Treatments available for Arthritis of the Hand and Wrist?
Non-surgical treatment methods for relieving pain in an arthritic joint include activity modification, anti-inflammatory medications, use of splints and steroid injections. Surgery is only considered if non-surgical treatment fails to provide relief. There are different surgical procedures that can be used, and these may include:
Synovectomy: This surgery is usually indicated for early cases of inflammatory arthritis where there is significant swelling (synovitis) that is causing pain or is limiting the range of motion of your digits and thumb. Synovectomy is a surgical removal of the inflamed synovium (tissue lining the joint). The procedure may be performed using arthroscopy.
Arthroplasty: In this procedure, your surgeon removes the affected joint and replaces it with an artificial implant. If you have post-traumatic arthritis and osteoarthritis where the bone is hard and demand on the hand is moderate, metallic implants may used. These are not desirable for severely damaged or an unstable joint. For inflammatory arthritis, where the bone is not strong enough and the demand on the hand is low, silicone implants, or rubber joints, are generally used. These can be used for more severe joint damage and an unstable joint.
Arthrodesis: A fusion, also called an arthrodesis, involves the removal of the affected joint and fusing the bones of the joint together using metal wires, plates or screws. The goal of this procedure is to eliminate the pain. Even though this surgery eliminates all motion at the joint, reasonable function can still be maintained.
This surgery is usually indicated when the joints are severely damaged, when there is limited mobility, damage to the surrounding ligaments and tendons, failed previous arthroplasty, and when heavy manual use is expected.
Your surgeon will discuss the options and help you decide which type of surgery is the most appropriate for you.
What is the Rehabilitation following Surgery for Arthritis of the Hand?
Following surgery, a rehabilitation program, often involving a hand or occupational therapist, may help to regain hand strength and movement. You may need to use a postoperative splint for a while after surgery to help protect the hand while it heals. You may need to restrict activities for a minimum of 12 weeks to let the joint reconstruction heal properly. Although recovery is slow, you should be able to resume your normal activities within a few months of surgery.
- Wrist Fracture
- Fractures of the Hand and Fingers
- Wrist Sprain
- Flexor Tendon Injuries
- Distal Radioulnar Joint (DRUJ) Arthritis
- Ulnar Nerve Compression in Guyon's Canal
- Scaphoid Facture
- Industrial Hand Trauma
- Distal Radius Osteotomy to Correct Mal-Union (Crooked Painful Wrist)
- Distal Intersection Syndrome
- Distal Biceps Avulsion
- Adult Forearm Fractures
- Arthritis of the Hand and Wrist
- Arthritis of the Thumb
- Ganglion Cyst
- Boutonniere Deformity
- Carpal Tunnel Syndrome
- De Quervain's Tendinosis
- Dupuytren's Contracture
- Hand Pain
- Hand Infections
- Trapeziometacarpal (TMC) Arthritis
- Wrist Injuries
- Wrist Tumors
- Boxer's Fracture
- Swan Neck Deformity
- Carpal Instability
- Bennett's Fracture
- Kienbock's Disease
- Scapholunate Dissociation
- Triscaphoid Joint Arthritis
- Ulnar Carpal Impaction
- Triangular Fibrocartilage Complex Injury (TFCC)
- Guyon's Canal Syndrome
- Hand Masses
- Distal Radioulnar Joint (DRUJ) Instability
- Work Related Hand Injuries
- Wrist Ligament Tear and Instability
- Metacarpophalangeal Joint Arthritis