There are many different types of arthritis that can affect the hand and wrist joints, including osteoarthritis and rheumatoid arthritis. Inflammation of these joints can cause many movements and tasks that we take for granted to become painful and difficult or impossible to perform. An orthopaedic hand and wrist specialist experienced in managing arthritis such as Dr Fleming can help to restore pain-free mobility and function through either non-surgical or surgical treatments.
Arthritis refers to inflammation of a joint. There are 27 joints in the hand and wrist and theoretically, any of these can develop arthritis, though certain joints are more commonly affected than others. Over time, inflammation leads to degeneration or damage of the cartilage that cushions the space between each joint, resulting in the bones rubbing against each other during movement.
The most common forms of arthritis are osteoarthritis and rheumatoid arthritis. These are typically a result of age-related wear and tear or chronic autoimmune dysfunction respectively, but arthritis in the hand or wrist can also be caused by other reasons, such as fractures involving the joint surface or a dislocation.
As osteoarthritis is the most common form of arthritis over rheumatoid arthritis, you may be more likely to develop arthritis in your hand or wrist if you have risk factors for osteoarthritis, including if you:
A specific form of arthritis is one that affects the thumb joint, also known as the basilar or carpometacarpal joint. This thumb joint is particularly susceptible to osteoarthritis due to its structure. Pain and stiffness in the thumb joint from arthritis can cause problems with gripping and pinching movements, such as holding a pen or opening a jar. In severe cases, thumb arthritis treatment may require a thumb joint replacement.
Arthritis symptoms can vary between individuals and even change week to week for the same person. The impact on your function will depend on the joint affected and what your typical activities look like.
The characteristic symptoms of arthritis in the hand or wrist include:
Arthritis symptoms of pain, stiffness, and swelling are often exacerbated by moving or using the joint, and improved with resting. These symptoms are also often worse in the morning or with wet weather.
Symptoms such as finger joint pain or a family history of arthritis in the fingers can support a diagnosis of arthritis alongside imaging techniques such as X-rays. In some instances, you may require other tests such as an MRI or blood test to rule out other causes of painful, stiff joints or to determine the specific form of arthritis.
It is important to see a doctor early if you are concerned you have arthritis in your hand or wrist, as catching the condition early can allow you to implement measures to slow progression. If you do have arthritis in your hand or wrist that is impacting your function, non-surgical or surgical treatment options can help to reduce pain and improve mobility. Dr Fleming tailors his treatment recommendations to your specific circumstances, including whether it is your dominant or non-dominant hand affected, other co-existing medical conditions, your usual level of activity, and how many joints are affected.
Conservative, non-surgical treatments are usually the first step to managing hand and wrist arthritis and alleviating your symptoms. These can include:
There are several different surgical approaches to managing arthritis that hasn’t responded to more conservative treatments. Where possible, Dr Fleming aims to preserve or reconstruct the joint. For arthritis in your thumb, this is commonly achieved using a procedure known as a trapeziectomy with ligament reconstruction and tendon interposition (LRTI), where damaged tissue is removed and a healthy nearby tendon is repositioned to provide cushioning in the joint.
Other types of surgery for hand and wrist arthritis include:
After undergoing any form of surgery for hand or wrist arthritis, a period of tailored hand therapy is essential to regain your strength, mobility, and function such as fine motor skills.
