- Orthopaedic & Neurosurgery Specialists PC (ONS)

The hand and wrist are comprised of multiple small joints that work together to produce many intricate motions, from threading a needle to turning a key in a door. When joints become affected with arthritis, the activities of daily living can be very difficult. When a joint becomes arthritic, the cartilage has worn away and the joint can no longer function smoothly with the bones gliding easily over each other. Movement is painful and the range of motion is reduced.
The most common form of arthritis is osteoarthritis or wear and tear arthritis, which generally affects people over 45. Rheumatoid arthritis is a form of the disease that causes significant joint inflammation.

Traumatic arthritis can affect people of any age and may occur as a result of an injury or trauma to the joint. A joint that has sustained an injury is more likely to become arthritic, even if the injury has been properly treated. Fractures that damage the cartilage or joint surface and dislocations are the most common injuries that lead to arthritis.

Illustration reproduced with permission from Fischer S, (interim ed): Your Orthopaedic Connection. Rosemont, IL, American Academy of Orthopaedic Surgeons. Available at http://orthoinfo.aaos.org.org/.

Arthritis Symptoms

Common symptoms of hand or wrist arthritis include:

• Joint pain
• Pain after strenuous hand or wrist activity such as gripping or grasping
• Morning pain and stiffness in the hands
• Pain that disrupts sleep
• Swelling in fingers or wrist

Heberden nodes are "bumps" which occur at the last joint of the finger or thumb due to wear and tear arthritis. As the joints deteriorate, small bone spurs form over the back of the joints and make them appear "lumpy." Since most Heberden nodes are not painful and seldom interfere with function, no specific treatment is usually required.

Treatment for Arthritis

Medications are used to treat arthritis symptoms but cannot restore joint cartilage or reverse damage. Anti-inflammatory medications are commonly used to reduce pain and swelling.

If anti-inflammatory medications do not control pain, steroidal injections into the joint may be used.

Splinting to help support the joint is often done in combination with injections. It should be small enough to allow functional use of the hand and should only be used during periods when the joint is painful. Wearing a splint for too long can actually lead to further joint and muscle stiffening.

Arthritis Surgery

If non-operative treatments fails and the joint surfaces no longer work, surgery may be an option. A joint fusion (arthrodesis) provides long-term pain relief but the joint will no longer move. Since the damaged joint surfaces are gone, the symptoms disappear.

For wrist arthritis, surgical options include partially or completely removing the arthritic joint surfaces and fusing the joint to make it solid.

Joint replacement surgery can help with certain types of hand and wrist arthritis.