The hand and wrist have multiple joints that allow movement. Arthritis is inflammation of one or more of your joints. Osteoarthritis is the more common form of arthritis, known as “wear and tear.” Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by osteoarthritis, but it is particularly common in the hand. Arthritis is a chronic disease that is more common in patients over 40. Any prior trauma to the joint, such as dislocations or fractures, also increases the risk of osteoarthritis.
Patients who have osteoarthritis in their hands may experience pain, swelling, warmth, looseness, and even grinding of the joint.
Pain in the early morning and stiffness are typically present in arthritic hands. Pain can be worse with increased use of your hands; it frequently occurs after a strenuous activity such as grasping. You may experience difficulty manipulating objects that require pinching or gripping motions. As arthritis progresses, it may even wake you up at night.
Hand osteoarthritis can be diagnosed by obtaining X-rays to look at the bone. Occasionally a bone scan is helpful. A bone scan may help the doctor diagnose arthritis when it is in an early stage, even if the x-rays look normal.
Our goal in treating osteoarthritis of the hand is to decrease pain and maintain the function of your hands. Treatment options vary and depend on the severity of arthritis, activity level, number of joints involved, and your personal goals.
Noninvasive options are tried first before surgical treatment for hand arthritis.
This can include medication such as anti-inflammatories. Anti-inflammatory medications slow the production of chemicals that cause joint swelling and pain. Examples of anti-inflammatories are naproxen and ibuprofen.
Another treatment option involves injections into the joint. Injecting an anesthetic and steroid can provide relief for weeks to months. Injections may be repeated but are limited due to possible side effects. Steroid injections may cause lightening of the skin, weakening of the tendons, and elevation in blood sugar.
Splinting may also provide relief to arthritic hands. When a splint or brace is worn, it can support the affected joint from frequent use activities. It is a good idea to wear a brace when you are most active to allow your joints to rest. We do not want to wear braces at all times as bracing can cause muscle atrophy or weakening of muscles.
If non-surgical treatment has not been successful and your pain limits the function of your hands, it may be time to talk about surgery. There are a variety of surgical treatments for hand arthritis that should be discussed in detail with your surgeon.
Joint fusions provide pain relief but block any movement of the joint. Once the joint has fused together, the damaged arthritic surface is gone, therefore it cannot cause pain.