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Osteoarthritis of the hand and wrist is a relatively common condition that can lead to significant pain, stiffness and functional limitation. In some cases, arthritis can develop after a fracture or other trauma. However, most of the time it occurs as part of the aging process. Over time, the normal cartilage within the joint degenerates, thins and can wear away entirely, causing pain and inflammation.

Arthritis can occur in any of the joints of the hand and/or wrist, but the joint at the base of the thumb and the small joints of the fingers are most commonly affected. So, how do you know if you may be affected?

Patients with arthritis typically have pain and swelling in the affected joints. They also may notice that certain knuckles become more prominent as a result of osteophyte (bone spur) formation. Range of motion often becomes more limited. Many patients report difficulty with pinching and gripping activities, like opening jars or turning doorknobs or car keys.

Unfortunately, there is no good way to prevent hand and wrist arthritis. Its believed to be caused by a combination of genetics and just general wear and tear that occurs during life. If you do experience symptoms, however, seeing a doctor as soon as possible may allow for more treatment options.

Initial evaluation of the patient with arthritis usually will include a detailed history, including activities or treatments that worsen or improve symptoms. Physical exams can help determine which areas are most symptomatic, as well as assessing the motion and stability of the affected joints. Often, X-rays will be ordered to confirm the diagnosis and guide treatment.

For patients with earlier-stage disease and milder symptoms, conservative treatments such as ice or heat, rest or activity modification can be effective. Anti-inflammatory medications like ibuprofen (Motrin, Advil) or naproxen (Aleve) or pain relievers like acetaminophen (Tylenol) also can help with symptoms. For arthritis in certain locations like the joint at the base of the thumb splint usage or hand therapy may have a role. As symptoms become more severe, steroid injections into arthritic joints may provide short-term relief.

For patients with more advanced disease and symptoms not adequately addressed by non-surgical therapies, surgery may be an option. For patients with arthritis in the joint at the base of the thumb (carpometacarpal [CMC] arthritis), surgery can provide significant pain relief while preserving strength and motion in the thumb. Typically, the surgeon removes the arthritic bone (called the trapezium) through a small incision at the base of the thumb. One of the tendons in the area is then rerouted to support the thumb while it heals. After a period of immobilization and rehab, patients are able to return to full activity.

For the smaller joints of the fingers, arthroplasty (joint replacement) with silicone or pyrocarbon implants can preserve motion while relieving pain. These procedures are more commonly performed in the proximal finger joints (those closer to the wrist). For the more distal finger joints (those farther from the wrist), stability is often a more important concern, and an arthrodesis (fusion) procedure can relieve pain and provide a stable platform for pinch-and-grip activities.

Dr. Michael Potter is with Sentara Martha Jefferson Orthopedics.

This column, which promotes community health, is sponsored by Sentara Martha Jefferson Hospital, Region Ten Community Services Board, Thomas Jefferson Health District and the University of Virginia Health System.

See the article here:
Vital Signs: Treatment options can ease pain of hand and wrist arthritis - The Daily Progress

This entry was posted on February 13, 2017 at 2:41 pm and is filed under Arthritis. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |