Arthritis is an inflammatory joint disorder which is characterized by progressive deterioration as the smooth cartilage which provides cushioning between the joints wears away. The two most common types affecting the hand and wrist are osteoarthritis and rheumatoid arthritis. A doctor can diagnose arthritis by examining the joints and soft tissues and determine whether the cause is from trauma or if it is inherited and caused by environmental factors. In the wrist, most pain is caused by the following two types:
Osteoarthritis (OA) – Also known as degenerative arthritis, it is progressive condition that destroys the cartilage that covers the ends of the bones. The condition is more common later in life and mainly affects the hands or lower-body joints. When joints are healthy, they move easily because of the cartilage, with OA this cartilage wears away as pain and deformity set in. As people with OA move their joints rubs together which cause limitation of motion, stiffness, and weakness. OA may result from trauma, joint infections and overuse. Rheumatoid Arthritis (RA) – Also known as inflammatory arthritis, RA is a chronic autoimmune disease that affects multiple joints throughout the body, RA normally starts off in smaller joints like the fingers and wrist and then moves on to attack larger joints. The disease attacks symmetrically, meaning that it will attack the same joint on both sides of the body. With RA, the body’s natural defenses against infection actually destroy normal healthy tissue like cartilage, ligaments and even soft bone. Because of how RA affects the body, tendons can become easier to tear which can lead to joint deformity like bent wrists and gnarled fingers.
Wrist Arthritis Causes
Osteoarthritis can develop because of normal use over time, especially in people who have a family history of arthritis. OA can also happen due to a traumatic injury like a broken or sprained wrist. Kienböck's disease which limits the blood flow to a small bone call the lunate can also lead to osteoarthritis. Women are more likely to be affected than men, and often at a younger age.
The cause of Rheumatoid Arthritis is still being researched but many scientists believe that there may be a genetic reason why the disease develops. There is also speculation that chemicals or environmental factors play a role in the activation of the disease.
Wrist Arthritis Symptoms
The symptoms between each form of arthritis differs somewhat between the two, here’s what to look for:
- Swelling of the wrist
- Limited range of motion
These symptoms usually only occur in the wrist joint itself.
- Swelling of the wrist
- Bone grinding against bone
- Fingers drifting away from the thumb
- Finger contracture
- Limited range of motion
With RA, these symptoms occur in the fingers as well as the wrist.
Wrist Arthritis Diagnosis
The wear and tear of the joints caused by arthritis is visible on x-rays which can show the structural changes. X-rays may be ordered to show images of the bones and help distinguish which form of arthritis you may have. Blood tests can help with diagnosing RA, but there are no known blood abnormalities associated with OA.
Wrist Arthritis Treatment
When nonsurgical treatments stop working, surgery may be recommended. The goal of surgery for arthritis is to relieve the pain and to preserve or improve normal hand function.
Usually, your doctor will start treatment with more conservative measures to relieve pain and swelling. Suggested therapies may include:
- Activity modification to limit any usage that exacerbates pain.
- Splinting can help immobilize the wrist to protect the area and help relieve pain.
- NSAID medication can reduce pain and swelling.
- Physical therapy can improve range of motion.
- Cortisone injections can be utilized for the wrist joint. These may be repeated every few months to achieve the same effect.
If nonsurgical treatments fail to achieve lasting results, then you may experience progressive loss of hand or wrist function. In these cases, your orthopedist will suggest surgical treatment to relieve pain and preserve hand use. Usually, surgery does not improve joint motion, and the goal of surgery is to lessen pain. Surgical options include: Proximal row carpectomy – Involves removing three arthritic bones in the wrists called the carpal bones. This procedure relieves the pain while maintaining partial motion of the wrist. Fusion – If the source of pain is caused by motion, the carpal bones in the wrist can be fused together. With this surgery the pain is eliminated and still retains normal wrist motion. If the damage done by arthritis is severe a complete fusion of the bones may be necessary. If all the bones are fused together it will eliminate any wrist motion but will not affect forearm rotation. Joint replacement – Doctors will remove the damage joint and replace it with an artificial device or prosthesis. This surgery tries to retain or recover as much wrist movement as possible. Once the damage has been repaired, doctors will stitch the incisions closed and bandage the area. It is important to understand all of the risks and to follow the doctor’s instructions.
For 90% of patients, surgical treatment is very successful and rewarding. However, like with any surgery, there are risks involved that patients need to be aware of:
- Replacement joints are not as durable
- Complete loss of wrist range of motion
- Nerve and blood vessel damage
- Possible prolonged rehabilitation
- Loss of strength
- Loss of flexibility
- The need for further surgery
Arthritis effects millions of people everyday. Don't suffer with pain and discomfort because of day-to-day activities. Get real results that provide real relief. If you are interested in learning more about the causes, symptoms, and treatment options for wrist arthritis in Los Angeles, please call the West Medical offices at (855) 690-0565 and one of our representatives will be happy to address any of your questions, comments, or concerns.
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