Hand & Wrist: Arthritis of the Wrist


Arthritis means “inflamed joint.” In normal joints cartilage covers the end of bones and acts as a shock absorber allowing smooth, pain-free movement. Arthritis occurs when these joint surfaces become irregular. The cartilage layer covering the ends of the bones wears out, resulting in bone-on-bone contact, pain, or joint deformity.

The wrist is a complex joint. It is made up of many small joints and arthritis may occur in one or more of these small joints.

There are many types of arthritis and most of these can affect the wrist. The most common types of arthritis are osteoarthritis, post-traumatic arthritis (after an injury), and rheumatoid arthritis. Other types of arthritis in the wrist may be due to injection, gout or psoriasis.

Causes of Arthritis of the Wrist

  • Osteoarthritis – is usually caused by a combination of factors, rarely is there a single or exact cause. Genetics, old injuries, and/or generalized joint laxity lead some people to develop this type of “wear and tear” arthritis.
  • Post-traumatic arthritis – develops after an injury, such as a broken wrist or torn ligament. It may develop many years after the initial injury, even if proper care and treatment was received at the time.
  • Rheumatoid arthritis – a chronic autoimmune disease that can affect multiple joints throughout the body. The exact cause is unknown. Symptoms, typically joint pain and swelling, are usually symmetrical – meaning it affects the same joints on both sides of the body.

 




Signs and symptoms of an Arthritis of the Wrist may include:
  • Pain - achy or sharp
  • Swelling
  • Weakness
  • Decreased range of motion or joint stiffness
Activity Modification

Changing or avoiding symptom provoking activity may help reduce pain. Using different equipment – such as an ergonomic keyboard, tools with a pistol grip, or a key holder – helps to reduce stress to joints, which can relieve pain.

Heat and Cold

Heat and cold can be used 3-4x/day for 10-15 minute sessions. Heat is typically helpful in reducing joint stiffness and achy pain, while cold packs may help reduce inflammation and pain. Use whichever makes your hands feel better.

Topical Creams

Over-the-counter creams, ointments, or gels may help temporarily decrease pain.

Medication

Medication can address symptoms of arthritis, but cannot cure the underlying cartilage and joint damage. Non-steroidal anti-inflammatory (NSAID) medications such as acetaminophen (Tylenol™), ibuprofen (Advil™), or naproxen (Aleve™) may help manage pain. Used as directed by your doctor or per manufacturer instructions.

Splinting

Intermittent use of a splint is a good long-term strategy to help improve joint stability, minimize pain, and decrease stress to the affected joints during daily activities. Soft sleeves or gloves may also provide some relief when a rigid splint is too restrictive.

Cortisone injection

An injection of this strong anti-inflammatory medicine into the affected joint may help decrease pain. Response to the injection will vary from person to person. Relief is usually temporary.

Surgery

If or when conservative treatment is no longer providing adequate relief of your
symptoms, surgery may be an option. Depending on the progression of damage, surgery options include removing arthritic bones, joint replacement to provide pain relief and restore joint mobility, partial fusion to provide pain relief and maintain some mobility or joint fusion to provide pain relief, but the wrist joint is permanently immobile. A consultation with your hand surgeon can help decide your best course of treatment.

This video is meant to provide a general description of wrist arthroscopy. The way this procedure is performed by orthopedic surgeons at TRIA can vary from the description in the video.