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about the Hand & Wrist> Arthritis of the Wrist:
An Overview What is Arthritis of the Wrist? Arthritis is the name of any of more than 300 inflammatory joint disorders. The two most common types of arthritic disease to affect the wrists are osteoarthritis and rheumatoid arthritis. Arthritis in some form is suffered by more than 31 million people of all ages. Osteoarthritis, or degenerative joint disease, most commonly affects the elderly. As its name suggests, the joints begin to degenerate, often simply as a result of the aging process. The cartilage cushioning the surfaces of bones begins to wear out, causing crepitation, or the grinding of bones against each other. Osteoarthritis usually strikes the weight-bearing joints first (the knees, hips, and spine), putting those who are overweight at risk. Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes pain, stiffness, and swelling in the joints, usually in a symmetrical pattern (if one hand has it, the other one will also). In RA, the joint lining (synovium), normally smooth and shiny, becomes inflamed, painful and swollen. The disease, which lasts over a long period of time, can cause damage to cartilage, bone, tendons and ligaments. RA can also cause inflammation in the blood vessels and the outer lining of the heart and lungs. Rheumatoid arthritis often results in deformities of the hand and the destruction of smaller joints of the body. It frequently develops in the prime of life, affecting more women than men. Because it tends to flare up periodically and then progress variably over time, this disease requires long-term systemic management. Causes of Arthritis of the Wrist? The cause of primary arthritis is not known. Secondary arthritis is sometimes the long-term result of joint injuries, mechanical trauma, or preexisting lesions. Sometimes arthritis develops as the result of an infection in a joint, resulting in septic arthritis. Symptoms of Arthritis of the Wrist? All arthritic conditions result in stiffness, swelling, and the loss of motion. In arthritis of the wrist, it becomes difficult to bend the wrist, as the joint becomes increasingly tender and swollen. As time passes, arthritis of the wrist alters the function of the hand significantly. One common symptom of arthritis of the wrist is diminished grip strength. The fingers of the hand are able to move because of the connection of tendons within them to the muscles of the forearm. Full function of the hand and wrist depends on the successful operation of many interrelated parts. As arthritis weakens the wrist of the hand, strength and “pinch” in the fingers and thumb are also affected. The tendons are no longer able to work on stable joints, often resulting in an unnatural rotation of the wrist. Treatment of Arthritis of the Wrist? If you are suffering from some form of arthritis of the wrist or hand, consult a doctor for tests, diagnosis, and pain management. Treatment is generally aimed at relieving painful symptoms and controlling the inflammatory process. Your doctor will inquire about your medical history and any other previous or persistent conditions affecting the hands, arms, and other joints of the body. X-rays of the wrist are very helpful in distinguishing among varieties of arthritis. Rheumatoid arthritis appears in radiographs as a generalized thinning of the bone structure (osteopenia) with erosions of the bone in the joint surface. X-rays also indicate the related conditions pseudogout and gout, which can be confirmed with lab tests. Blood studies help identify rheumatoid arthritis, the presence of antinuclear antibodies (ANA), and uric acid. Temporarily immobilizing the wrist joint with a splint often helps relieves pain and swelling. Other conservative treatment for arthritis includes the intermittent use of NSAIDs (non-steroid anti-inflammatory drugs) or other salicylate drugs such as aspirin. There is no cure for rheumatoid arthritis. In the absence of infection, cortisone injections directly to the wrist can be very helpful in relieving pain and improving flexibity; they are sometimes given in addition to the systemic rheumatoid treatment. Cortisone (a steroid drug) must be used judiciously, however, in part because it appears to be less effective over time. Injections of gold compounds, hydroxychloroquine, penicillamine, and immune suppressants are also widely used. Your doctor will consider your individual health history in making prescriptive recommendations. Hand and wrist surgery for patients with various forms of arthritis has progressed rapidly in recent years. Surgery is recommended if it can stabilize the joints and deliver pain relief. Sometimes the one or more of the eight bones of the wrist may be replaced with a prosthesis, helping improve the function of the joint. Surgery also helps limit the spread of the disease. Surgical stiffening of the wrist can improve the strength and use of the fingers. Many surgical procedures are now performed on an outpatient basis, requiring only local anesthesia. Living with any form of arthritis requires pain management and lifestyle adjustments. Very often occupational and recreational changes are required. Gentle physiotherapy can be helpful, as can whirlpool treatments and the application of heat. Heat increases the flow of blood and nutrients to the hands. The application of ice packs to the joints before and after motion can also be beneficial. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |