Hand and wrist arthritis

What is arthritis?

Arthritis is a condition that affects the tissues surrounding the joints and can cause pain, swelling and stiffness. It is estimated that approximately 10 million people live with arthritis in the UK. It can affect people of all ages, although certain types of arthritis are commonly seen in older people.

Arthritis can cause reduced range of motion in the affected joint, joint deformity, and loss of function. Many joints in the body can be affected by arthritis, the hands and wrist are frequently affected by common types of arthritis.

Osteoarthritis is a degenerative type of arthritis and is the most common type of arthritis. Onset is usually diagnosed later in life and can affect one or more joints anywhere in the body.

Osteoarthritis is more common in women than men and can present from the 5th decade onwards. In the hand this is typically seen in the base of the thumb.

Osteoarthritis begins with roughening of the cartilage which is the smooth cushioning tissue that lines the joints. As these wear down, the body attempts to repair what is eroding away and the following can occur:

Very small bits of extra bone can form at the ends of a bone within the joint
An increase in the amount of thick fluid around the joint
The joint can lose its shape due to stretching

Whilst the cause of osteoarthritis is not known, there are some risk factors that can help determine the chances of developing this type of arthritis. These include:

Age – the risk of developing arthritis increases as you get older
Family history – it is thought there might be a genetic link that osteoarthritis runs in families, although this has not been established
Being overweight can put extra stress on your joints and cause problems
Joint injury – overusing the affected joint and not allowing enough time for it to recover after trauma

The main symptoms associated with osteoarthritis are:

Pain in the joint – this can start off quite mild and will come and go to begin with. The pain can be worse when the affected joint is being used, and then subside when the joint is rested. People who are affected can go many weeks without feeling any pain but as the condition advances, pain becomes more frequent and occurs at rest as well
A clicking or cracking noise as the joint is moved
Loss of motion in the joint
Swollen joints that are red and swollen and tender to touch
Weakness in the joint from loss of motion, deformity, and pain

Rheumatoid arthritis is a type of inflammatory arthritis and is an auto-immune condition which means that the body mistakenly attacks healthy tissues such as joints causing inflammation.

Non-surgical treatment methods

To help manage the symptoms and discomfort associated with arthritis, there are some non-surgical treatment methods that your doctor can advise you on:

Reducing the activities that make the discomfort and pain worse
Using a splint to keep the joints still can help relieve painful symptoms
Applying heat and ice to the affected joint can help ease discomfort and reduce swelling
Your doctor can advise you to take paracetamol and ibuprofen to ease any pain and swelling
A steroid injection can help reduce symptoms in the affected joint and provide relief for a period of time. Your doctor can advise you on whether you may need more than one injection over a few months to help treat symptoms
Exercising the joints gently daily

Surgical treatment

Surgery is advised when all non-surgical treatment methods have been tried and unfortunately have not been able to ease pain and discomfort of the arthritis. There may also be deformity in the joint and loss of motion and when this happens, your surgeon can discuss with you how surgery can help.

Surgical procedures used to help different types of arthritis include:

Reconstructive surgery

This is performed on patients with osteoarthritis in the thumb. The surgeon removes the arthritic bone and replaces it with a tendon from the forearm. This operation restores function to the thumb, increasing the range of motion in the joint and reducing pain.

Joint fusion

This type of procedure is commonly used to treat arthritis in the hand and wrist. It involves fusing the joint with the joint below, to stabilise and strengthen the affected joint. It reduces pain but the affected joint is no longer able to bend.

Joint replacement surgery

This is performed to increase range of motion and improve function of the fingers. Following surgery patients can use their hand more freely and their level of pain is significantly reduced. Joint replacements, however, do not provide the same level of stability as joint fusion and in time will wear down.

Your recovery

Recovering from surgery can differ from person to person, but on average you can expect to be back to normal activities after around 12 weeks.

If the surgery you had required an incision, this may be sore for a couple of days but it should settle down. However, you may experience pain, swelling and stiffness up to a few weeks or months after surgery. If you feel any pain or discomfort during your recovery, you can take over the counter pain relief like paracetamol or ibuprofen to help.

It is important that you keep the area clean and dry, and you will need to try and keep the site of surgery propped up to alleviate further pain and swelling. A follow-up appointment will be made for you to see your surgeon to ensure that you are healing correctly, this appointment is normally two weeks after your operation. At this appointment, you will have your stitches removed, you may also have a splint made and fitted. Your surgeon may refer you to a hand therapist to assist further with the rehabilitation process.

You may have some discomfort and swelling around the surgery site and you may need to adapt to different techniques to achieve some tasks. Your surgeon will advise when you can return to your usual activities, however most people are back to some light activities within 6-8 weeks after surgery. Depending on your type of job, your surgeon will advise when you can go back to work.

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Hand and wrist arthritis

What is arthritis?

Non-surgical treatment methods

Surgical treatment

Surgical procedures used to help different types of arthritis include:

Reconstructive surgery

Joint fusion

Joint replacement surgery

Your recovery

Whatever your hand or wrist condition is, we can help.

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