Arthritis In Hand And Wrist Treatment

What is arthritis in the hand and wrist?

Arthritis, or osteoarthritis, is a painful condition caused by long-term wear and tear of the smooth cartilage that normally covers the ends of the bones inside the joint. This causes the bones in the joint to rub together, causing pain and swelling. Arthritis is the most prevalent joint disease and a leading source of chronic pain and disability in the developed world.

Mucous cysts of the terminal finger joints

mucous cyst is a small, fluid filled sac that forms on the back of the finger near the base of the finger nail. It is a form of ganglion cyst that erupts from the capsule of the joint at the end of the finger (DIP joint). The cyst is attached to the joint capsule by a stalk that allows fluid to move into the cyst from the joint. 

Mucous cysts commonly affect the index finger of the dominant hand but can affect any finger or the thumb. They are caused by joint synovitis or arthritis at the DIP joint of the finger. A mucous cyst appears as a visible bump under the skin. It is not typically painful, but if it is repeatedly knocked or rubbed the skin covering the cyst may become irritated. If the arthritic joint is inflamed this may also cause discomfort. 

A mucous cyst is usually diagnosed clinically but an xray and an ultrasound scan can be helpful in certain situations. Depending on the size and associated symptoms surgical excision or debridement may be recommended. 

What causes arthritis in the hand and wrist?

Anyone can develop arthritis. It is more common in those with other joint diseases such as rheumatoid arthritis. Those carrying out heavy manual work, taking part in high impact sports such as tennis, or those who have had previous surgery are also more susceptible. Women are more frequently affected than men, and it is more common in those over the age of 40. There may also be a genetic element. 

Hand and wrist arthritis symptoms

Typically, symptoms start as an ache when using the hand to pinch and twist, for example when using a door handle or turning the lid of a jar. It can then progress with periods of inflammation and pain becoming more prolonged.

How is hand and wrist arthritis diagnosed?

Your consultant will ask you some questions to establish whether you have any risk factors for arthritis, and talk to you about the severity of your symptoms. They will also carry out a detailed examination of your hand and wrist. In most cases the diagnosis is made clinically and confirmed on x-ray. Occasionally further tests or scans may be required.

Non-surgical treatment
For early or minimally symptomatic wrist osteoarthritis, non-surgical options include lifestyle modification and physiotherapy potentially in combination with dietary supplements or pain killers. There are also injections, such as steroid, hyaluronic acid or platelet-rich plasma (PRP) which can alleviate many of the symptoms from osteoarthritis and negate or postpone the need for surgery.

Surgical treatment
If non-surgical measures fail, surgery is often required to relieve pain and improve function. These include joint preservation techniques, such as arthroscopy or osteotomy. All of these options, and the risks and benefits of each, will be discussed with you during your consultation.

Arthritis in hand and wrist treatment

The best course of treatment for the hand and wrist depends on a number of factors, including your general health, activity levels, the severity of the symptoms, as well as the effect the arthritis has already had. 

Non-surgical treatment

Thumb splints can often control the symptoms along with pain relief including non-steroidal anti-inflammatory drugs (NSAIDs). Lifestyle modification, physiotherapy and dietary supplements can also provide symptom relief. 

If these fail to control the pain and function is greatly affected, steroid injections can alleviate many of the symptoms from osteoarthritis, negating or postponing the need for surgery.

Surgical treatment

If non-surgical measures fail, surgery may be required to relieve pain that is affecting daily function and activities including work. The type of operation required depends on the extent of the arthritis, your age and activity levels and the joint involved. The options, including the risks and benefits of each, will be discussed with you during your consultation.

Treatment options

The One Orthopaedics team specialists

Peter Magnussen

Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Hand and Wrist

AnthonyHnew

Anthony Hearnden

Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist

James Logan

Consultant Orthopaedic Surgeon FRCS (Tr&Orth),Elbow, Hand and Wrist