Hand & Wrist Arthritis

What is Hand & Wrist Arthritis?

Hand and wrist arthritis is a group of conditions characterised by inflammation of one or more of the joints in the hand or wrist, leading to pain, swelling, stiffness, and often reduced range of motion.

In a healthy joint, cartilage – a firm but flexible tissue – covers the ends of the bones, allowing smooth movement. With arthritis, this cartilage breaks down, causing the bones to rub against each other, leading to pain and stiffness.

Impact of Hand & Wrist Arthritis On Anatomy and Health

As the cartilage deteriorates, the bones of the joints may rub together, causing pain, inflammation, and the formation of bone spurs. Over time, this can lead to changes in the appearance of the hands and wrists, such as swelling or bumps on the joints, and can limit your ability to perform daily tasks that require manual dexterity, such as buttoning a shirt, writing or opening a jar.

Who is Most at Risk for Hand & Wrist Arthritis?

While anyone can develop hand and wrist arthritis, certain factors increase the risk. These include advancing age, being female, having a family history of arthritis, previous injury to the hand or wrist, and engaging in occupations or activities that put repetitive stress on the hand or wrist.

Causes of Hand & Wrist Arthritis

Hand and wrist arthritis is primarily caused by factors leading to the cartilage breakdown that cushions the joints. Here are the most common causes:

Age: The risk of developing arthritis increases with age. Over time, the cartilage in our joints can naturally wear down, leading to osteoarthritis.
Injury: Injuries to the hand or wrist, such as fractures or dislocations, can damage the cartilage and eventually lead to arthritis. This is known as post-traumatic arthritis.
Repetitive stress: Occupations or activities that involve repetitive hand or wrist movements or put high stress on the joints can cause gradual wear and tear of the cartilage, leading to arthritis.
Genetics: Some people may be genetically predisposed to developing arthritis. If your parents or siblings have arthritis, you may be more likely to develop the condition.
Metabolic factors: Conditions like diabetes can increase the risk of developing arthritis. Diabetes can cause changes to the collagen in the cartilage, leading to increased stiffness and, eventually, arthritis.
Autoimmune disorders: Conditions like rheumatoid arthritis, in which the body's immune system attacks its tissues, can cause inflammation and damage to the cartilage in the joints, leading to arthritis.

Symptoms of Hand & Wrist Arthritis

The symptoms of hand and wrist arthritis can range from mild to severe and vary depending on the type and stage of arthritis. Common symptoms include:

Pain: Often the first sign of arthritis. Pain may be felt in the wrist, the base of the thumb, or the fingers, and it may be more noticeable with movement or when pressure is applied to the joint.
Stiffness: The joints in the hand and wrist may feel stiff, especially in the morning or after periods of inactivity.
Swelling: Arthritis can cause joint inflammation, leading to visible swelling.
Decreased range of motion: As arthritis progresses, you may find it more difficult to fully bend or straighten the joints in your hand or wrist.
Grinding sensation: You may feel or hear a grinding or clicking noise when you move your hand or wrist. It is caused by the bones rubbing together due to the breakdown of cartilage.
Weakness or loss of grip strength: You may have difficulty performing tasks that require a strong grip or fine motor skills, such as opening jars or buttoning shirts.
Deformity: In severe or advanced cases of arthritis, the fingers or wrist may become deformed. For example, the fingers may shift towards the little finger, or nodules may form on the joints.

Types of Hand & Wrist Arthritis

Hand and wrist arthritis can present in several different forms. The type of arthritis can determine the symptoms a person experiences and the most effective treatment options. Here are the most common types of hand and wrist arthritis:

Osteoarthritis (OA): The most common form of arthritis, which involves wear-and-tear damage to the joint's cartilage that occurs as we age. It often affects the base of the thumb and the end joints of the fingers.
Rheumatoid Arthritis (RA): This is an autoimmune condition in which the body's immune system attacks the lining of the joint capsule, causing inflammation and swelling. It typically affects the wrist and finger joints and can lead to deformities over time if not treated effectively.
Post-traumatic Arthritis: This type of arthritis occurs after an injury to the hand or wrist, such as a fracture or dislocation, and can develop years after the injury. It's similar to osteoarthritis and occurs due to damage to the cartilage.
Psoriatic Arthritis: This form of arthritis occurs in some people with psoriasis, an autoimmune skin condition. It can cause joint pain, stiffness, and swelling.
Gout: Although less common in the hand and wrist, gout can still occur in these locations. It's caused by a build-up of uric acid crystals in the joints, which leads to sudden, severe episodes of pain, redness, and swelling.
Infectious Arthritis: Also known as septic arthritis, an infection in the joint causes this type of arthritis. It can cause sudden pain, swelling, and fever and requires immediate medical attention to prevent permanent joint damage.

Stages of Hand & Wrist Arthritis

The stages of arthritis generally progress from mild to severe.

Early-stage: Minimal wear of the joint cartilage, causing occasional pain or stiffness.
Mid-stage: More significant cartilage loss, frequent pain, inflammation and limited mobility.
Late-stage: The cartilage is worn away, leading to bone rubbing against bone. This stage is associated with constant pain, severe loss of mobility and potential joint deformity.

Hand & Wrist Arthritis Diagnosis

The diagnosis of hand and wrist arthritis is primarily based on a detailed medical history, physical examination, and imaging tests. Here's a detailed look at the diagnostic process:

Medical History: Your doctor will ask about your symptoms, their duration and severity, and whether certain activities or times of day worsen them. They may also inquire about any history of injury or repetitive stress to the hand or wrist, as well as a family history of arthritis or other autoimmune disorders.
Physical Examination: Your doctor will visually inspect your hand and wrist for signs of inflammation, swelling, redness, or deformity. They'll also test the range of motion in your joints and assess any tenderness, pain, or difficulty with movement.
Imaging Tests: X-rays can reveal changes in the bones and degradation of the joints characteristic of arthritis. Other imaging studies, such as a computerised tomography (CT) scan or magnetic resonance imaging (MRI), may be used to get a more detailed look at the joints and surrounding tissues.
Laboratory Tests: Blood tests may be done to identify inflammation markers and help diagnose certain types of arthritis, such as rheumatoid arthritis or gout. In some cases, a sample of synovial fluid (the lubricating fluid within joints) may be taken from your hand or wrist to check for signs of infection or crystals associated with gout.
Hand Function Tests: Evaluate your hand and wrist strength, flexibility, and functionality. They may involve tasks like gripping or pinching objects.

Hand & Wrist Arthritis Treatment

Treatment for hand and wrist arthritis can involve a variety of strategies, often used in combination, to help manage symptoms and slow the progression of the disease. Here's a detailed look at the options:

Medication: Over-the-counter pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation. In cases of rheumatoid arthritis, disease-modifying antirheumatic drugs (DMARDs) or biologics can help slow the progression of the disease.
Topical Treatments: Topical creams, gels, and patches containing pain relievers or capsaicin (a compound found in hot peppers) can temporarily relieve arthritis pain.
Hand therapy: A hand therapist can provide exercises and treatments to help maintain or improve joint range of motion, strengthen the muscles supporting the joints, and reduce pain.
Occupational Therapy: An occupational therapist can help you find ways to perform daily tasks without putting extra stress on your painful joints.
Splinting or Bracing: These can support the affected joint, relieve pain, and prevent or reduce deformities.
Hot and Cold Therapy: Heat can help relax muscles and increase blood flow to relieve pain and stiffness. Cold can help numb the area and reduce inflammation.
Steroid Injections: Injections of corticosteroids into the affected joint can help reduce inflammation and pain. These are usually reserved for severe symptoms or when other treatments are ineffective.
Lifestyle changes: Maintaining a healthy weight, eating a balanced diet, and regular exercise can help reduce symptoms and improve overall health. Avoiding activities that strain the joints of the hand and wrist can also help.
Surgery: If conservative treatments aren't successful and arthritis severely affects your quality of life, surgery may be considered. Procedures can range from joint replacement to fusion of the bones in the wrist or hand.

What if Hand & Wrist Arthritis is Untreated?

If left untreated, arthritis in the hands and wrists can lead to permanent joint damage and deformity, chronic pain, and significant loss of function, which can greatly impact a person's quality of life. Early diagnosis and treatment may slow the progression of the disease and help maintain joint function.