Arthritis is a condition that is common in weight bearing joints such as hips, knees, shoulders. Arthritis in the wrist is not an uncommon presentation. It affects a significant number of people, and causes much difficultly in performing their activities of daily living.
Symptoms
Wrist arthritis commonly leads to the following symptoms:
- Wrist pain
- Joint swelling
- Redness and Warmth
- Weakness – difficulty in gripping objects
- Wrist deformity and instability
- Stiffness
Causes
There are many causes of wrist arthritis, it is commonly seen in association with several common disorders:
Osteoarthritis (OA) – OA is a progressive disorder where the joint surface wears away, allowing both ends of the bones to rub against each other, resulting in pain and stiffness. OA of the wrist also develop due to previous traumatic injury to the wrist, forearm or ligaments.
Rheumatoid Arthritis (RA) – RA is a condition where the body’s immune system attacks its own tissues (mainly the joint linings) destroying joints, bones and tissues. The wrist and the smaller joints of the hand are commonly affected. It is symmetrical, meaning that if one wrist is affected, the other one is usually, too.Post-traumatic – commonly occurs when the fracture involves the cartilage surface of the joint. If the fracture extends into joint surface, the cartilage can become uneven and prone to wrist arthritis.
Risk Factors
The risk factors include:
- Female, age more than 40.
- Previous trauma or injury such as, sprain or fracture to the wrist.
- Certain conditions which alter the function and structure of cartilage, such as rheumatoid arthritis.
- Activities that place high stress on this joint.
Investigations
Your doctor may begin with history taking by asking questions about the pain, how it interferes with your daily lifestyle and family history of the similar problem. The doctor may also enquire about any previous injuries to the wrist, even if they had happened many years ago.
Your doctor will then move on to physical examination of the wrist and also other joints as well. He / She will try to localise the exact site of the pain, assess the range of movements and also the alignment of the wrist.
X-rays will be the best way to see what is happening to the bone. It helps to distinguish various forms of arthritis. Your doctor may also order blood test to show certain systemic disease, such as rheumatoid arthritis.
Complications
As the condition progresses, there will be increased pain, stiffness and reduced mobility of the wrist. This can significantly affect the simplest acts of daily life, such as difficulty gripping objects, using utensils, and you can end up dropping whatever is in your hand.
Treatment
Treatment can be non-surgical and surgical. In general, early treatment is non-surgical and is designed to relieve pain and swelling.
Non – surgical treatments:
- Medication: Your doctor may recommend NSAID’s such as ibuprofen and aspirin to help control swelling and pain.
- Steroids: Injection of steroids into the wrist can temporarily reduce the wrist pain, usually lasting several weeks to months.
- Splint: A special brace can be used to support the wrist and reduce pain during activities.
- Exercise: By following a prescribed program, arm and hand strengthening can help steady the wrist and prevent it from shock and stress.
- Modifying activities: Adjust activities to reduce stress and strain on the wrist joint. In severe cases, you may need to change job, if your job requires repetitive motions of the hand and wrist.
If pain becomes unmanageable or hand function decreases, then surgery is an option. Main objective of the surgery is to relieve the pain. Which surgical procedure is right for you depends on your underlying problem, how much of the wrist joint is involved and how you need to use your wrist. Your doctor will discuss these options with you and select the best surgical treatment.
Surgical treatments include:
- Removing the arthritic bones
- Fuse the wrist bones (arthrodesis)
- Wrist joint replacement
Seeking Advice
Your Family Doctor (GP)
Your Family Doctor will be able to diagnose and help treat your problem. He or she will be able to
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
Prevention
Take daily supplements: Take daily supplements that contain chondroitin sulphate, glucosamine, vitamin C and D, as these will strengthen your joints
Exercise your wrist: Give them a good stretch. Exercise that move your wrist through its full range of motion can help improve your joint’s mobility.
Prevent falls: Wear sensible shoes, prevent wet/slippery walkways, remove home hazards, and install grab bars in your bathroom or stairways if necessary.
F.A.Q. | Frequently Asked Questions
What happens after surgery?
Your wrist and hand will be bandaged with a well padded dressing and a splint for support after surgery.
Rehabilitation
You will undergo physiotherapy sessions for up to 3 months after surgery. The sessions include controlling the swelling and pain after surgery, exercises that help strengthen and stabilise the muscles around the wrist joint, improving fine motor control and dexterity of the hand. Tips will also be given on how to perform activities without putting much strain on the wrist.