Arthritis of the Hand
The hand and wrist have a number of small joints that collaborate to generate motion, including the fine motion required to thread a needle or tie a shoelace. Whenever the joints are influenced by arthritis, activities of daily living can be difficult. Arthritis can occur in many areas of the hand and wrist and can have more than a single cause.
With time, if the arthritis is not treated, the bones which comprise the joint can lose their normal shape. This causes even more pain and further reduces movement. These are all huge reasons why you should understand what you are competing with if you are facing arthritis in Mexico, Missouri.
Simply defined, arthritis is inflammation of one or more of your joints. The most common kinds of arthritis are osteoarthritis and rheumatoid arthritis, but there are over 100 different types.
Healthy joints move easily because of a smooth, slippery tissue called articular cartilage. Cartilage covers the ends of bones and provides a smooth gliding surface for the joint. This smooth surface is lubricated by a fluid that looks and feels like oil. It is produced by the joint lining called synovium.
Whenever arthritis occurs because of disease, the onset of symptoms is gradual and the cartilage decreases slowly. The two most common kinds of arthritis from disease are osteoarthritis and rheumatoid arthritis.
Osteoarthritis is a lot more common and generally affects much older individuals. Also called "wear and tear" arthritis, osteoarthritis causes cartilage to wear away. It appears in a predictable pattern in particular joints.
Rheumatoid arthritis is a chronic disease which can affect many parts of your body. It causes the joint lining (synovium) to swell, which causes pain and stiffness in the joint. Rheumatoid arthritis most frequently starts in the small joints of the hands and feet. It usually impacts the same joints on both sides of the body.
Fractures, particularly those that damage the joint surface, and dislocations are among the most common injuries that result in arthritis. Even whenever properly treated, an injured joint is more likely to become arthritic over time.
Early symptoms of arthritis of the hand include joint pain which may feel "dull," or a "burning" sensation. The pain often occurs after periods of increased joint usage, such as heavy gripping or grasping. The pain may not be present instantly, but may show up hours later or even the following day. Morning pain and stiffness are typical.
As the cartilage erodes and there is less material to give shock absorption, the symptoms occur more frequently. In advanced disease, the joint pain might wake you up during the night.
Pain might be made worse with use and relieved by rest. Many people in Central Missouri with arthritis complain of increased joint pain with rainy weather. Activities which once were very easy, such as opening a jar or starting the car, become difficult due to pain. To avoid pain at the arthritic joint, you may change the way you use your hand.
Whenever the affected joint is subject to greater stress than it can bear, it may swell in an attempt to prevent further joint use.
Changes within Surrounding Joints
In patients with advanced thumb base arthritis, the surrounding joints may become more mobile than normal.
The arthritic joint might feel warm to touch. This is because of the body's inflammatory response.
Crepitation and Looseness
There might be a sensation of grating or grinding in the affected joint (crepitation). This is triggered by damaged cartilage surfaces rubbing against one another. If arthritis is because of damaged ligaments, the support structures of the joint might be unstable or "loose." In advanced cases, the joint may appear bigger than normal (hypertrophic). This is typically because of a combination of bone changes, loss of cartilage, and joint swelling.
Whenever arthritis affects the end joints of the fingers (DIP joints), small cysts (mucous cysts) might develop. The cysts may then cause ridging or dents in the nail plate of the impacted finger.
A physician can diagnose arthritis of the hand by analyzing the hand and by taking x-rays. Specialized studies, like magnetic resonance imaging (MRI), are typically not needed except in cases where Keinbock's disease (a condition where the blood supply to one of the little bones in the wrist, the lunate, is interrupted) is suspected. Often a bone scan is helpful. A bone scan might help the physician identify arthritis when it is in an early stage, even if x-rays look normal.
Arthritis does not need to result in a painful or inactive life. It is very important to seek help early so treatment can begin and you can return to doing what matters most to you.
Treatment options for arthritis of the hand and wrist consist of medication, splinting, injections, and surgery, and are determined based on:
- How far the arthritis has progressed
- How many joints are involved
- Your age, activity level and other medical conditions
- If the dominant or non-dominant hand is impacted
- Your personal goals, home support structure, and capacity to understand the treatment and comply with a therapy program
Medicines treat symptoms but can not restore joint cartilage or undo joint damage. The most popular medications for arthritis are anti-inflammatories, which stop the body from producing chemicals which cause joint swelling and pain. Examples of anti-inflammatory drugs include medications like acetaminophen and ibuprofen.
Glucosamine and chondroitin are widely advertised dietary supplements or "neutraceuticals." Neutraceuticals are not drugs. Instead, they are compounds which are the "building blocks" of cartilage. They were originally utilized by veterinarians to treat arthritic hips in canines. However, neutraceuticals have not yet been researched as a treatment of hand and wrist arthritis. (Keep in mind: The U.S. Food and Drug Administration does not test dietary supplements. These compounds might cause negative interactions with other medications. Always consult your physician before taking dietary supplements.)
Whenever first-line treatment with anti-inflammatory medication is not appropriate, injections may be used. These typically contain a long-lasting anesthetic and a steroid that can offer pain relief for weeks to months. The injections can be repeated, but only a minimal number of times, because of possible adverse effects, like lightening of the skin, weakening of the tendons and ligaments and infection.
Injections are usually combined with splinting of the affected joint. The splint helps support the impacted joint to ease the stress put on it from frequent use and activities. Splints are generally worn during periods whenever the joints hurt. They ought to be small enough to allow functional usage of the hand when they are worn. Wearing the splint for too long can result in muscle deterioration (atrophy). Muscles can assist in stabilizing injured joints, so atrophy ought to be prevented.
If nonsurgical treatment cannot give comfort, surgery is usually discussed. There are lots of surgical options. The chosen course of surgical treatment should be one that has a practical chance of delivering long-term pain relief and return to function. It ought to be customized to your individual needs.
If there is any way the joint may be preserved or reconstructed, this option is usually chosen. When the damage has progressed to a point that the surfaces will no longer work, a joint replacement or a fusion (arthrodesis) is performed.
Joint fusions provide pain relief but stop joint motion. The fused joint no longer moves; the harmed joint surfaces are gone, so they can not cause pain and other symptoms. The goal of joint replacement is to give pain relief and recover functionality. Just like hip and knee replacements, there have been notable improvements in joint replacements in the hand and wrist. The replacement joints are made of materials similar to those utilized in weightbearing joints, like ceramics or long-wearing metal and plastic parts. The goal is to improve the function and long life of the replaced joint.
Most of the major joints of hand and wrist can be replaced. A surgeon frequently needs extra training to perform the surgery. Just like any evolving technology, the long-lasting results of the hand or wrist joint replacements are not yet known. Early results have been encouraging. Talk with your doctor to figure out if these implants are right for you.
After any kind of joint reconstruction surgery, there is a time period of recovery. Commonly, you will be referred to a trained hand therapist, who can help you maximize your recovery. You may need to use a postoperative splint or cast for some time after surgery. This helps safeguard the hand while it heals.
During this postoperative period of time, you might need to modify activities to permit the joint reconstruction to heal correctly.
Typically, pain medication you take by mouth is also used to decrease discomfort. It is essential to discuss your pain with your doctor so it can be properly treated.
Length of recovery time varies widely and depends upon the extent of the surgery performed and multiple individual factors. However, people typically can return to most if not all of their desired activities in about three months following most major joint reconstructions.
Increasingly, physicians are concentrating on how to preserve the damaged joint. This includes getting an earlier diagnosis and fixing joint components before the whole surface becomes damaged.
Arthroscopy of the small joints of the hand and wrist is now achievable because the equipment has been made much smaller.
There have been encouraging results in cartilage repair and replacement in the bigger joints like the knee, and a few of these techniques have been applied to the smaller joints of the hand and arm.
Additionally, stem cell research might be an option to regenerate damaged joint surfaces.
As you can see, arthritis within the hand, wrist, or any other part of the body is not something to mess around with. If you begin to feel its effects, please think about speaking with a specialist like Dr. Kathleen Weaver of Audrain Orthopaedics in Mexico, MO.