Arthritis does not have to result in a painful or sedentary life. It is important to seek help early so that treatment can begin and you can return to doing what matters most to you.
Nonsurgical Treatment
Treatment options for arthritis of the hand and wrist include
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 affected
- Your personal goals, home support structure, and ability to understand the treatment and comply with a therapy program
Medications treat symptoms but cannot restore joint cartilage or reverse joint damage. The most common medications for arthritis are anti-inflammatories, which stop the body from producing chemicals that cause joint swelling and pain. Examples of anti-inflammatory drugs include medications such as acetaminophen and ibuprofen.
Glucosamine and chondroitin are widely advertised dietary supplements or "neutraceuticals." Neutraceuticals are not drugs. Rather, they are compounds that are the "building blocks" of cartilage. They were originally used by veterinarians to treat arthritic hips in dogs. However, neutraceuticals have not yet been studied as a treatment of hand and wrist arthritis. (Note: The U.S. Food and Drug Administration does not test dietary supplements. These compounds may cause negative interactions with other medications. Always consult your doctor before taking dietary supplements.)
Injections
When 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 provide pain relief for weeks to months. The injections can be repeated, but only a limited number of times, due to possible side effects, such as lightening of the skin, weakening of the tendons and ligaments and infection.
Splinting
Injections are usually combined with splinting of the affected joint. The splint helps support the affected joint to ease the stress placed on it from frequent use and activities. Splints are typically worn during periods when the joints hurt. They should be small enough to allow functional use of the hand when they are worn. Wearing the splint for too long can lead to muscle deterioration (atrophy). Muscles can assist in stabilizing injured joints, so atrophy should be prevented.
Surgical Treatment
If nonsurgical treatment fails to give relief, surgery is usually
discussed. There are many surgical options. The chosen course of
surgical treatment should be one that has a reasonable chance of
providing long-term pain relief and return to function. It should be
tailored to your individual needs.
A joint fusion using a plate and screws at the base of the thumb.
An example of a finger joint prosthesis used in joint replacement surgery.
Most of the major joints of hand and wrist can be replaced. A surgeon often needs additional training to perform the surgery. As with any evolving technology, the long-term results of the hand or wrist joint replacements are not yet known. Early results have been promising. Talk with your doctor to find out if these implants are right for you.