Hand and wrist arthritis affects millions of Americans, limiting daily activities and causing significant discomfort. Dr. Matthew Belton, hand and wrist surgeon at CU Medicine, explains the symptoms, causes and treatment options for this common condition.

Understanding hand and wrist arthritis

“Usually when patients come to see me about arthritis in their hands, it’s due to the pain associated with the disease,” explains Dr. Belton.

The three types of arthritis affecting the hands and wrists are post-traumatic arthritis, osteoarthritis and inflammatory arthritis. Post-traumatic arthritis happens after an injury. For instance, if a person fractured their wrist in their 20’s and it wasn’t set just right, that person could end up dealing with post-traumatic arthritis. Osteoarthritis develops from wear and tear on the joints over time, while inflammatory arthritis can be from autoimmune conditions where the body's immune system attacks the joint lining.

Examples of inflammatory arthritis are:

• Rheumatoid arthritis
• Psoriatic arthritis
• Lupus
• Gout

Recognizing the symptoms

Early recognition of symptoms can lead to better management of hand and wrist arthritis. 

Common signs include:

• Pain during or after normal use of the hand or wrist
• Joint stiffness, especially in the morning
• Swelling around the affected joints
• Weakness in grip strength
• A grinding sensation during movement
• Changes in joint appearance, including bumps or deformities

“Symptoms can be intermittent or constant,” notes Dr. Belton. “It’s different for every patient and that’s why we take a patient-centered approach when diagnosing and creating a treatment plan.”

Risk Factors and causes

Several factors can increase the risk of developing hand and wrist arthritis:

Age: The risk increases as we get older, with most cases of osteoarthritis appearing after age 50.

Gender: Women are more likely than men to develop inflammatory arthritis in their hands.

Genetics: A family history of arthritis may increase your risk.

Previous injuries: Fractures or ligament tears can lead to post-traumatic arthritis.

Occupational factors: Jobs requiring repetitive hand motions may contribute to joint wear.

Diagnosis and treatment options

Diagnosing hand and wrist arthritis typically involves physical examination, medical history review, and imaging tests like X-rays or MRIs.

“I always start with getting an understanding of what patients use their hands for,” shares Dr. Belton. “A rock climber uses their hands very differently than someone like me, a surgeon. If they aren’t able to do the things they love or even basic tasks, we start there.”

Treatment options range from conservative approaches to surgical interventions:

Conservative Treatments:

• Activity modification to reduce joint stress
• Splinting or bracing to support affected joints
• Over-the-counter pain medications like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs)
• Prescription medications for certain types of arthritis
• Corticosteroid injections to reduce inflammation
• Referral to rheumatology for autoimmune/inflammatory arthritis

Physical and occupational therapy

When it comes to certified hand therapists Dr. Belton, shares, “our certified hand therapists go through as much training as I did to learn surgery, that’s how subspecialized they are.”

Hand therapy can help decrease swelling, improve movement and reduce pain.

Surgical options

When conservative treatments don't provide adequate relief, surgical procedures may be considered:

• Joint fusion (arthrodesis)
• Joint replacement (arthroplasty)
• Joint debridement
• Nerve denervation

When it comes to surgery, Dr. Belton shares, “I will never tell you that you need to have surgery. You will tell me that you’re ready for the next step.”

Living with hand and wrist arthritis

Dr. Belton emphasizes that while there's no cure for arthritis, proper management can significantly improve quality of life.

“As we get older, most people experience some kind of arthritis in their life,” explains Dr. Belton. “We’re in an age of great research at the University of Colorado and we’re working on ways to address arthritis before it even starts at the genetic level.”

When to see a specialist

Consult with a hand specialist if you experience:

• Persistent pain lasting more than a few weeks
• Significant swelling or redness
• Decreased range of motion
• Difficulty performing everyday tasks
  

CU Medicine's team of hand and wrist providers offer comprehensive evaluation and individualized treatment plans for patients with arthritis. For more information or to schedule an appointment with Dr. Belton or another hand provider at CU Medicine Orthopedics - Longmont, visit here or call (720) 718-8288.