What are the treatment options for hand and wrist arthritis?
Dr. Cavo discusses treatment options for hand and wrist arthritis.?Click play to watch the video or?read the transcript.
What are the treatment options for hand and wrist arthritis?
Nonsurgical treatment may not work for some patients just because of how severe their arthritis is. Once that cartilage is gone, you can't really regrow it. Once the bones are rubbing against each other, it really is a pain generator. Some people are able to benefit quite a bit from nonsurgical steroid injections or bracing different kinds of treatments, but some people, those treatments don't prove effective, and surgery is really the best option.
Steroid injections are like a high dose anti-inflammatory directly to a certain area of the body. Like anti-inflammatories that you take orally, ibuprofen or naproxen, they deliver an anti-inflammatory effect. Those things you take orally go throughout your whole body and affect your kidney, your stomach, everywhere. Whereas corticosteroid or steroid injections are like a high dose, targeted therapy just to one joint of the body. When you give an injection in the knee for knee arthritis, you're getting a targeted therapy just there. Similarly, in the hand, if you give an injection for base of thumb arthritis, you give a small dose of steroid directly where you need it.
Determining the best surgical treatment for a patient with wrist arthritis can depend on what they want to do with their wrist. Some heavy duty laborer type patients need the stability and strength in their wrist, and they don't mind losing some motion. In that situation, we would probably lean more toward what we call a fusion procedure where we make the bones stable and actually act as one long bone. Whereas if someone isn't as heavy lifting type daily activities, they can save their motion and do alternative procedures where we take out the arthritic bone, but we don't fuse the two bones together.
Both surgical and non-surgical treatment options are available if you have hand and wrist arthritis.
According to the American Academy of Orthopaedic Surgeons
(AAOS), those options include:
Non-surgical treatments – These are typically tried first before moving on to a surgical option.
- Activity modification – Limit or stop the activity making your pain worse
- Exercise – Use special exercises from your doctor or physical therapist to help with range of motion
- Immobilization – Wear a wrist splint for a short time to help support the joint and ease pain during some activities
- Medications – Take medicine, such as acetaminophen, naproxen, and ibuprofen to help reduce pain and swelling
- Steroid injections – Cortisone is a powerful anti-inflammatory that can be injected into a joint affected by arthritis
Surgical treatments – These are last resort options if non-surgical treatments are no longer helping with pain.
- Proximal row carpectomy – The doctor removes three carpal bones to help reduce pain but keep some wrist motion.
- Fusion – Your bones of the wrist or finger joint are “welded” together into one solid bone. You will lose motion in your wrist or finger, but the surgery also should stop the pain caused by wrist motion.
- Total wrist replacement – Damaged cartilage and bone are removed and replaced with a new plastic or metal joint to help you regain wrist function.
- Joint replacement – This procedure will help ease pain and restore function in the hand, as worn cartilage and bone are removed and replaced with plastic or metal parts.
For more information about treatment options for hand and wrist arthritis, talk with your doctor.
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