Arthritis can affect your wrist, causing pain, swelling, and stiffness. This condition involves inflammation within a joint, and the wrist, a complex structure of many small bones, is particularly susceptible. Wrist arthritis can significantly impact daily activities, as it allows for bending, straightening, and rotating the hand.
Types of Wrist Arthritis
Several types of arthritis can affect the wrist. Osteoarthritis, often called “wear-and-tear” arthritis, results from the gradual breakdown of cartilage that cushions the ends of bones. This leads to bones rubbing, causing pain and stiffness. In the wrist, osteoarthritis can develop due to long-term wear or be accelerated by previous injuries like fractures.
Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system mistakenly attacks the synovium, the lining of the joints. This condition often affects both wrists symmetrically and can lead to significant pain, swelling, and potential joint deformity. RA typically starts in smaller joints, including those in the hand and wrist.
Psoriatic arthritis (PsA) is an inflammatory arthritis connected to psoriasis, a skin condition causing scaly patches. PsA can affect various joints, including those in the wrist, and may also involve changes in fingernails and toenails.
Post-traumatic arthritis occurs after a physical injury to the wrist, such as a fracture or ligament tear. Even with proper treatment, altered mechanics or damaged cartilage from the injury can lead to arthritis years later. This type is similar to osteoarthritis but is directly linked to a specific traumatic event.
Recognizing Wrist Arthritis
Wrist arthritis presents with several common signs and symptoms. Pain is a primary indicator, often described as a dull ache or sharp pain with movement, and it frequently worsens with activity. The pain may also be more noticeable during specific actions like turning doorknobs or gripping objects.
Stiffness is common, particularly noticeable after periods of rest, such as in the morning. This stiffness tends to improve as the day progresses and the joint is used. Swelling around the wrist joints can also be visible, indicating inflammation.
A decreased range of motion makes it challenging to perform everyday tasks. Movements like bending, twisting, or gripping may become difficult or limited. Some individuals may experience grinding or clicking sensations, known as crepitus, as bones rub together due to cartilage loss. A loss of grip strength or general wrist weakness can also develop, further impacting function.
Diagnosing Wrist Arthritis
Diagnosing wrist arthritis begins with a medical history and physical examination. The doctor will inquire about the patient’s symptoms, including when the pain started and how it affects daily life. During the physical exam, the wrist is assessed for reduced range of motion, tenderness, swelling, and any visible deformities.
Imaging tests are crucial for confirming the diagnosis and determining the extent of joint damage. X-rays can reveal bone changes, joint space narrowing, and bone spurs, which are characteristic of arthritis. Magnetic Resonance Imaging (MRI) provides detailed images of soft tissues, including cartilage and ligaments, while Computed Tomography (CT) scans offer more intricate views of bone structures.
Blood tests are often utilized, particularly when inflammatory types of arthritis are suspected. These tests can identify specific inflammatory markers or antibodies that indicate conditions like rheumatoid arthritis. Osteoarthritis typically does not show abnormalities in blood tests. In some instances, joint fluid analysis may be performed by drawing fluid from the joint to rule out infection or identify crystals, which can indicate certain types of arthritis like gout.
Management and Treatment Strategies
Managing wrist arthritis involves strategies ranging from conservative methods to surgical interventions, depending on the severity and type of arthritis. Initial conservative management often includes medications. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. For more severe cases, prescription medications such as corticosteroids, which reduce inflammation, or disease-modifying antirheumatic drugs (DMARDs), which slow disease progression in inflammatory arthritis, may be prescribed.
Physical and occupational therapy play a significant role in maintaining wrist function. Therapists can guide patients through exercises designed to improve range of motion, strengthen surrounding muscles, and teach adaptive techniques for daily activities to minimize strain on the wrist.
Splinting or bracing the wrist can provide support, reduce pain, and limit aggravating movements, especially during flare-ups or periods of increased activity. Lifestyle modifications, such as adjusting activities to avoid excessive wrist use and implementing ergonomic changes, can also help manage symptoms.
When conservative treatments are insufficient, injections may be considered. Corticosteroid injections directly into the joint can offer temporary but potent relief from pain and inflammation.
Surgical interventions are reserved for severe cases where other treatments have failed to provide adequate relief or when joint damage significantly impairs function. One option is joint fusion (arthrodesis), where damaged bones are permanently joined to eliminate movement and pain. This procedure can involve fusing a few bones (partial fusion) or all the carpal bones and the forearm bone (complete fusion), with the goal of reducing pain by stopping bone-on-bone friction. Another surgical option is joint replacement (arthroplasty), which involves removing damaged joint surfaces and replacing them with artificial components made of metal and plastic. This procedure aims to relieve pain while preserving more wrist movement compared to fusion, though it may have limitations regarding heavy lifting.