Arthritis of the Hand and Wrist: Causes, Symptoms, and Treatment Options
Introduction
Arthritis of the hand and wrist is a common condition that can cause significant pain, stiffness, and loss of function. Because the hands and wrists are essential for nearly every daily activity—from buttoning a shirt to lifting groceries—arthritis in these areas can be especially disruptive. Whether caused by age, injury, or autoimmune disease, arthritis of the hand and wrist requires accurate diagnosis and proper treatment to restore hand function and relieve pain.
Anatomy of the Hand and Wrist
The wrist is a complex joint made up of eight small carpal bones arranged in two rows. These carpal bones connect to the two arm bones, the radius and ulna, and to the finger bones. Healthy joints are lined with articular cartilage, a smooth tissue that allows pain-free motion. Tendons connect muscles to these small joints and pass through tight tunnels around the wrist, while nerves and blood vessels provide motion and sensation. When cartilage wears down or the immune system attacks its own tissues, arthritis symptoms begin.
What is Arthritis of the Hand and Wrist?
Arthritis is an inflammatory condition that damages the affected joints, leading to joint pain, stiffness, swelling, and deformity. The most common type is osteoarthritis, often called “wear-and-tear arthritis.” In the hand, arthritis most often affects the joint at the base of the thumb, but it may also involve the finger joints or the wrist bones. Wrist arthritis can limit wrist motion and make everyday tasks difficult.
Causes of Hand and Wrist Arthritis
Arthritis commonly develops with age, but it can affect people of all ages. The exact cause depends on the type:
- Osteoarthritis occurs as cartilage wears down over time.
- Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks the lining of the joints.
- Post-traumatic arthritis may develop years after wrist injuries such as fractures, dislocations, or ligament tears.
- Psoriatic arthritis is linked to psoriasis, a skin condition.
- Repetitive stress from work or hobbies can also contribute to joint damage.
Injury, genetics, and even maintaining an unhealthy weight may increase the risk of arthritis.
Types of Arthritis in the Hand and Wrist
Osteoarthritis
This is the most common type, especially in middle age and older adults. As cartilage wears away, bones rub together, causing swelling, stiffness, and bony lumps.
Rheumatoid Arthritis
A chronic inflammatory disease where the immune system attacks joint tissue. It commonly affects the small joints of the hands and wrists on both sides. Patients may experience morning stiffness, reduced range of motion, and joint damage if untreated.
Post-Traumatic Arthritis
This develops after wrist fractures or other injuries. Even after a bone heals, abnormal mechanics or cartilage damage can cause long-term wrist pain.
Psoriatic Arthritis
Associated with psoriasis, this type affects the ends of the finger joints and may also involve the spine.
Symptoms of Hand and Wrist Arthritis
Arthritis symptoms may develop gradually or appear after an injury. Common signs include:
- Swelling and tenderness
- Joint pain that may be worse at night or with activity
- Hand and wrist pain that limits grip strength
- Morning stiffness and difficulty with everyday tasks
- Reduced range of motion in the wrist bones or finger joints
- Bony lumps or deformities in advanced stages
Some patients also notice other symptoms such as fatigue, skin changes, or nail changes if the arthritis is linked to inflammatory diseases.
Diagnosis of Hand and Wrist Arthritis
A healthcare professional begins with a physical examination of the hand and wrist. X-rays can reveal cartilage loss, joint damage, or bone spurs in the small carpal bones. Blood tests may be ordered to confirm inflammatory arthritis such as rheumatoid arthritis or psoriatic arthritis. In certain cases, advanced imaging may be needed for an accurate diagnosis.
Non-Surgical Treatment Options
For many patients, nonsurgical treatments can help reduce pain and relieve swelling. Options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and to reduce inflammation
- Steroid injection into the joint for temporary pain relief
- Over-the-counter medications such as acetaminophen for mild symptoms
- Wrist splinting or bracing to rest the joint
- Ice pack or heat therapy to reduce swelling
- Activity modification and occupational therapy to protect hand function
- Working with a physical therapist or hand therapist to strengthen surrounding muscles
A personalized treatment plan helps balance activity with joint protection.
Surgical Options for Severe Arthritis
When non-surgical treatment fails, surgical procedures may be considered:
Synovectomy
Removal of inflamed joint lining, often performed arthroscopically.
Arthroplasty (Joint Replacements)
Replacement of damaged joints with silicone, ceramic, or other implants. This is often used in finger joints or for wrist arthritis in select patients.
Arthrodesis (Joint Fusion)
Joint fusion stabilizes the bones, eliminating motion but reducing pain worse than nonoperative care. Strong fusions may be preferred for patients who use their hands heavily.
Proximal Row Carpectomy
Removal of part of the small carpal bones to reduce wrist pain while preserving some wrist motion.
Your orthopedic surgeon will explain the risks, benefits, and recovery timeline for each option.
Rehabilitation and Recovery
After surgery, a hand therapist or physical therapist will guide you through rehabilitation. A splint or cast may be required for several weeks. Patients typically limit activities for 8–12 weeks to allow proper healing. With consistent therapy and proper treatment, many regain strong hand function and can return to everyday tasks within months.
Living with Hand and Wrist Arthritis
Lifestyle changes can make a difference. Maintaining a healthy weight, avoiding repetitive stress on the hands, and following a guided treatment plan can slow disease progression. Many patients benefit from occupational therapy strategies to make daily activities easier.
Related Conditions We Treat
Arthritis of the hand and wrist often overlaps with other conditions such as carpal tunnel syndrome, trigger finger, and nerve compression injuries. Dr. Neustein also treats sports injuries, fractures, and ligament tears that may lead to arthritis later.
Why Choose Dr. Neustein
Dr. Thomas Neustein is a fellowship-trained, board-certified orthopedic hand and upper extremity surgeon. Patients across North Georgia trust him for his expertise in treating hand and wrist arthritis, carpal tunnel syndrome, wrist injuries, and other complex conditions. His approach combines advanced surgical techniques with patient-focused care to deliver the best outcomes.
Schedule an Appointment
If you are struggling with hand and wrist pain, don’t wait for it to get worse. With the right treatment options, you can reduce pain, restore function, and return to the activities you enjoy. Contact Specialty Orthopaedics today to schedule an appointment with Dr. Neustein.
