Expert Treatment for Wrist Arthritis and Chronic Wrist Pain
Wrist arthritis is a painful and progressive condition that can affect how you move, grip, and use your hand every day. Many patients in Blairsville live with stiffness, swelling, and loss of motion without realizing that specialized treatment is available just a short drive south in Dawsonville. At Specialty Orthopaedics, board-certified orthopedic hand and upper extremity surgeon Dr. Thomas Neustein provides advanced surgical and nonsurgical options to restore motion, reduce pain, and improve wrist function.
Understanding Wrist Arthritis
Wrist arthritis occurs when the smooth articular cartilage that covers the wrist bones wears away, causing pain and stiffness. The wrist joint is a complex structure made up of multiple small joints, including the distal radioulnar joint and carpal bones that connect the hand to the forearm. When this cartilage breaks down, the bones rub together and inflammation develops, leading to pain, swelling, and loss of motion. Over time, the joint may become deformed or unstable.
Common Forms of Wrist Arthritis
There are several types of wrist arthritis. The most common form is osteoarthritis, a degenerative arthritis caused by wear and tear over time. Rheumatoid arthritis and psoriatic arthritis are forms of inflammatory arthritis in which the body’s immune system attacks its own joint tissues. Avascular necrosis and Kienbock disease can also lead to joint damage by reducing blood supply to the wrist bones. In each case, the result is similar — pain, stiffness, and loss of motion in the wrist.
Causes and Risk Factors
Wrist arthritis can occur after trauma, fracture, or repetitive strain. Previous injuries, such as distal radius fractures, can lead to post-traumatic arthritis if the joint doesn’t heal evenly. Risk factors include age, inflammatory disease, genetics, and repetitive wrist motion at work or during sports. In rheumatoid arthritis or psoriatic arthritis, the body’s immune system attacks the wrist joint, causing pain and swelling even without injury. Identifying these risk factors early helps prevent worsening joint damage.
Early Symptoms and Warning Signs
Common symptoms include wrist pain, swelling, stiffness, and a grinding sensation during motion. The pain may worsen with movement or after activity. Some patients notice reduced grip strength or difficulty lifting objects. In advanced stages, the wrist may appear enlarged or deformed, and motion becomes limited. The symptoms often occur gradually but can worsen after an injury or period of heavy strain.
Diagnosis and Accurate Evaluation
An accurate diagnosis begins with a detailed physical examination and imaging studies. X-rays show narrowing of the joint space, changes in the wrist bones, and bone spurs that cause pain. Computed tomography (CT) or magnetic resonance imaging (MRI) may reveal early cartilage wear, stress fractures, or avascular necrosis. Dr. Neustein carefully evaluates wrist motion, grip strength, and finger function to determine the best treatment options for each patient.
Nonsurgical Treatment Options
In the early stages of wrist arthritis, conservative treatments can reduce pain and preserve motion. These include rest, bracing, and activity modification to minimize strain on the wrist joint. Nonsteroidal anti inflammatory drugs help decrease inflammation and swelling. Corticosteroid injections may provide temporary pain relief for several months. Physical therapy improves range of motion and strengthens the muscles supporting the wrist. For mild arthritis, these treatments can slow disease progression and postpone the need for surgery.
When Surgery Becomes Necessary
When pain persists despite conservative care, surgical treatment may be recommended. Surgery is often considered when wrist pain limits daily activities or when X-rays show significant degeneration of the wrist joint. The goal of surgery is to reduce pain, improve motion, and restore hand function. Dr. Neustein specializes in several reconstructive procedures, including proximal row carpectomy, partial wrist fusion, total wrist arthrodesis, and total wrist arthroplasty.
Proximal Row Carpectomy
A proximal row carpectomy is one of the most effective surgical options for degenerative wrist arthritis. This procedure removes the first row of small carpal bones from the wrist — the scaphoid, lunate, and triquetrum — which are often the source of pain. Removing these bones allows the remaining wrist bones to move more smoothly, reducing pain while preserving motion. Proximal row carpectomy offers excellent long-term results for patients with arthritis limited to specific areas of the wrist joint.
Partial Wrist Fusion
Partial wrist fusion is another surgical procedure that stabilizes the wrist while maintaining partial motion. By fusing selected carpal bones together, the procedure relieves pain from the worn joint surfaces while keeping nearby joints mobile. Screws or small plates hold the bones in place while they heal. This procedure reduces pain significantly while preserving grip strength and functional movement for daily tasks.
Total Wrist Arthrodesis (Complete Wrist Fusion)
For severe arthritis involving the entire wrist, a total wrist arthrodesis may be the best option. This procedure permanently fuses the wrist joint by connecting the radius and carpal bones into one solid bone. The goal is to eliminate pain completely by stopping all motion in the arthritic joint. While motion is lost, strength and stability are restored, allowing patients to lift, push, and perform many daily tasks without pain. Total wrist arthrodesis is especially helpful for patients with advanced rheumatoid arthritis or degenerative arthritis.
Total Wrist Arthroplasty (Joint Replacement)
Total wrist arthroplasty, or wrist joint replacement, is a newer surgical option designed to restore both motion and pain relief. In this procedure, the damaged wrist bones are replaced with a specialized artificial implant that mimics natural movement. Wrist replacement is ideal for selected patients with rheumatoid arthritis, psoriatic arthritis, or degenerative arthritis who wish to maintain motion while reducing pain. Performed under general anesthesia, this surgical procedure provides a balance between stability and flexibility.
Distal Radioulnar Joint Procedures
Arthritis sometimes affects the distal radioulnar joint, which connects the two forearm bones near the wrist. When this joint becomes painful, surgical options include partial resection, tendon interposition, or fusion of the distal ulna. These procedures relieve pain while maintaining forearm rotation. Addressing the distal radioulnar joint is an important part of comprehensive wrist arthritis surgery.
Treating Avascular Necrosis and Kienbock Disease
In certain cases, wrist arthritis develops because of avascular necrosis, in which the blood supply to one of the wrist bones is lost. Kienbock disease is a form of avascular necrosis that affects the lunate bone. Treatment focuses on relieving pressure, restoring blood flow, or reconstructing the wrist joint to prevent collapse. When caught early, joint-preserving procedures can prevent the need for full wrist fusion later.
Carpal Tunnel and Associated Conditions
Many patients with wrist arthritis also experience carpal tunnel syndrome. Swelling and inflammation around the wrist joint can compress the median nerve, causing numbness or tingling in the fingers. Carpal tunnel release surgery is often performed at the same time as wrist reconstruction to relieve these symptoms. Treating both conditions together provides more complete pain relief and better hand function.
Recovery After Wrist Reconstruction
Recovery time depends on the procedure performed. After a proximal row carpectomy or partial fusion, the wrist is immobilized in a splint or cast for several weeks to allow early bone healing. Once the wrist bones have stabilized, physical therapy begins to restore motion and strength. Most patients experience gradual improvement and can return to light activities within two to three months. Full recovery after total wrist arthrodesis or arthroplasty may take four to six months.
Postoperative Care and Physical Therapy
After surgery, patients begin a structured rehabilitation program focusing on controlled wrist motion, strengthening, and scar management. Splinting may continue for several weeks to support the healing bones. Hand therapy plays a vital role in maximizing grip strength, finger motion, and coordination. Patients are encouraged to follow their therapy plan closely to achieve the best possible results.
Long-Term Results and Pain Relief
Most patients experience excellent pain relief and improved function after wrist reconstruction surgery. Partial procedures preserve some wrist motion, while total fusion provides stability and complete pain control. Wrist replacement can restore motion for selected patients while maintaining long-term comfort. The goal of all surgical treatments is to reduce pain, restore functional motion, and help patients return to their normal activities.
Preventing Further Joint Damage
Although arthritis cannot be reversed, proper care and early treatment can prevent worsening symptoms. Using ergonomic tools, avoiding repetitive heavy lifting, and maintaining good bone health reduce strain on the wrist joint. Nonsteroidal anti inflammatory drugs and lifestyle adjustments can control inflammation and slow disease progression. Patients with inflammatory arthritis benefit from coordinated medical care to manage systemic disease.
Why Patients Near Blairsville Choose Specialty Orthopaedics
Many patients in Blairsville and across North Georgia trust Dr. Thomas Neustein for advanced wrist arthritis and hand surgery. His Dawsonville practice specializes exclusively in the hand, wrist, and upper extremity — offering precision procedures like proximal row carpectomy, partial wrist fusion, and total wrist arthroplasty. Patients receive individualized care from diagnosis through recovery, ensuring the best possible outcome and a return to active living.
Schedule an Appointment for Wrist Arthritis Evaluation
If you live in or near Blairsville and are experiencing wrist pain, stiffness, or limited motion, it’s time to see a specialist. Early evaluation can prevent further joint damage and restore comfort and mobility. Dr. Thomas Neustein and his team at Specialty Orthopaedics in Dawsonville offer a full range of treatment options — from nonsurgical care to advanced wrist reconstruction. Schedule your consultation today and take the first step toward lasting pain relief.
