Hand & Wrist Arthritis | Symptoms, Diagnosis & Treatment | MedStar Health

Arthritis is an inflammation of the tissues that line your joints. This inflammation can cause pain, swelling, and joint damage. Types of arthritis that most often affect your hand, wrist, and elbow include:

  • Osteoarthritis: The natural aging process can wear away at the protective cartilage that allows the many bones in your hand and wrist, and the elbow, to move smoothly, causing inflammation, swelling, and pain.
  • Rheumatoid arthritis: This immune system dysfunction attacks and wears away at the cartilage lining between the small, delicate bones in your hand and wrist. Rheumatoid arthritis generally affects the joints on both hands. It is less likely to affect your elbow.

What causes hand and wrist arthritis?

Depending on the type of arthritis you are suffering from, the disease may be caused by any of the following:

  • Prior hand or wrist injury
  • Natural aging process/wear and tear
  • Immune system problem
  • Genetics (family history of arthritis)

Hand and wrist arthritis symptoms

Hand arthritis symptoms can include:

  • Pain or burning in the hand or wrist joints, especially in the morning and with heavy use
  • Swelling
  • Warmth due to inflammation
  • Nearby joints become unusually flexible to compensate for the affected joint
  • Feeling or hearing grinding of the joint inside the hand
  • Appearance of cysts on the fingers
  • Difficulty moving the wrist

Along with the symptoms above, rheumatoid arthritis can also cause:

  • A weak grip
  • Difficulty using the hand
  • Pain in the knuckles
  • Fatigue
  • Weight loss
  • Fever

Hand and wrist arthritis diagnosis

Our orthopedic surgeons are experts at diagnosing the full range of hand and wrist arthritis problems.  Our initial exam generally includes:

  • Taking your medical history: This includes asking questions about when your pain began, whether it affects one or both sides of your body, and when the pain feels most severe. Other questions may be about whether you have other medical problems, and if you take any medications.
  • Physical exam: The orthopedist will examine your affected hand, wrist, or elbow.
  • Imaging tests: Your orthopedist may want to examine the bones and joints themselves using an X-ray, CT scan, or MRI.

Hand and wrist arthritis treatment

Treatment for hand, wrist, and elbow arthritis usually depends on whether you suffer from osteoarthritis or rheumatoid arthritis, and how severe your disease is.  The experienced team of orthopedists at MedStar Health will examine you carefully and work to develop the most effective treatment plan for you, to ease your pain and improve your ability to use your hands and wrists. 

Treatment options aside from surgery may include:

  • Prescription and over-the-counter anti-inflammatory medications
  • Injections of steroids or anti-inflammatory medications
  • Temporarily restricting hand or wrist movement with a splint to ease pain
  • Physical therapy

If non-surgical treatment does not relieve your pain, you may need surgery. The orthopedic surgeons at MedStar Georgetown are experienced in the most advanced and innovative surgical procedures for arthritis treatment.

Surgical procedures we use to treat arthritis include:

  • Arthroscopy: In this procedure, your orthopedic surgeons will insert an arthroscope, or thin tube, into your affected joints. The arthroscope uses a small camera and lights to beam images of your joints onto a screen for your surgeons to see. The surgeons will then insert specialized instruments into your joints to repair any damage.  Georgetown offers the most advanced arthroscopic surgical technology and expertise in the region.
  • Joint Fusion Surgery: This procedure fuses bones to remove a problematic joint and minimize pain.
  • Joint Replacement Surgery or Arthroplasty: This procedure replaces the damaged joint with a prosthetic or artificial one.

Thumb arthritis

Thumb arthritis, also called basal joint arthritis, is a type of osteoarthritis caused when cartilage wears away in the joint at the base of the thumb. 

People who work with their hands and perform repetitive gripping movements are more likely to develop the condition. Massage therapists, hairdressers, or others who work with tools or instruments have the greatest risk of developing the disease. Basal joint fractures or ligament injuries can also increase the likelihood of developing thumb arthritis.

Left untreated, thumb arthritis can cause severe pain and make it difficult to perform even simple tasks. The best way to minimize the damage of thumb arthritis and treat it successfully is to see your doctor when symptoms begin. The sooner you begin treatment, the more options you’ll have to manage the condition.

Symptoms often include:

  • Pain felt at the base of your thumb when you grip or pinch something.
  • Pain when you apply pressure to the heel of your hand.
  • Stiffness in the morning that gets better during the day but begins to ache in the evening.
  • Swelling and tenderness at the base of the thumb.
  • Aching in the joint after prolonged use.
  • A limited range of motion in the thumb, or loss of strength while gripping or pinching items
  • A bump on the joint or an enlarged, out-of-joint appearance

Thumb arthritis treatment

In the early stages of thumb arthritis, a number of treatments can alleviate symptoms, including:

  • Oral or topical medications, such as acetaminophen, ibuprofen, prescription pain relievers, or pain-relieving gels
  • Icing the area for five to 15 minutes as needed throughout the day to relieve pain and swelling
  • Working with a hand therapist to strengthen supporting muscles and tendons and learning adaptive techniques to lessen the strain on the joint
  • Wearing a supportive splint or brace to limit thumb movement and allow the joint to heal

In many cases, your doctor will suggest a combination of treatments to control symptoms. When medications, self-care, and physical therapy aren’t successful, steroid injections can relieve pain and swelling for several months. Because steroid injections can’t be used indefinitely, they only offer a temporary solution.

When nonsurgical treatments are no longer effective, surgery can offer relief. Most often, surgeons use the ligament reconstruction and tendon interposition (LRTI) technique, which can restore thumb movement and eliminate pain. During this outpatient procedure, surgeons remove the arthritic joint and replace it with a graft from one of your tendons to stabilize the thumb. Because tendons are used, rather than a metal or plastic implant that can wear out, the surgery can provide a long-term solution.