Arthritis In Wrist

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A young woman holding her wrist due to a sprain, arthritis or other injury.

Arthritis in the wrist is a medical condition that causes inflammation of the wrist joint, followed by wrist pain and stiffness as well as loss of range of motion of the joint.

There are two predominant forms of arthritis that affect the wrist – osteoarthritis and rheumatoid arthritis. Other, less commonly encountered forms are gout, post traumatic arthritis and psoriatic arthritis.

According to a report released in 2021, around 13.6% of American has wrist arthritis and about 2.5 million Americans (0.75% of the population) suffer from rheumatoid arthritis. Another 0.28% of the population suffers from gout (another form of inflammatory arthritis, discussed below) in the wrist.

Unfortunately, there is no fundamental cure for this chronic disease. Doctors can “treat” mild forms of wrist arthritis by trying to reduce the impact of the symptoms on the quality of life and by trying to slow their rate of progression. They do this by using a combination of activity modification, physical therapy and pain relief medication. However, as the condition progresses, it may become necessary to use surgical intervention to manage the symptoms.

Anatomy Of The Wrist

The wrist comprises 10 bones:

  • Two forearm bones – the radius and the ulna; and
  • Eight small bones, arranged in two rows of four at the base of the hand. These are known as the carpal bones.

You can see the arrangement of the wrist bones in the above illustration.

The bone ends in the joint are each covered with a tough but slick substance known as bone cartilage. The cartilage helps the bone ends to glide smoothly and painlessly over each other in the wrist joint, and prevents direct bone to bone contact.

Types Of Wrist Arthritis

Osteoarthritis

This is the most common kind of arthritis generally and wrist arthritis specifically. It primarily affects the elderly population, although it can occur across all age groups.

Osteoarthritis is caused by wear and tear of the cartilage covering the bone ends in the joint, causing the bones to rub directly against each other. The result is wrist pain and stiffness – the signature symptoms of arthritis in the wrist. When it appears, this type of wrist arthritis tends to occur on one side only (i.e. either the left or right wrist).

The main risk factors that increase the chances of someone suffering from wrist arthritis are:

  •  Increasing age;
  • Hereditary factors (having a family member with the condition);
  • Gender – it tends to affect males more than females.

Rheumatoid Arthritis

This form of wrist arthritis  is a result of the body’s immune system mistaking the synovial lining of a joint as a foreign substance and trying to destroy it. Since the purpose of the joint lining is to lubricate the joint, its destruction tends to cause wrist stiffness and pain when you attempt to move the joint.

This form of arthritis tends to affect females more than males and it also tends to occur simultaneously in both the left and right wrists.

Other Forms Of Wrist Arthritis

Other, less commonly observed forms of the condition are:

  • Gout in the wrist. This is a result of the accumulation of excess uric acid in the body. This acid then crystallizes in the joints (the wrist in this case) causing pain and stiffness in the joint.Gout is an example of crystal-induced arthritis.It most typically occurs in the foot, but can sometimes also appear elsewhere.
  • Post traumatic wrist arthritis. This is caused by a previous wrist injury (a fracture, for example) which directly damages the bone cartilage in the joint. Alternatively, the injury may have changed the proximity of the wrist bones and caused them to rub directly against each other, which in turn damages the cartilage over time.Post traumatic arthritis can sometimes appear several years after suffering the underlying injury.

Symptoms Of Wrist Arthritis

Some people with wrist arthritis experience no symptoms at all. Others who do experience symptoms may experience them with varying severities from person to person. Symptoms may also vary greatly from day to day for the same individual.

However, speaking generally, the symptoms of wrist arthritis, when present, include the following:

  • Wrist pain
  • Wrist stiffness
  • Swelling of the wrist;
  • Redness near the joint;
  • Wrist weakness and difficulty gripping objects with the strength needed;
  • Lost range of motion (most in evidence when performing tasks like combing your hair or brushing your teeth); and
  • Clicking or grinding sounds when you attempt to move your wrist.

If you are experiencing some or all of these symptoms, you should seek medical advice as soon as possible. Treatment of wrist (and other forms of ) arthritis is best started as early as possible to have the most success in managing the condition.

Diagnosis

To diagnose a case of wrist arthritis, your doctor will probably discuss your symptoms with you and review your medical history. You may be asked what activities or times of day make your pain worse. Previous wrist injuries listed in your history will be of particular interest.

The next step will probably be to physically examine your wrist(s) to understand the exact location of the swelling and pain.

The doctor will try to assess your wrist range of motion by asking you to flex and extend your wrists in various directions and report any pain you may experience while doing so. The results of these tests will help in the differentiation between wrist arthritis and other causes of similar wrist pain such as carpal tunnel syndrome.

If your doctor believes that the arthritis may be of an inflammatory nature (e.g. gout) blood tests may be ordered to look  for serum antibodies that this type of arthritis may produce.

Treatment

Most doctors will first try to treat wrist arthritis by using non surgical methods. Only if these are unsuccessful will surgical options be considered.

Non Surgical Treatment Options

These will include some or all of the following:

  • Medications to relieve pain, including non steroidal anti inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen;
  • For inflammatory types of arthritis (like rheumatoid arthritis0, doctors may suggest a special class of drugs known as disease modifying anti rheumatic drugs to reduce pain and inflammation;
  • Oral steroid can also be prescribed to relieve inflammation, although they can have serious side effects that you should discuss with your doctor;
  • Steroid injections into the wrist to reduce inflammation and pain;
  • Physical therapy exercises that improve wrist range of motion and flexibility

Home Remedies

These may include:

Surgery

The three main types of surgery to treat wrist arthritis are:

  • Surgery to remove affected wrist carpal  bones. This is only feasible if the affected bones are in the row closer to the arm;
  • Fusing adjacent wrist bones together to prevent them moving relative to each other. The disadvantage of this option is that it eliminates some types of wrist movement;
  • Replacement of the wrist joint by one made from metal or plastic. This is the most invasive option. Although it is analogous to hip and knee replacement surgery, it is generally less successful. It is normally seriously considered only for older, less active patients who are suffering excruciating pain from their wrist arthritis.

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