Arthritis Relief for Hands and Wrists

Hand or wrist arthritis is a common condition that affects many people as they age, or it can result from an injury. The most common type of arthritis is osteoarthritis (OA), also known as “wear and tear” or degenerative arthritis.

“OA occurs when the protective cartilage that cushions the ends of the bones wears down and over time disappears, causing bone-on-bone arthritis,” said orthopedic surgeon Dominik Rog, MD, of Boulder Medical Center during a recent online BCH health lecture. Dr. Rog specializes in treating conditions of the hands, wrists and upper extremities.

He described the latest non-surgical and surgical treatment options for hand and wrist OA sufferers. His co-presenter, occupational therapist Ann Brexa, OTR/L, with BCH’s outpatient rehabilitation, demonstrated exercises for hand and wrist arthritis.

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Watch: “Relief for Hand or Wrist Arthritis"

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Symptoms of hand OA

OA in the hands affects the joint at the base of your thumb and the middle and top joints of your fingers, Dr. Rog explained. It typically presents with symptoms such as:

• Pain, especially during movement or after periods of rest
• Loss of range of motion (stiffness)
• Joint swelling, visible around the joints
• Deformity in some joints, change in shape, and/or bumps (osteophytes) become apparent
• Loss of grip strength

Symptoms of wrist OA

Most common forms of wrist OA are from post-traumatic injury or an autoimmune/inflammatory arthritis condition. Wrist OA symptoms include:

• Loss of wrist motion
• Pain with activity
• Swelling of top and thumb side of wrist

It is the rubbing of “bone-on-bone” that causes these symptoms.

Non-surgical treatments

“Most OA symptoms can be managed effectively without surgery,” said Dr. Rog. “However,” he added, “non-surgical treatment options can’t cure OA of the hand or wrist and can’t halt its progression.”

Non-surgical treatment options for OA of the hand and wrist, include:

• Topical and oral medications to help manage pain and inflammation in affected joints. These include topical nonsteroidal autoinflammatory drugs (NSAIDs), such as Voltaren, and oral NSAIDs (ibuprofen, naproxen and celecoxib). Tylenol (acetaminophen) can also offer pain relief.

• Supplements, there are many, but the better known are glucosamine with chondroitin and turmeric (curcumin is the active ingredient). Dr. Rog noted that there are many supplements available but not a lot of evidence to support their effectiveness.
• Corticosteroid injections, which are injected synthetic derivatives of naturally occurring cortisone.
• Biologic injections such as platelet rich plasma (PRP) and stem cells. PRP is a treatment that uses a patient's own blood cells to accelerate healing in a specific area. Dr. Rog said, "Although PRP can be effective for larger joints, some studies on PRP specifically in hands show the treatment isn’t much more effective than a placebo." He added, "Stem cell technology is still in its infancy, with not much long-term clinical research available yet.”

• Braces or splints to support and protect the affected joint, provide joint stability, lessen strain and promote proper joint alignment.
• Hand/occupational therapy is a useful adjunct for managing OA symptoms, according to Dr. Rog.

Ann Brexa, OTR/L, emphasized the importance of exercises and joint protection principles in managing arthritis symptoms. Therapists provide personalized evaluations, recommend splints, and teach adaptive techniques to ease daily activities and prevent further joint damage. Ann explained, “These exercises might be introduced early on to achieve prevention even before arthritis develops.”
View/download Ann’s hand and wrist exercise flyer.

Surgical treatment options

When conservative measures are insufficient, surgical interventions may be necessary and include:

• Joint fusion to stabilize severely damaged joints, sacrificing flexibility for pain relief.
• Joint replacement to replace damaged joint surfaces with artificial components such as those in finger and hand joints.
• Specific joint reconstruction procedures tailored for bone spur removal or thumb arthritis may be recommended.

Schedule an appointment

If you have any questions or would like to schedule an appointment with: Dominik Rog, MD, at Boulder Medical Center call (303) 440-3036 and/or occupational therapist Ann Brexa, OTR at Boulder Community Health Outpatient Rehabilitation call 303-415-4400

Click here to view/download a PDF of slides shown during the lecture.

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