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Osteoarthritis of the hand and wrist



Finger and wrist joints can wear out in the same way as hip or a knee joints due to years of use.

Arthritic joints can be very painful and stop you from doing everyday tasks. It is most common in the base of your thumb, the middle joint of the finger, or the top joint of the finger.

Symptoms of osteoarthritis

Depending on the severity of the osteoarthritis in your hands and wrists you may experience:

- Pain
- Difficulty with small tasks such as doing up buttons
- Click and cracking in your joints (crepitus)
- Reduction in the strength of your grip
- Bumps near your finger joints

What causes osteoarthritis?

The main cause is wear and tear over time as the cartilage that cushions the joints thins which causes the bones to rub together and cause inflammation and pain.

Other contributing factors are if you have a past injury to the joint such as broken or dislocated finger or if you are female having gone through the menopause due to the reduction in hormones.

You may also notice your joint pain worsen in cold weather, from repetitve use or if you are stressed.

Diagnosing osteoarthritis

You will have an examination to see how the joints move as well as for any swelling and inflammation. Based on where your pain is, you may have an x-ray and if it isn't clear then you may have an ultrasound or MRI.

Treating osteoarthritis

Arthritis of the fingers, hand and wrist as well as arthritis of any joints tend to get better and get worse depending on factors such as temperature. It can worsen in colder months and better in the summer.

However, if your pain levels are high then we can look at treating with anti-inflammatories, activity moderation to avoid the things that cause strain to the joints, use of splints for support and physiotherapy.

If you feel you need something stronger, more interventional treatment such as steroid injections can help.

Surgery for basal thumb arthritis is called a trapeziectomy. The trapezium is a small bone at the base of the thumb which when removed vastly improves the arthritic pain.

A small gap is left which is filled with a tendon or a spaced. This can weaken the thumb slightly but if the pain from the arthritis was so severe then it may outweigh having a slightly weakened thumb.

It is also possible to have key hole surgery to shave the top surface off the bone, this also leaves a gap which the body fills with a haematoma and eventually scare tissue.
Joint replacement is also an option, and works very well at getting you back to normal function levels prior to having arthritis.




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