Rheumatoid Arthritis of the Hand and Wrist
Rheumatoid arthritis may affect the joints of the wrist, thumb, and finger knuckles. Common symptoms include pain and swelling in the affected hand and wrist, along with eventual deformity and limited function. Treatment can ease the symptoms of rheumatoid arthritis and help you live a healthy life despite this condition.
Symptoms of rheumatoid arthritis in the hand and wrist may include:
- Joint pain (dull, burning, or sharp) that appears or worsens after increased use of the hand and wrist
- Pain that affects how you use your hand and wrist
- Swelling of the joints in the hand and wrist
- Deformity of the joints of the hand and wrist
- Bony nodules on the finger joints (Bouchard’s nodes or Heberden’s nodes)
- Stiffness in the affected joints
- Signs of inflammation (such as red or tender skin) around the affected joints
- Limited joint extension (for example, fingers cannot fully open or close)
- Weakness in the hand and wrist that limits the ability to accomplish daily tasks
Rheumatoid arthritis cannot be cured, but treatment can ease symptoms and help you manage the condition. Treatments include:
- Splinting/bracing: Splints or braces can immobilize painful joints to ease symptoms as needed.
- Anti-Inflammatory Medications: Non-steroidal anti-inflammatory medications can decrease inflammation and pain due to rheumatoid arthritis.
- Injections: Steroid injections can be administered to reduce inflammation and ease symptoms in painful hand and finger joints affected by rheumatoid arthritis.
- Lifestyle Modifications: Some patients benefit from lifestyle modifications, such as limiting, stopping, or adapting certain activities that cause or aggravate pain due to rheumatoid arthritis. Adopting an anti-inflammatory diet may also help to ease symptoms, as well as various strengthening/stretching exercises and hot or cold packs to reduce pain, swelling, and stiffness.
- Surgery: In some cases, surgery may be necessary to treat rheumatoid arthritis in the hand and wrist. Surgery options may include joint fusion, joint replacement, or tendon transfer. In most cases, more conservative treatments are attempted before surgery is considered.
Frequently Asked Questions
The precise cause of rheumatoid arthritis is not known, but it is likely to have a genetic factor. This condition is more likely to appear in individuals who are older than 35, female, white, overweight, genetically predisposed, who smoke, and who have had previous hand or wrist injuries.
A diagnosis can be made by specialist evaluation with physical examination and diagnostic testing, including X-rays (which will show loss of bone cartilage and bone spurs), a blood test for rheumatoid factor and other markers, and sometimes also exclusionary tests (such as EMG) to rule out nerve-based or other potential underlying conditions.
There is no cure for arthritis, but treatment can help lessen your symptoms.
Unfortunately, once arthritic deterioration of the hand and wrist joints begins, it will almost always progress or worsen. However, effective treatment can slow arthritis down considerably and help you live a full, enjoyable life.
The best treatment will depend on your individual situation. Usually, some combination of medications, injections, and lifestyle modifications will be recommended. Surgery will usually not be considered unless symptoms indicate and more conservative treatments have failed.
If you are experiencing severe pain or mobility limitations due to arthritis of the hand and wrist, you should consult an orthopedic surgeon and/or rheumatologist. He or she will be able to evaluate your symptoms and recommend whether surgery may be appropriate for you.