The fingers, hand and wrist are made of 29 bones in multiple small joints that take a lot of stress and strain every day performing all sorts of normal daily activities from threading a needle, to opening a jar, turning a key to start your car and brushing your hair. The ends of the bones are covered with articular cartilage for smooth movements. The joints are lubricated with synovial fluid made in the joint lining called the synovium. Healthy joints move easily.
There are many types of arthritis that can affect the fingers, hands and wrists, degrading the articular cartilage and deforming the joint. Deterioration of the cartilage leads to painful bone on bone movements, causes stiffness, and limits dexterity and range of motion. The result is a declining quality of life. Daily activities become challenging and lead to a loss of independence.
What is arthritis?
Arthritis is inflammation of the joints that causes the smooth cartilage at the ends of the bones to break down and wear away. It also causes bone spurs in and around the affected joints increasing pain and stiffness. Arthritis is a leading cause of disability among adults.
Osteoarthritis and rheumatoid arthritis are the most common types. The most common site for OA is the base of the thumb, the end joints near the fingertips, and the middle joint of the fingers. Post-traumatic arthritis frequently develops after a joint injury, especially fractures, even when the injury is correctly treated. As cartilage is damaged, symptoms gradually appear.
What are the symptoms?
- Pain with activity
- Pain and stiffness hours after use
- Morning pain and stiffness
- As the condition worsens, pain may interfere with sleep
- Joint pain that worsens with rainy weather
- The loss of mobility can affect nearby joints
- Hand weakness makes activity even more difficult
- Warmth of the joint caused by inflammation
- Crepitation – the sensation of grating or grinding in the joint
- If the ligaments are damaged by arthritis, they may loosen and cause the joint to become unstable
- In the worst cases, the joint enlarges and deforms due to the combination of bone changes, lost cartilage and swelling
- If arthritis affects the end joints of the fingers, small cysts can develop
- Bony lumps called nodules can affect the finger joints
Your OANC orthopedic surgeon will review your medical history and conduct a physical examination looking for tenderness and reduced range of motion. X-rays will confirm a clinical diagnosis. Blood tests may be ordered. A strong family history of arthritis can increase the risk of developing arthritis. Arthritis is also more common in people who have heart disease, diabetes and obesity. Early diagnosis and aggressive treatment can slow the progression of this disease and relieve pain and inflammation.
Nonsurgical treatments are designed to manage symptoms and reduce the risk of disability. Simple changes like carrying bags with the forearm and not the fingers, activity modifications that reduce strain, splinting, icing and heating can help. Anti-inflammatory medications relieve pain and swelling. Topical analgesics may help. Corticosteroid injections can provide relief for short periods but are limited due to the negative effects including tendon damage.
Surgical options include involve removal of arthritic bone, joint fusion and joint replacement. The choice of surgery depends on the type of arthritis, the stage of the disease and the severity of symptoms. The goal is to treat pain and improve function. When surgery is required it can usually be accomplished with minimally invasive arthroscopic surgery.
Losing hand function is a serious problem. Count on OANC board-certified orthopedic surgeons to provide the treatments that can help restore function and provide long-term pain relief. Our offices are in Chico, California. Call to schedule a consultation now.