Arthritis is a potentially painful and debilitating condition that affects 3.85 million Australians according to the Australian Institute of Health and Welfare.  When arthritis affects the joints of the hands and wrists, the condition can make it difficult, and for some people nearly impossible, to perform even the most rudimentary of daily tasks.  Thankfully, advances in modern medicine has provided arthritis sufferers with a greater number of effective treatments, both surgical and non-surgical, than ever before.  At Southern Hand & Wrist, we offer a comprehensive range of these treatments for arthritis of the hand and wrist to patients of our Sutherland Shire clinic, convenient to South-Eastern Sydney and other parts of New South Wales.

If you are suffering from arthritis of the hand and wrist, Dr. Jai Sungaran can help you find relief from your symptoms and improve your overall quality of life.  Please contact Southern Hand & Wrist to schedule your initial consultation today.

What are the different types of arthritis of the hand and wrist?

Arthritis is an umbrella term that covers any sort of inflammation of the joints.  There are literally hundreds of types of arthritis.  However, the most common types of arthritis to affect the hand and wrist are:

• Osteoarthritis: Osteoarthritis is a degenerative condition in which the cartilage that provides cushioning between joints becomes progressively worn. Eventually, the cartilage will wear away altogether, leaving bare bone to rub against bare bone.  This can result in pain, stiffness, weakness, and the development of bone spurs on the joints.  Adjacent soft tissues can also become worn due to the missing cartilage.
• Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune disease, meaning that the immune system attacks the tissues that it would normally defend. In the case of rheumatoid arthritis of the hand and wrist, it often begins in the smaller joints and then spreads to the radius and ulna, the two long arms of the forearm.  As the immune system erodes the ulna, the flexor tendons responsible for bending the fingers can become damaged, resulting in wrist and finger deformities.  Typically, rheumatoid arthritis affects both hands in more or less equal measure.

What causes arthritis of the hand and wrist?

The most common cause of osteoarthritis is wear and tear over the years.  People with a family history of osteoarthritis of the hand and wrist are more likely to experience the condition as a result of wear and tear than those without such a history.  A serious injury to the hand or wrist could also put a person at higher risk of developing osteoarthritis.  When osteoarthritis develops as a result of injury, it is also known as post-traumatic arthritis.

The cause of rheumatoid arthritis is unknown, though there does appear to be at least some genetic link.

What are the symptoms of arthritis of the hand and wrist?

Certain symptoms are common to all forms of arthritis, including:

• Reduced range of motion in the affected joints
• Dull or burning pain in the affected joints
• Swelling of the affected joints
• Joint stiffness
• Joints that feel warm to the touch due to inflammation
• Weakness of the fingers and wrist

Symptoms unique to osteoarthritis of the hand and wrist include:

• The formation of mucous cysts (also known as ganglion cysts) toward the end of the fingers
• The feeling of grinding in the affected joints due to the lack of cartilage, a sensation called crepitation

Symptoms unique to rheumatoid arthritis of the hand and wrist include:

• The loss of ability to bend or straighten a finger completely
• Boutonniere deformity, or bent middle joint of a finger
• Swan deformity, or bent final joint and overextended middle joint of a finger
• Protruding bones in the wrist
• Firm lumps along the fingers
• Carpal tunnel syndrome

How is arthritis of the hand and wrist diagnosed?

Dr. Sungaran will first perform a physical exam and take a thorough medical history.  He will ask about your symptoms and how they have affected your life, as well as about any family history of arthritis.  Your physical exam will probably evidence symptoms of either osteoarthritis or rheumatoid arthritis; however, depending on this initial evaluation, Dr. Sungaran will order one or more of the following tests to confirm his diagnosis:

• X-ray: X-rays may reveal abnormalities in the structure of your bones and the possible development of bone spurs.
• Bone scan: A bone scan is a radiology procedure that identifies conditions of the bone that conventional x-rays can miss.
• Blood tests: Blood tests may be ordered if rheumatoid arthritis is suspected, as they can be useful in confirming the diagnosis. They are unnecessary in the diagnosis of osteoarthritis.
• MRI (magnetic resonance imaging): Very rarely, Dr. Sungaran may order an MRI if he suspects that arthritis of the hand and wrist may be connected to another condition. For example, some cases of arthritis are caused by Keinbock’s disease, a condition in which the lunate bone of the wrist loses its blood supply, resulting in arthritis and, eventually, the death of the bone.

How is arthritis of the hand and wrist treated non-surgically?

In its earliest stages, arthritis can generally be managed quite effectively using a combination of non-surgical methods.  These methods include:

• Hand therapy: Sungaran has several hand therapists whom he trusts and with whom he works exclusively. These therapists instruct arthritic patients on how to use their hands to perform daily tasks in such ways that they can minimise their pain and ease the pressure they put on their joints.  During hand therapy sessions, patients also learn exercises to help strengthen the hands and promote flexibility.
• Strategic rest and splint therapy: While underuse of the hands can lead to atrophy of the muscles which should be avoided at all costs strategic periods of rest and occasional use of a splint during certain activities can help to relieve pain and stress on joints.
• Corticosteroid injections: Corticosteroid injections directly into the affected joints can help to reduce inflammation and relieve pain. These injections are often combined with an anaesthetic to provide long-term pain relief.
• Medications: Anti-inflammatory medications such as aspirin and ibuprofen can help to reduce pain and swelling.

How is arthritis of the hand and wrist treated surgically?

Dr. Sungaran generally urges patients to consider non-surgical treatment before electing to undergo surgery.  However, in advanced cases of arthritis, or in cases in which patients with moderate arthritis wish to take preventive measures against their progressive conditions, surgery may be recommended as a primary course of treatment.  Certainly, surgery may be recommended if non-surgical methods fail to prove effective.

The primary goal of surgery for arthritis of the hand and wrist is to restore function and relieve pain to the fullest extent possible.  Surgical treatments include:

• Preventive surgery: Preventive arthritis surgery may include the removal of inflamed tissues, lumps, or bone spurs while leaving the joints themselves intact.
• Joint reconstruction: When viable, this is the preferable option, as it allows for optimal restoration of function while still relieving pain. If the joint is in adequate condition to be preserved, it may be possible to reconstruct it using the patient’s own natural tissues, such as a tendon graft, or an artificial substance.
• Joint fusion: This procedure involves removing the ends of the two bones that are rubbing together and then fusing the bones into one. While the fused joint will no longer be able to move, it will also no longer be the source of any pain.
• Joint replacement: Virtually all of the major joints of the hand and wrist can be replaced with prosthetic counterparts. A joint prosthesis may restore at least some function to the affected area while resolving pain through the removal of the damaged joint.

Learn More about the Diagnosis and Treatment of Arthritis of the Hand and Wrist

If you would like to learn more about how Dr. Sungaran can help you find relief from pain due to arthritis of the hand and wrist, please contact our Sutherland Shire practice, with Caringbah and Sydney Olympic Park office locations, today.