A Doctors answer to
Common Orthopedic Questions
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OUR BOARD CERTIFIED ORTHOPEDIC doctors.
How is arthritis in the hand treated?
Treatment options vary based on the type of arthritis, stage of arthritis, how many joints are affected, your age, activity level, the hand affected (if it’s your dominant hand), and other existing medical conditions.
Relief is usually found by splinting/bracing, medications, injections, non-drug approaches, and as a last case scenario, surgical procedures.
Braces & Splints
In general, braces and splints protect and help support the affected joint, reduce deformity, provide joint stability, lessen strain, and promote proper joint alignment. Keep in mind, that wearing splints or braces too long can cause your muscles to weaken.
Medication (Orally, Injections & IV)
Medications may be advised to reduce joint pain and swelling and, in the case of rheumatoid or psoriatic arthritis, to prevent joint damage.
Medications change depending on the severity and type of your arthritis.
*There are currently no medications approved that help slows the progression of osteoarthritis.
It is important to see an Orthopedic Specialist before taking over-the-counter medication for a period of time, as there are risks and reasons for not using these medications (depending on your other health conditions and/or medications).
The following drugs are commonly used to treat rheumatoid and psoriatic arthritis.
- Steroid injections. Steroids reduce inflammation and relieve pain. Steroids are usually used if medications don’t control inflammation or if the inflammation is limited to a few joints. Injections are administered directly into the affected joint. Because steroids can weaken tendons and ligaments, injections are repeated only a few times.
- Corticosteroids. These medications can be taken by mouth, injected into your muscle or given by IV, these medications reduce inflammation and other symptoms of rheumatoid arthritis.
- Disease-modifying antirheumatic drugs. These slow the progression of rheumatoid arthritis and relieve symptoms.
- Immunosuppressive drugs. Used to slow the progression of rheumatoid arthritis and reduce damage to bone surrounding joints.
- Biologic agents. These can slow joint damage in rheumatoid arthritis.
- Acetaminophen. This drug may help temporarily relieve pain.
- Nonsteroidal anti-inflammatory drugs. These drugs reduce pain and swelling in affected joints. Topical NSAIDs are the first topical treatment of choice for osteoarthritis. Acetaminophen. This drug may help temporarily relieve pain.
- Nonsteroidal anti-inflammatory drugs. These drugs reduce pain and swelling in affected joints. Topical NSAIDs are the first topical treatment of choice for osteoarthritis.
Other Management Strategies
A complete treatment plan for arthritis of the hand includes these additional approaches:
- Exercises — strengthening and stretching — to reduce symptoms and improve function. A hand therapist will work with you to prescribe the exercises best suited for your hand arthritis.
- Hot and cold packs. Cold can help reduce pain and swelling. Heat can help reduce stiffness. Apply for no longer than 20 minutes at a time.
- Rest. Regular rest periods can help relieve pain and inflammation in your joints.
- Healthy eating and managing diabetes and cholesterol.
- Weight loss if you’re overweight.
- Smoking cessation. Smoking increases your risk of developing arthritis.
- Occupational therapy to learn how to use self-help devices including those used to assist with dressing or preparing food in the kitchen.
If nonsurgical treatments no longer provide relief and the cartilage at the ends of your bones has worn away, surgery may be an option. There are several approaches:
- Joint fusion (arthrodesis): This surgery uses a plate and screws to keep the bones of your joint together. You’ll have a more stable, pain-free joint, but will have limited flexibility and movement.
- Joint replacement (arthroplasty): Similar to other joint replacements, surgeons use an artificial implant made of plastic, ceramics, silicone or metals to replace your damaged joint. Keep in mind that hinged finger implants don’t mimic normal finger movement.
- Tendon transfer: Tendons connect muscles to bones. The tendons that control your fingers attach to muscles in your palm and forearm. Ongoing inflammation from arthritis can cause tendons to rupture. If this happens, a portion of a healthy tendon can be used to restore your hand function.
What type of hand surgery is most commonly performed on the specific joints affected by arthritis?
- Base of the thumb: Where your thumb and wrist joint. Common surgical options include removing part or all of one of the trapezium bone (the wrist bone immediately below your thumb joint), tendon transfer, or joint fusion.
- Knuckles (metacarpophalangeal joints): Joint replacement is almost always considered for this repair. Rheumatoid arthritis can cause serious damage and disability to your knuckles.
- Second joint of your finger (proximal interphalangeal joints): Osteoarthritis commonly causes stiffness and loss of motion. Joint replacement or fusion is considered for these joints. Because you use these joints frequently, there is a chance your implant could wear out. In this case, your provider may recommend further surgery.
- Top of finger joint (distal interphalangeal joints): Joint fusion is commonly used to treat arthritis in this joint.
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