Treatment for Hand & Wrist Arthritis

Nonsurgical treatment methods for relieving pain in an arthritic joint include activity modification, pain medications, and use of splints, and steroid injections. Surgery is usually considered if nonsurgical treatment fails to give relief. 

There are different surgical procedures that can be used and may include:

Synovectomy: 

This surgery is usually indicated for early cases of inflammatory arthritis where there is significant swelling (synovitis) that is causing pain or is limiting the range of motion of digits and thumb. Synovectomy is the surgical removal of the inflamed synovium (tissue lining the joint). The procedure may be performed using arthroscopy.

Arthroplasty: 

In this procedure, your surgeon removes the affected joint and replaces it with an artificial implant. In patients with post-traumatic arthritis and osteoarthritis where the bone is hard and demand on the hand is moderate, new ceramic implants are used. These are not desirable to use for the severely damaged or unstable joint. In patients with inflammatory arthritis where the bone is not strong enough and the demand on the hand is low, older silicone rubber joints are generally used. These can be used for more severe joint damage and unstable joint.

Arthrodesis: 

A fusion also called arthrodesis involves removal of the joints and fusing the bones of the joint together using metal wires or screws. Even though this surgery eliminates all motion at the base of the thumb, the resulting fusion is very hard.

This surgery is usually indicated when the joints are severely damaged, when there is limited mobility, damage to the surrounding ligaments and tendons, failed previous arthroplasty, and when heavy manual use is expected.

Your surgeon will discuss the options and help you decide which type of surgery is the most appropriate for you.

Rehabilitation

Following surgery, a rehabilitation program, often involving a physical therapist may help to regain hand strength and movement. You may need to use a post-operative splint for a while after surgery that helps to protect the hand while it heals. You may need to restrict activities for a minimum of 12 weeks to let the joint reconstruction heal properly. Although recovery is slow, you should be able to resume your normal activities within few months of surgery.