Arthritis is an inflammation of one or more joints, which causes swelling, pain and stiffness in the joint.
Arthritis of the wrist and hand strikes a significant number of people, so that it becomes difficult for a person to carry out their daily activities.
The most common pain in the wrist caused by only two types: osteoarthritis and rheumatoid arthritis.
Osteoarthritis (OA) is a progressive condition that destroys the smooth articular cartilage covering the bone edges. Healthy joints move easily under the articular cartilage. Osteoarthritis leads to a blurring of the cartilage. When the bones rub against each other, this leads to pain, stiffness and weakness.
Rheumatoid arthritis (RA) is a chronic disease that affects multiple joints throughout the body. Rheumatoid arthritis often begins in the small joints, as well as those in the wrist and hand. This disease is symmetric, that is, usually affects the same joint on both sides of the body.
Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues.
RA often affects the connection between the two bones of the forearm, the radius and ulna. It can soften and weaken the ulna that can rupture tendons involved in straightening the finger. This may lead to deformation of the joints such as wrists and knotted bent fingers.
One of the best Israeli experts on the treatment of arm and hand (wrist) in Israel:
Dr. Igo Goldberg – Senior surgeon surgery department of the arm and hand, Rehabilitation Center for hands treatment of, Israel.
Dr. Yishai Rosenblatt – Senior physician, Department of Orthopaedic Surgery of the Hand, Medical Center, Tel – Aviv (Ichilov), Head of Department of the Hand and elbow Surgery , Assuta Hospital.
Osteoarthritis may develop due to normal “wear and tear” in the wrist, especially in people with a family history of arthritis. It can also occur as a result of a traumatic injury such as a fracture or sprain of the wrist.
Osteoarthritis of the wrist may also develop due to illness kienbock at which interrupts blood flow to one of the small bones of the hand near the wrist (lunate bone). If the blood supply to the bone stops, the bone may die out. Over time, this can lead to osteoarthritis.
The exact cause of RA is unknown. The cause may be genetic – some people may be more likely to develop the disease due to family heredity. However, doctors suspect that the “trigger” to activate the genetic disease is the chemical origin or arises from the environment.
The symptoms of OA of the wrist is swelling, pain, limited movement and weakness. These symptoms are usually limited by the wrist joint.
RA wrist joint and causes swelling, pain, limited movement and weakness. However, unlike the wrist OA, rheumatoid arthritis symptoms, usually accompanied by pain, swelling and stiffness in the joints of the hinge.
The doctor conducts a physical examination, taking into account the patient’s medical history, and assigns blood tests for diagnosis of wrist arthritis.
X-rays may be designated as a diagnostic imaging, which creates detailed pictures of dense bone structures. Pictures can help to distinguish different forms of arthritis.
Blood tests sometimes help diagnose rheumatoid arthritis. Osteoarthritis is never associated with abnormalities in the blood.
Nonsurgical treatment is intended to help relieve pain and swelling.
♦ Changing activity. Restriction or termination of activities that exacerbate the pain is the first step in alleviating the symptoms.
♦ Immobilization. Fixing the wrist may help alleviate the symptoms.
♦ Medication. Nonsteroidal anti-inflammatory drugs can reduce pain and swelling.
♦ Exercise. Specific exercises can improve range of motion in the wrist.
♦ Steroid injections. Cortisone is a potent anti-inflammatory drug which can be administered in the wrist joint.
If symptoms of rheumatoid arthritis are not adequately controlled by the above methods of treatment, the doctor may prescribe additional medication. This specific medications called disease-modifying antirheumatic drugs, the purpose of which is to stop the immune system from destroying the joints.
When nonsurgical treatments are no more effective, which leads to progressive loss of function of the wrist and hand, surgery may be an option. The goal of surgery is to reduce pain and maintain or improve hand function.
Surgical options include:
♦ Removal of arthritic bones. During this procedure, the procedure of the three carpal bones removed. This procedure, called proximal row carpectomy, helps to ease the pain while maintaining partial mobility of the wrist.
♦ Fusion. When the movement is a source of pain, doctor may perform a procedure to carry out fusion of the bones of the wrist to create one solid bone. The merger may be partial, in which only some of the carpal bones fused together. This will eliminate the pain and keep the partial mobility of the wrist. When arthritis is extensive, you may need a full fusion (complete fusion). During this procedure, all of the carpal bones are connected with each other. This completely eliminates the mobility of the wrist, but does not affect the rotation of the forearm.
♦ Endoprosthesis. During this operation, the damaged joint is removed and replaced with an artificial device (prosthesis). This surgery can help to preserve or restore the mobility of the wrist.
Doctor and patient will discuss surgical options together and choose the one that best suits the patient.