Arthritis in Wrist

What is arthritis in your wrist?

Arthritis of the wrist is one of the main causes of chronic wrist pain. It can also cause swelling and stiffness in your wrist. Your wrist is the joint that allows you to bend, straighten and rotate your hand. You use it to accomplish countless tasks throughout the day.

Arthritis is a chronic and progressive (ongoing and worsening) disease that wears away the cartilage in your joints. It especially affects joints that take a lot of stress from weight and/or frequent use. Your wrist doesn’t bear much weight, but you do use it a lot.

What are the different types of wrist arthritis?

Arthritis in your wrist may occur in different places where different bones connect. Your wrist is the most complex joint in your body, with more bones and connection points than any other joint.

Types of wrist arthritis by location include:

• Distal radioulnar joint arthritis. This is arthritis at the base of your wrist, where your two forearm bones, your radius and your ulna, meet. This joint allows you to turn your palm up.
• Midcarpal joint arthritis. This is arthritis between the eight small carpal bones that connect your hand to your arm bones. These bones move together with your finger bones when they move.
• Radiocarpal joint arthritis. This is arthritis at the point where your two forearm bones and your carpal bones meet. This joint allows you to rotate your wrist and flex and extend your hand.

In addition, different types of arthritis can affect your wrist. The most common type is osteoarthritis, which is from simple wear and tear. Inflammatory types of arthritis come from inflammatory diseases.

Noninflammatory types of arthritis in your wrist may include:

• Osteoarthritis. Osteoarthritis is when the cartilage in your joint gradually wears away from everyday use. It’s common with advancing age and with occupations that use your wrist more.
• Post-traumatic arthritis. Post-traumatic arthritis follows an injury that damages the cartilage in your joint. It’s often temporary, but sometimes it contributes to the onset of osteoarthritis.

Types of inflammatory arthritis in your wrist might include:

• Rheumatoid arthritis. RA is the most common type of inflammatory arthritis. It causes your immune system to attack your cartilage with inflammation. It can affect any joint in your body.
• Psoriatic arthritis. Psoriatic arthritis affects some people with psoriasis, an inflammatory disease of the skin. It can cause inflammation and swelling in the small joints of your hands and feet.
• Septic arthritis. You may get septic arthritis if you have a systemic infection — a whole-body bacterial or viral infection. Your immune system sends inflammation to fight the infection.
• Gout. Gout occurs when your body has too much uric acid. The excess acid causes tiny, painful crystals to form in your joints. It often affects your feet first, but it can also affect your hands.

What are the symptoms of wrist arthritis?

Different types can cause different symptoms, but the most common symptom is all-over wrist pain. Osteoarthritis may feel like a dull, constant ache. Inflammatory arthritis might feel intense and burning.

You might feel it more when you use your wrist to:

• Open jars
• Turn doorknobs
• Type

You may also experience:

• Discolored, warm or swollen joints
• Reduced range of motion
• Stiffness that’s worse in the morning and improves throughout the day
• Wrist and hand weakness
• Clicking or crackling sounds when your wrist moves
• Numbness or tingling in your wrist (carpal tunnel syndrome)

Osteoarthritis or post-traumatic arthritis may only affect one wrist. Inflammatory types (like rheumatoid arthritis) often affect both wrists and may also affect other joints. With inflammatory types, you may also have:

• Fever
• Fatigue
• Rash
• Nail discoloration and pitting (nail psoriasis)

With all types, severe swelling in your joints can force bones out of their normal positions, causing disfigurement.

What causes arthritis in your wrist?

Arthritis is gradual, ongoing damage to the cartilage in your joints. That’s the padding between the bones that helps them move smoothly against each other. Inflammatory diseases or common wear and tear can erode this padding, leaving bones to rub against bones. This causes pain, swelling and stiffness. Inflammation itself can also cause these symptoms, even before it starts to wear down the cartilage.

How is wrist arthritis diagnosed?

Your healthcare provider will perform a physical exam to assess your range of motion and check for signs of inflammation or disfigurement. Tests to diagnose the type of arthritis in your wrist include:

• X-rays to look for damage to your cartilage
• Blood tests to check for inflammation or other indicators

How do they fix arthritis of the wrist?

Treatment for wrist arthritis focuses on relieving your symptoms and slowing or stopping the damage, if possible. Healthcare providers usually start by recommending conservative treatments to relieve pain and reduce stress on your wrist. Depending on your need, they might prescribe medications for pain relief or to reduce inflammation. If these don’t do enough to help, they might recommend surgery.

Conservative recommendations include:

• Hot/cold therapy. Both heat and cold can reduce arthritis pain in different ways. Ice packs or gel packs are helpful for reducing inflammation. Heat pads or baths can help relax a stiff joint.
• Over-the-counter pain relievers, especially NSAIDs (nonsteroidal anti-inflammatory drugs), which reduce both inflammation and pain. Topical pain relief products can also be helpful.
• Physical therapy. A physical therapist can recommend specific hand and wrist exercises to practice. Regular, gentle exercise helps nourish your tissues and prevent them from stiffening.
• Activity modifications. While some exercise is helpful, too much repetitive stress on your joint worsens arthritis. An occupational therapist can recommend new ways to accomplish tasks.

Prescription treatments may include:

• Cortisone shots. Steroid injections provide powerful, temporary pain relief and inflammation control directly to your wrist. They’re a standard treatment for all types of arthritis.
• Platelet-rich plasma injections. PRP is an alternative pain relief option and a standard treatment for osteoarthritis. Studies suggest it may help stimulate your cartilage to repair itself.
• Oral corticosteroids. Steroids are anti-inflammatory drugs that work by suppressing your immune system. They’re a standard treatment for inflammatory types of arthritis.
• DMARDS. Disease-modifying antirheumatic drugs are another group of medications that treat auto-inflammatory arthritis. They reduce inflammation and symptoms throughout your body.

Surgical treatments for wrist arthritis include:

• Proximal row carpectomy. This procedure removes a few of the carpal bones in your wrist to make more room for the others. This frees up the other bones to move again without friction.
• Joint fusion surgery. This procedure uses pins and screws to fuse together the bones that cause pain when they move. When they heal, they won’t move anymore, so they won’t cause pain.
• Joint replacement surgery (wrist arthroplasty). This procedure replaces damaged parts of your wrist with artificial parts. It relieves arthritis symptoms and preserves movement in the joint.

What is the outlook with wrist arthritis?

Most people with wrist arthritis can manage their pain with conservative treatments. Steroid injections can also help, if needed. If your arthritis is very advanced and you’ve lost a lot of cartilage, it might be harder to manage conservatively. When wrist arthritis begins to seriously affect your life, talk to your healthcare provider. They’ll discuss your surgery options and recommend the best procedure for you.