Arthritis in wrist is a common cause of wrist pain as we age. This is because the cartilage in the radiocarpal joint wears away in wrist osteoarthritis, leading to bone-on-bone exposure. So, what are the symptoms of wrist arthritis, and what should you do?
Causes of Arthritis in Wrist
Generally, most cases of wrist osteoarthritis occur in the elderly. However, some young people can develop arthritis, too. Common causes of wrist arthritis in young people include a history of fracture or ligament damage. Sometimes, a fracture can extend into the joint surface, making the cartilage uneven and accelerating cartilage wear. Moreover, trauma to the wrist’s ligaments affects the wrist bones’ movement, leading to more significant cartilage wear. For example, a scapholunate ligament tear or Keinbock’s disease can lead to early wrist arthritis.
Symptoms of wrist arthritis
Common symptoms of arthritis in the wrist include pain at the wrist joint (also known as the radiocarpal joint), focal swelling, and difficulty picking up objects. Sometimes, bony spurs can pressure the nerve within the carpal tunnel, causing pain, pins and needles, and numb fingers.
Generally, we make a diagnosis with a plain X-ray of the wrist. However, an MRI scan is sometimes needed to show early cartilage wear or ligament damage. Also, blood tests may be necessary if we think you have inflammatory arthritis, such as rheumatoid arthritis.
Arthritis in Wrist Treatment
Usually, we try simple treatments for an arthritic wrist first. Examples of simple measures include:
- Activity modification: Most people with wrist arthritis find that simply changing how they lift helps their symptoms.
- Medications: Applying a topical cream such as ibuprofen can be helpful
- Wrist splints: Wearing a splint on your wrist can help you perform activities with less pain.
- Exercise therapy: Performing simple daily activities reduces pain and improves function. We suggest seeing an experienced hand therapist.
In complex cases, injections can help reduce pain and improve function.
Finally, surgery should only be considered as a last resort. Surgical procedures include wrist fusion, proximal row carpectomy, and wrist replacement. They all have positives and negatives, so you should speak to a good hand surgeon if you’re considering surgery.
More on Injections for Arthritis in Wrist
Generally, injections are a good option if simple treatments fail, but you don’t want to consider surgery. Injection options include cortisone, hyaluronic acid, and platelet-rich plasma.
Firstly, cortisone is a potent anti-inflammatory and reduces swelling and pain in an arthritic wrist. Current evidence suggests that pain relief averages 2-3 months, although it can be longer in some people. Repeated cortisone injections for wrist arthritis are concerning due to the risk of arthritis progression.
Secondly, hyaluronic acid is a natural substance found in joints, tendons, and bones. Injecting hyaluronic acid into joints changes the joint fluid and reduces inflammation and pain. Hyaluronic acid injections are a good option for pain relief, especially if you’ve already tried cortisone.
Finally, platelet-rich plasma, or PRP, uses the person’s blood. We spin the blood in a centrifuge, separating the plasma from the cells. Then, the plasma is injected into the joint, leading to reduced inflammation. Although there is good evidence for PRP in knee arthritis, we need more studies in wrist arthritis before we can recommend it.
You should speak to your doctor about which injection is suitable for you. Importantly, you should have an injection with ultrasound to help guide the injection into the right spot. You should always do your homework before having an injection. For example, some practitioners who perform injections are not doctors experienced in ultrasound-guided injections.
Final word from Sportdoctorlondon on Arthritis in Wrist
Overall, wrist arthritis can be a debilitating condition. Usually, we suggest simple treatments first, including hand therapy. In complex cases, we trial a cortisone injection first. Finally, we use hyaluronic acid or PRP, depending on the person’s preference.
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