Arthritis in the wrist is a common cause of wrist pain as we age. The cartilage in the radiocarpal joint wears away — wrist osteoarthritis — leading to bone rubbing on bone. So what are the symptoms of wrist arthritis, and what should you do about it?
What causes arthritis in the wrist?
Most cases of wrist osteoarthritis occur in older people, as the cartilage gradually wears away. But younger people develop it too — usually after an earlier injury.
A previous wrist fracture is a common cause. A fracture that extends into the joint surface leaves the cartilage uneven, which accelerates wear. Ligament damage matters too: an untreated scapholunate ligament tear changes how the wrist bones move, driving faster cartilage wear and a recognised pattern of arthritis. Untreated Kienbock’s disease can lead to wrist arthritis in the same way.
Besides osteoarthritis, the wrist can be affected by inflammatory arthritis such as rheumatoid disease, and occasionally by gout.
Symptoms of an arthritic wrist
Wrist arthritis typically causes:
- Pain in the wrist, worse with activity and gripping
- Stiffness and reduced movement
- Swelling of the wrist
- Popping or cracking with movement
- Weakness of grip
Other conditions can cause similar wrist pain, so it’s important to confirm the diagnosis and rule out other causes — such as thumb arthritis, STT joint arthritis, a TFCC tear, and carpal tunnel syndrome.
How is wrist arthritis diagnosed?
An X-ray usually confirms wrist arthritis and shows its severity and pattern. Ultrasound assesses soft tissues and guides an injection, while MRI provides detailed imaging when the diagnosis is unclear, or another cause is suspected. Interestingly, the severity on X-ray doesn’t always match the pain — some people with marked changes have little pain, and vice versa.
Treatment of wrist arthritis
Most cases of wrist arthritis are managed with simple, conservative treatment.
- Hand therapy — an experienced hand therapist guides exercises that reduce pain and improve function, and simple daily activities help keep the wrist moving.
- A wrist splint — supports the joint during flare-ups and painful tasks (though avoid over-using a splint, as it can stiffen and weaken the wrist).
- Topical and oral anti-inflammatories — help the pain and swelling.
Where these don’t control the pain, injections help; surgery is a last resort — options include wrist fusion, proximal row carpectomy, and wrist replacement, each with trade-offs, so discuss them with a good hand surgeon.
Injections for wrist arthritis
Injections are a good option where simple treatments have failed, but you’d rather avoid surgery. We perform them under ultrasound guidance because the wrist joints are small and precise placement is critical.
Cortisone injection
Cortisone is a potent anti-inflammatory that reduces the swelling and pain of an arthritic wrist. The relief averages about 2–3 months, though it can last longer. We use cortisone sparingly, because repeated injections into an arthritic joint may accelerate the arthritis.
Hyaluronic acid injection
Hyaluronic acid is a natural joint lubricant. Injected into the wrist, it reduces pain and — unlike cortisone — doesn’t have adverse effects on cartilage. A high-molecular-weight product such as Durolane tends to last longer, and around 65–70% of people respond.
PRP injection
PRP (platelet-rich plasma) is prepared from your own blood and injected into the joint. The evidence is strongest for knee arthritis, where around 65–70% respond; it’s also used in the wrist, though the evidence there is more limited.
How much does a wrist injection cost?
Dr Masci offers a one-stop appointment for an injection into an arthritic wrist— consultation, diagnostic ultrasound, and the injection in a single visit. At the Chelsea clinic (the most cost-effective location), a consultation with an ultrasound-guided cortisone injection is £400; hyaluronic acid is £470–£490 depending on the product, and PRP is priced separately. Other clinic locations cost more. See the full one-stop injection fees here, along with our clinic locations.
Frequently asked questions about arthritis in the wrist
Can you get wrist arthritis at a young age?
Yes. While most wrist arthritis comes with age, younger people develop it after an earlier injury — most often a wrist fracture that involved the joint surface, or an untreated ligament tear such as a scapholunate injury. This is why those injuries shouldn’t be dismissed at the time.
What’s the best treatment for wrist arthritis?
Hand therapy is the foundation, supported by splinting during flares and topical or oral anti-inflammatories. Where these aren’t enough, an ultrasound-guided injection helps, and surgery is reserved for severe cases. There’s no single “best” — the right plan depends on the severity and how it affects you.
Which injection is best for an arthritic wrist?
Cortisone settles an acute, swollen, painful wrist quickly but is used sparingly. For longer-lasting relief without harming the cartilage, a high-molecular-weight hyaluronic acid such as Durolane is often preferred. PRP is an option too. The choice depends on your wrist and what you’ve had before.
Does wrist arthritis always get worse?
Not necessarily, and not quickly. Many people keep good function for years with hand therapy, activity changes, and occasional injections. Interestingly, the appearance on X-ray doesn’t reliably predict the pain — so significant changes don’t automatically mean a poor outcome.
When should I consider surgery?
Only when the pain is severe and hasn’t responded to hand therapy, splinting, and injections, and it’s significantly affecting your life. Wrist fusion, proximal row carpectomy, and wrist replacement each have pros and cons, so a discussion with a hand surgeon is essential before deciding.
Final word from Sport Doctor London about arthritis in the wrist
Wrist arthritis can be a debilitating condition, but most people do well with simple treatment. We start with hand therapy, and in complex cases, we trial a cortisone injection first, then move to a longer-lasting hyaluronic acid injection, such as Durolane, where needed. Surgery is a last resort — worth discussing carefully with a hand surgeon.
If you have persistent wrist pain, Dr Masci can assess you in London, including ultrasound in clinic. Contact the team here or call +44 (0) 203 488 0350.
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