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Hand and Wrist
Arthritis

DISEASE AWARENESS PAGE FOR R3 STEM CELL – HAND AND WRIST ARTHRITIS

What is It?

Hand and wrist arthritis is a condition characterized by degeneration of the joint capsule and ligaments in the hand and wrist. Hand and wrist arthritis is usually caused by a type of arthritis, and that determines the severity and kind of pain experienced. Hand and wrist arthritis can be particularly debilitating for the individual because of the crucial role the hands play in the activities of daily living.

 

In some cases, the arthritis is present in both wrists, as well as other joints in the body. However, If the pain is localized to the wrist alone, it can be confused with other conditions like carpal tunnel syndrome. X-rays are useful in situations like these. 

THE TYPES OF ARTHRITIS THAT AFFECT THE HAND AND WRIST 

There are several types of arthritis, and they all have the potential to affect the wrist and hand. The common factor among all these types of arthritis is pain. But regardless of the type, arthritis comes with joint capsule inflammation and cartilage erosion. This, in turn, causes pain in individuals. The kind of pain felt differs from person to person and from condition to condition.

 

In conditions like rheumatoid arthritis, the pain is often felt on the same joint in both hands and wrists and is worse in the mornings or after periods of rest. Osteoarthritis, on the other hand, does not affect the same joint on both hands.

 

Some types of arthritis that can affect the hand include:

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RHEUMATOID ARTHRITIS

Rheumatoid arthritis is different from all the other types of arthritis because it is an autoimmune condition. This means that it happens when the body turns on itself, and the immune system starts to attack healthy body tissue. Other autoimmune conditions include systemic lupus erythematosus and multiple sclerosis. 

 

In rheumatoid arthritis, the joint capsule is attacked by the immune system, and it causes inflammation of the capsule, along with degeneration of the interarticular cartilage. The progression of rheumatoid arthritis can often lead to joint deformity, causing severe pain and impairment of function for the individual.

 

Rheumatoid arthritis is known to affect mostly the joints of the wrist and hand and other small joints in the body. However, it can also affect other joints, including those of the toes, hips, knees, shoulders and elbows.

OSTEOARTHRITIS

Unlike rheumatoid arthritis, osteoarthritis is a natural part of ageing, and mostly affects older people. As people age, the joint capsule and articular cartilage in their joints weaken and degenerate. Eventually, the condition progresses enough to cause discomfort and pain in the individual. 

 

Osteoarthritis is often seen in several joints in the body, including in the spine. When it occurs in the spine, it is known as spinal arthritis, and it affects the intervertebral joints. Osteoarthritis is most common in the larger joints of the body, especially the knees and hips.

GOUT

Gout is a kind of arthritis that’s most commonly observed in the big toe of the foot. However, it can also affect other joints of the body, including the hands and wrists. Even though it is often localized to these small joints, it can be quite debilitating. Individuals cannot perform most activities without feeling pain. This often leads to a sedentary lifestyle, which in turn leads to further complications.

 

Gout arthritis is caused by an excessive accumulation of uric acid in the blood. This condition is also called hyperuricemia, and the acids build up and form small needlelike crystals in the joints. These then cause severe pain in the affected joints.

IS THERE A LINK BETWEEN WRIST AND HAND ARTHRITIS AND CRACKING THE KNUCKLES?

This subject is often debated, and some people are of the conception that cracking your knuckles can predispose you to arthritis. The idea is that because the popping sound is not heard in normal movements of the hand, it must be related to abnormal activity.

 

As a matter of fact, cracking your knuckles does not predispose you to arthritis. Neither does it have any other adverse effects on the hand. The pop sound heard is due to the release of gases. These gases are contained in the synovial fluid in the joint capsule, and cracking your knuckles forces them out of the joint space. The rapid release of gas is what’s heard as the popping sound.

 

However, in hand and wrist arthritis where there is severe degeneration of the joint cartilage and inflammation of the joint capsule, cracking your knuckles can cause pain. This is often a more severe version of the same pain experienced in the normal movement of the joint.

WHAT ARE THE SYMPTOMS OF WRIST AND HAND ARTHRITIS?

Depending on the type of arthritis, weakness and stiffness in other joints of the body can also be associated with hand and wrist arthritis.

Hand and wrist arthritis caused by rheumatoid arthritis also has symptoms such as 

HOW COMMON IS IT AND WHO IS AT RISK?

Studies have shown that arthritis is the most common cause of disability in the United States. About 54 million adults have been diagnosed with arthritis. Additionally, the most common type of arthritis, osteoarthritis affects about 31 million Americans.

Risk factors of wrist and hand arthritis include:

HOW IS HAND AND WRIST ARTHRITIS DIAGNOSED?

Hand and wrist arthritis is usually diagnosed using several approaches. History and physical examination can help narrow down the source of the pain and identify the unique symptoms. These can not only point to the severity of the arthritis but can also help identify the type of arthritis involved. For example, hand and wrist arthritis present in the same joints on both hands is more than likely an indication of rheumatoid arthritis.

 

Further investigations like X-rays, blood tests and sometimes MRIs can be used to investigate further. X-rays can pinpoint the joints affected, as well as see the extent of the joint degeneration. Blood tests can help identify blood markers and differentiate gout arthritis from other types.

WHAT ARE THE TREATMENT OPTIONS AVAILABLE? 

Some of the treatments of hand and wrist arthritis depends on the kind of arthritis that caused the condition. However, bulk of the treatment modalities overlap, and are usually focused on the following goals:

These goals are often achieved by a combination of various treatments including physical therapy, medication, and recommendation for assistive devices

PAIN MODULATION

NSAIDs (nonsteroidal anti-inflammatory drugs) are very effective in the management of arthritis. They modulate pain and reduce the inflammation around the joint space. Other painkillers like Acetaminophen can also be used.

Sometimes, ice packs and heat therapy may also be effective in reducing the pain associated with hand and wrist arthritis.


PHYSICAL THERAPY

Physical therapy focuses on stretching and exercising the muscles of the hand. Regardless of the type of arthritis, a common threat is deformity and reduction in functional use. Physical therapy aims to prevent this.


ASSISTIVE DEVICES

Assistive devices like splints and sleeves can be prescribed primarily to hold the hand in a particular position and prevent pain. However, these have to be used with caution because they can also promote immobility of the joint, which can lead to unwanted symptoms.

Here are answers to many of the frequently asked questions we receive.

TYPES

Arthritis can be classified into several types. Osteoarthritis is caused by the normal aging process of the body, or could be a result of injury.

Rheumatoid arthritis, the most common type of arthritis, happens due to autoimmune problems, wherein the body’s own immune system attacks healthy cells of the body. Infectious arthritis is caused by an infection to the joint. Patients with psoriasis may be affected by Psoriatic arthritis. Finally, excessive uric acid in the body can cause Gout, an arthritis that often starts at the toe.

RHEUMATOID ARTHRITIS

 

What is it?

Rheumatoid arthritis is an inflammatory form of arthritis. This disease causes chronic inflammation of the joints and can lead to deterioration of a variety of systems in the body. Rheumatoid arthritis occurs when the immune system attacks the lining of the membrane around the joints known as the synovium, which causes inflammation that thickens the synovium and ultimately deforms the cartilage and bone of the joints.

 

How common is it and who is at risk?

An estimated one percent of the entire world population suffers from rheumatoid arthritis. As the case with osteoarthritis, women are more likely to develop rheumatoid arthritis. Other groups at risk are people middle-aged or older as well as those suffering from obesity. Rheumatoid arthritis risk is inheritable, which may be accelerated by smoking or unknown environmental exposures.

 

What are the symptoms?

Signs of the disease include swollen, tender joints that may feel stiff, particularly in the mornings. Fever, fatigue, and loss of activity are also common symptoms. Rheumatoid arthritis tends to manifest initially in the smaller joints like those in the fingers and toes. Symptoms are exhibited in joints of other body parts as the disease spreads.

 

How is it diagnosed?

Diagnosis begins with a physical test checking for redness, warmth, and swelling as well as the state of reflexes in the affected joints. Multiple blood tests are conducted as people with rheumatoid arthritis usually have elevated erythrocyte sedimentation rates and C-reactive protein levels. Additionally, X-rays, MRIs, and ultrasounds are conducted to track the spread of the disease.

 

What are the treatment options available?

While no cure exists as of now, research has revealed that the symptoms may be controlled by early application of disease modifying anti-rheumatic drugs (DMARDs). Steroids or nonsteroidal anti-inflammatory drugs may be prescribed depending on the case. Exercises to retain joint flexibility also provide some relief. If medications fail to slow down the disease, doctors may recommend surgery to repair or replace joints or swollen tendons.

RHEUMATOID ARTHRITIS

 

What is it?

Rheumatoid arthritis is an inflammatory form of arthritis. This disease causes chronic inflammation of the joints and can lead to deterioration of a variety of systems in the body. Rheumatoid arthritis occurs when the immune system attacks the lining of the membrane around the joints known as the synovium, which causes inflammation that thickens the synovium and ultimately deforms the cartilage and bone of the joints.

 

How common is it and who is at risk?

An estimated one percent of the entire world population suffers from rheumatoid arthritis. As the case with osteoarthritis, women are more likely to develop rheumatoid arthritis. Other groups at risk are people middle-aged or older as well as those suffering from obesity. Rheumatoid arthritis risk is inheritable, which may be accelerated by smoking or unknown environmental exposures.

 

What are the symptoms?

Signs of the disease include swollen, tender joints that may feel stiff, particularly in the mornings. Fever, fatigue, and loss of activity are also common symptoms. Rheumatoid arthritis tends to manifest initially in the smaller joints like those in the fingers and toes. Symptoms are exhibited in joints of other body parts as the disease spreads.

 

How is it diagnosed?

Diagnosis begins with a physical test checking for redness, warmth, and swelling as well as the state of reflexes in the affected joints. Multiple blood tests are conducted as people with rheumatoid arthritis usually have elevated erythrocyte sedimentation rates and C-reactive protein levels. Additionally, X-rays, MRIs, and ultrasounds are conducted to track the spread of the disease.

 

What are the treatment options available?

While no cure exists as of now, research has revealed that the symptoms may be controlled by early application of disease modifying anti-rheumatic drugs (DMARDs). Steroids or nonsteroidal anti-inflammatory drugs may be prescribed depending on the case. Exercises to retain joint flexibility also provide some relief. If medications fail to slow down the disease, doctors may recommend surgery to repair or replace joints or swollen tendons.

JUVENILE IDIOPATHIC ARTHRITIS

Arthritis Stem Cell Therapy

What is it?

Juvenile Idiopathic Arthritis (JIA) is the most prevalent form of arthritis within kids. It is characterized by persistent pain, swelling, and stiffness in the joints. The disease occurs when the body’s own tissues are attacked by its cells. In some cases, it can create more serious complications such as growth problems and eye inflammation.

 

How common is it and who is at risk?

It is the most common form of arthritis diagnosed in children under the age of sixteen. Certain gene mutations can make the body more vulnerable to the external environment, which can result in Juvenile Idiopathic Arthritis occurring. Although reasons are unknown, girls are more susceptible to Juvenile Idiopathic Arthritis than boys.

 

What are the symptoms?

Commonplace symptoms include joint pain or a limp caused by the pain, swelling of joints and stiffness of the joints that results in clumsiness by the child. In some cases, the disease can manifest as high fever and rashes.

 

How is it diagnosed?

Diagnosis for Juvenile Idiopathic Arthritis is difficult as the pain and swelling in the joints could be attributed to a number of diseases. Quite a few blood tests are conducted to determine the status of markers like erythrocyte sedimentation rate, C-reactive protein levels, and quantity of anti-nuclear bodies, among others. However, many children with Juvenile Idiopathic Arthritis show no abnormalities in these tests.

 

What are the treatment options available?

The treatment for Juvenile Idiopathic Arthritis is geared towards making sure the child can maintain a regular level of physical activity. This can include different types of medication like nonsteroidal anti-inflammatory drugs to reduce pain and swelling or disease modifying anti-rheumatic drugs in more severe cases. Biologic agents may be recommended to help prevent joint damage. Physical therapy can also help the child maintain a full range of motion with or without joint supports or splints based on the situation. Surgery is the most extreme option used to improve the position of the affected joint.

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