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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.
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:
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.
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 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.
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.
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
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:
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.
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
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 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 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.
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