Arthritis of the Wrist

Arthritis involves inflammation of one or more of your joints. Pain and stiffness are common symptoms of arthritis, and when these occur in your wrist, simple daily activities can become more difficult.

There are many types of arthritis, and most of these can affect the wrist. Although the severity of symptoms related to arthritis can vary, most arthritis-related diseases are chronic. This means that they are long-lasting—even permanent—and can eventually cause serious joint damage.
Your wrist is a complex joint—it is actually made up of multiple small joints. When healthy, the bones glide easily over each other during movement, protected by smooth cartilage that coats the joint surfaces. Arthritis damages this cartilage. As the disease progresses, there is a gradual loss of cartilage. Without a smooth joint surface, the bones rub against each other, leading to joint damage that cannot be repaired.
Although there is no cure for arthritis today, there are many treatment options available to help relieve your symptoms. Some options may also slow the progression of joint damage. With proper treatment, many people are able to manage their symptoms and stay active.

Anatomy

The wrist is a complex joint that connects the hand to the forearm. It is formed by the two bones of the forearm—the radius and the ulna—and eight small carpal bones. The carpal bones are arranged in two rows at the base of the hand. There are four bones in each row.

The joint surface of each bone is covered with articular cartilage—a slippery substance that protects and cushions the bones as you move your hand and wrist.

Description

Although there are many types of arthritis, the three that most commonly affect the wrist are:

. Osteoarthritis

. Rheumatoid arthritis

. Posttraumatic arthritis

Osteoarthritis

Osteoarthritis can develop due to normal "wear-and-tear" in the wrist, particularly in people who have a family history of arthritis. It is a common problem for many people after they reach middle age, though it may occur in younger people, too.
In osteoarthritis, the smooth, slippery articular cartilage that covers the ends of the bones gradually wears away over time. Because the cartilage surface has little to no blood supply, it has little ability to heal or regenerate when it becomes injured or worn down.

Osteoarthritis in the wrist can also develop from Kienböck's disease. In Kienböck's disease, the blood supply to one of the carpal bones—the lunate—is disrupted, causing the bone to die and slowly collapse. Over time, this collapse can lead to changes and arthritis in the joints around the lunate.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease that can affect multiple joints throughout the body. The condition often starts in smaller joints, such as those found in the hand and wrist. It is symmetrical, meaning that it usually affects the same joint on both sides of the body.
Rheumatoid arthritis is an autoimmune disease. This means that the body's immune system attacks its own tissues. In rheumatoid arthritis, the defenses that normally protect the body from infection instead damage normal tissue (such as cartilage and ligaments) and can soften bone.
Rheumatoid arthritis often affects the joint between the two bones of the forearm, the radius and ulna. The deformity in the ulna can cause wearing and possible rupture of the tendons that straighten your fingers. This can cause more deformity and loss of function in your hand.
The exact cause of rheumatoid arthritis is not known—there are no clear genetic or environmental factors. Although it is not an inherited disease, researchers believe that some people have genes that could make them more likely to have rheumatoid disease.

Posttraumatic Arthritis

Posttraumatic arthritis can develop after an injury, such as a broken wrist bone or a torn ligament. This trauma can cause a direct injury to the cartilage or a delayed wearing of the cartilage due to a change in the way the bones move together—such as after a ligament tear.
Posttraumatic arthritis can develop over many years from the initial injury. Despite proper treatment, an injured joint is more likely to become arthritic over time.

Symptoms

Not all patients with arthritis will experience symptoms. When they do occur, the severity varies greatly from patient to patient. For some patients, the symptoms are not constant—but may come and go depending on their level of activity and other factors.

Symptoms of arthritis may include:

sharp,
dull,
stabbing,
tearing,
cramps,
twisting,
pressure,

Tests

X-rays. X-rays provide detailed images of dense structures, such as bone. X-rays of your wrist will help your doctor learn more about the exact location and severity of your arthritis. They can also help your doctor distinguish between various types of arthritis.
Blood tests. Your doctor may recommend blood tests to determine which type of arthritis you have. With rheumatoid and other types of inflammatory arthritis, blood tests are important for an accurate diagnosis. Osteoarthritis is not associated with blood abnormalities.

Treatment

There is no cure for arthritis, but there are a number of treatments that may help reduce the frequency of your symptoms and relieve the pain and loss of function it can cause.

Nonsurgical Treatment

In general, initial treatment for arthritis is nonsurgical in nature and designed to help minimize your symptoms.

Nonsurgical treatment options may include:

Activity modification. Limiting or stopping the activities that make your pain worse is the first step in relieving symptoms.
Immobilization. Wearing a wrist splint for a short time will help support the joint and ease the stress placed on it by frequent use and activities.
Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen, and ibuprofen can help reduce both pain and swelling. Topical NSAIDs can be applied directly to the skin in the area of the joint.
Exercise. Specific exercises will help improve range of motion and function in your wrist. Your doctor or a physical therapist can help develop an exercise program that meets your specific needs.