Wrist arthritis

The wrist joint will often have a mild degree of arthritic change in it through normal ageing, but the main causes of troublesome wrist arthritis are as a result of previous injury.

The wrist is frequently injured. Whether these injuries happen in your younger active years, or when you are older and fall or stumble easily, the natural response is to put your hand out to save yourself. As a result, wrist fractures, ligament and cartilage injuries occur in a significant number of people. Sometimes these are brushed off as being "just a sprain" by people anxious to get on with life and unable to believe that a simple fall could cause damage. In time, the symptoms of 'the sprain' ease off and it may be some years later before the effects of that injury - wrist arthritis - are experienced.

Wrist arthritis will often produce a visible deformity of the wrist - thickening of the joint and areas of swelling. The invariable symptom is a reduction in the range of movement (which can be compared to the opposite wrist) and this is frequently accompanied by pain. The combination of pain and stiffness will alter the ability to function normally, and it is at this stage that medical advice and attention may be sought.

Your doctor will examine your wrist and document its movements, as well as ask you about your pain and loss of function. X-rays of the wrist (usually taken from two different angles) will provide information on the condition of the joint surfaces. X-rays only act as a guide in wrist arthritis. There is no link between the severity of symptoms and the degree of wear and tear seen on an x-ray.

Treatment begins with advice about modifying activity - at work and at home. A resting splint in the shape of a fingerless gauntlet often provides enormous pain relief to allow activities to be performed less uncomfortably, but a splint will reduce movement and may, in itself, make function difficult, though not uncomfortable. There are many different splints available in all shapes and sizes.

Simple painkillers, such as paracetamol or anti-inflammatory drugs, can reduce pain and allow more movement. If these measures fail to provide sufficient relief, surgery may be offered. There are two broad categories of operations which surgeons use in wrist arthritis; motion-eliminating procedures and motion-preserving procedures. As the name suggests, motion-eliminating procedures remove all movement from the joint, but hope to remove the pain as well. Sometimes, wrist arthritis reduces the movement so much that the joint will hardly move at all, anyway. In these cases, the joint can be surgically stiffened in a fusion (or arthrodesis) procedure. If, however, a substantial range of movement remains, but pain prevents it from being useful, surgical division of some of the small pain-carrying nerves can reduce the density of pain signals received by the brain and make life more comfortable. This motion-preserving surgery may only be effective for a few years until the arthritis pain once more increases, but that may allow an individual crucial time to modify their job or other activities.