Mr D J Murray, Consultant Orthopaedic Hand and Wrist Surgeon.
- Opening jars / lids
- Holding a pen
- Making a tight grip
- Riding a bike
- Doing up buttons
- Using a computer
Arthritis takes many forms and can affect all the joints of the fingers, thumb hand and wrist. Patients who suffer from arthritis often find their symptoms to be heightened in the winter, as the cold weather draws in. This can lead to increased pain, stiffness, and sometimes swelling of the affected joints.
Arthritis can be due to a number of factors - previous injury, rheumatoid problems, wear and tear, part of the aging process, and many others.
Common joints affected in the hand and wrist are the joint at the base of the thumb, especially in ladies, and the joints at the end of the fingers. At the base of the thumb this can be felt as an aching, sometimes burning pain, when making a tight grip, or an inability to perform fine tasks requiring the thumb to form a pinch with the index finger. There is often an obvious bump at the base of thumb, which can become warm and tender.
In the finger joints, patients often complain of stiff, swollen joints, which often cannot be fully straightened or flexed. As the arthritis becomes more advanced, new bone can develop around the joint, leading to bony swelling and small cysts that are painful when knocked.
The stage of arthritis is diagnosed with an XRay and clinical examination. Treatment is tailored to the individual and ranges from simple lifestyle changes, strengthening exercises and painkillers to pain relieving steroid injections, and various forms of surgery.
In mild cases, a custom made splint can be worn when performing some activities, to relieve the pressure on the affected joints also during the cold weather ensure that gloves are worn to keep the hands warm or use pocket hand warmers to help relieve symptoms. As the condition worsens, painkillers can be taken which reduce the inflammation caused by the arthritis, easing the symptoms. Despite these measures, the arthritis can progress to a more severe level and further intervention is required. Steroid injections are an effective and minimally invasive treatment option. It is recommended that the injections are performed under XRay guidance by a trained specialist, to be most effective. Steroid injections can give symptomatic relief for 6 months to a year, and repeat injections can be considered.
Ultimately, if the arthritis becomes resistant to treatment with injections, then surgery is warranted.
There are multiple surgical techniques for arthritis in the fingers, hand and wrist. These include replacing joints, excising joints, or fusing joints. The type of operation offered is based on the patient’s symptoms and circumstances. The aims of all the different types of surgery, is to provide a pain free functional joint.
Mr Murray has clinics throughout Cheshire and Manchester for more information visit www.ukhandsurgery.com or call 01204 416186.