Rheumatoid Arthritis in the Wrist

The wrist is one of the main joints affected by rheumatoid arthritis (RA) since this condition often starts in the small joints of the hand and wrist. About one in seven people in the United States has wrist arthritis. This condition can be mild to severe and cause a variety of symptoms, including wrist pain, that can disrupt everyday functioning.

The wrist is the joint connecting the hand to the forearm, and is formed by the radius and the ulna bones. Daily work and personal life activities require the use of the wrist. If you experience wrist pain or discomfort when you use your wrist or at rest, it may be due to arthritis.

Woman on couch clutching wrist

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How RA Affects the Wrist

Rheumatoid arthritis is one type of arthritis, and is an autoimmune and chronic condition. An autoimmune disease causes the body's immune system to attack its own tissue. This means in RA in the wrist, the condition will cause damage to the nearby tissue and soften the bone in the wrist.

Everyone's experience with RA and wrist arthritis varies. Some won't have symptoms right away, while others may experience extreme pain. People with wrist arthritis may have overlapping symptoms between RA and another condition like carpal tunnel syndrome or gout.

RA joint damage and deformity cannot be reversed, so it's best to catch the problem and start the treatment early.

Joint Pain

Pain in the wrist joint is a common symptom of rheumatoid arthritis in the wrist, and the severity of the pain can range from minimal to extreme.

It should also be noted that RA is known to be a symmetrical disease, where joints of the hands, feet, wrists, elbows, knees, and ankles are commonly affected on both sides.

Other Symptoms

In addition to pain, there are many other notable symptoms to look out for, including:

  • Stiffness
  • Swelling
  • Redness
  • Weakness
  • Joint pain
  • Difficulty gripping items
  • Limited range of motion
  • Grinding or clicking
  • Deformity

Symptoms can be a slight inconvenience or a barrier to getting things done from day to day. With RA, the wrist is often only one of several affected body parts. Along with the symptoms felt in the wrist from RA, the disease can also cause physical symptoms of fatigue, fever, and weight loss.

Diagnosis

Keep in mind that wrist pain isn't always due to an underlying condition. There may be another reason for your wrist pain, like carpal tunnel syndrome, tendonitis, or simply overuse. That said, it's always a good idea to have your wrist pain checked out by a healthcare provider. It's important to get a diagnosis as early as possible for RA to avoid deformity of the joint.

When it comes to RA, diagnosis can be difficult due to its similarities to other conditions. To accurately diagnose the cause of your wrist pain, your medical provider will take a full medical history and family history, listen to your symptoms, and rule out other possible causes to your complaints.

Your healthcare provider may also order several tests to diagnose your condition, including imaging and blood tests. An X-ray of your wrist can reveal the severity and progression of RA. RA also shows up in blood work through these tests:

  • Elevated erythrocyte sedimentation rate
  • C-Reactive protein
  • Rheumatoid factor
  • Anti-cyclic citrullinated peptide antibodies

Severity

Your healthcare provider will also look at the severity of your RA to determine the best treatment, which is classified into stages. Rheumatoid arthritis has four stages:

  • Stage 1: This is the first and earliest stage of RA. It involves initial inflammation in joints and some swelling in the tissue. There are also symptoms of joint pain, swelling, and stiffness
  • Stage 2: This is the moderate stage where the inflammation becomes severe enough to do damage to the cartilage. Symptoms increase to additional loss of mobility and decreased range of motion
  • Stage 3: This stage is considered severe. Inflammation is destroying the cartilage of the joint and bone. Increased pain, swelling, low mobility, and loss of strength are all included in this stage. The joint may also start to show deformity
  • Stage 4: This is the end stage of RA, where the inflammatory process stops and the joints don't function at all. This stage is associated with pain, swelling, stiffness, and loss of mobility

Treatment

There a few treatment options for wrist arthritis. It's important to discuss your options with your healthcare provider to determine if the benefits of a treatment outweigh the risks.

Splints and Supports

Wrist splints and arthritic gloves can be used to ease the pain. You may get them sized specifically to fit your wrist. These will not prevent injury or take away the pain completely, but are great for support and comfort during the day.

Medication

Medications can be used to control pain and inflammation in RA. There are a few different types of medications, depending on your level of pain and the severity of your RA:

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter treatment for pain that doesn't slow the progression of the disease
  • Disease-modifying anti-rheumatic drugs (DMADs): These are used as first-line treatment to reduce immune system activity and reduce inflammation
  • Oral steroids: A temporary measure for quick results to lower inflammation
  • Injections: Cortisone shots are injected into the pain site for pain relief and inflammation three to four times per year

Oral glucocorticoids like prednisone may reduce symptoms, but they don’t affect the disease itself. The risks of this medication may outweigh the benefits.

Physical Therapy

Physical therapy is another option that can be coupled with other treatments to manage arthritis in the wrist. In physical therapy, you'll learn how to stretch and strengthen your wrists to relieve the pain in that joint.

Coping

An RA diagnosis can be a shock, and will likely spark changes in your life, from the medications you take to the activities you can do.

Lifestyle Modifications

Some lifestyle changes may have to be made to ease wrist joint pain and live a healthy life with wrist arthritis:

  • Being active
  • Watching your weight
  • Staying in contact with your healthcare provider
  • Joining a community of RA patients
  • Protecting your joints

A Word From Verywell

While an RA diagnosis can be distressing, getting diagnosed is a great start and allows you to begin treatment as soon as possible to slow the disease progression. Feeling pain in your wrist can be upsetting, but there are many ways you can manage it and prevent it from interfering with your daily life. With the right combination of treatment and support, you will be able to continue your life as usual for many years to come.

Once you are clear on the cause of your pain and discomfort, you can work with your medical team to come up with a doable plan for you. You are your biggest advocate, so keep a record of your symptoms and concerns to help your healthcare provider investigate and keep track of your RA.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Zangger P, Keystone EC, Bogoch ER. Asymmetry of small joint involvement in rheumatoid arthritis: prevalence and tendency towards symmetry over timeJoint Bone Spine. 2005;72(3):241-247. doi:10.1016/j.jbspin.2004.08.013

  3. Rheumatoid Arthritis Support Network. RA progression: what are the signs of rheumatoid arthritis progression? Published October 27, 2018.