What You Need to Know About Wrist Osteoarthritis

Is your wrist painful and stiff? Is it swollen? These are signs that you may have osteoarthritis of the wrist. Osteoarthritis can affect joints in any part of the body, including the wrist. Early diagnosis and treatment help people with wrist osteoarthritis manage their symptoms.

Osteoarthritis is a degenerative joint disease. Cartilage, a tough but flexible tissue that covers the ends of the bones forming a joint, wears away gradually with osteoarthritis. That's the nature of the disease but what causes osteoarthritis of the wrist specifically?

Injuries to the wrist, whether they be sprains or fractures, change the anatomy of the wrist. The injury can damage articular cartilage (the type of cartilage present in the joints). When severely damaged, cartilage may even be torn away from the bone.

With any injury that causes abnormal joint movement, there is increased stress on the articular cartilage. Over time, the changes in joint mechanics cause damage that can lead to wrist osteoarthritis.

The diagnosis of wrist osteoarthritis begins with your medical history and your description of your symptoms. The most important information to disclose to your doctor is a description of past injuries involving the wrist.

Your doctor will perform a physical examination of your wrist to see how your wrist moves, whether it has normal alignment, and where the pain is located. You will likely be sent for x-rays to assess joint damage, so your doctor can gauge if it is worsening over time.

If blood tests are ordered, it is being done to rule out other types of arthritis. This would be done if there was any uncertainty about your diagnosis or the type of arthritis you have.

As with any joint affected by osteoarthritis, the primary symptom associated with wrist osteoarthritis is pain. In the early stages of osteoarthritis, pain is brought on by activity. Usually, while performing the activity, pain subsides. Once the activity is stopped, pain and stiffness increase again.

Aside from pain, other symptoms associated with wrist osteoarthritis include:

• swelling of the wrist
• fluid around wrist joints
• crepitus (crackling) when the wrist is moved
• stiffness and limited range of motion

Usually, conservative treatment options are tried first, and surgery is considered a last-resort treatment option for those not getting a satisfactory response. The goals for treatment of wrist osteoarthritis are to relieve pain and improve joint function. Treatment options include:

• nonsteroidal anti-inflammatory drugs (NSAIDs)
• cortisone injection
• heat
• rest
• topical rubs
• physical therapy/exercise
• occupational therapy
• brace or wrist support

Surgical options include wrist fusion and wrist replacement. Both are excellent for pain relief but with fusion there is little or no motion left in the wrist. Wrist fusions involve 12 or 13 bones that need to fuse together. Your doctor will help you decide if you are a candidate for either procedure and, considering your work and lifestyle, which is better for you.