Treatment options for hand arthritis
Non-surgical treatments for hand arthritis
There are a number of ways that we can help manage your hand arthritis symptoms and challenges, without the need for surgery. However, should your arthritis develop significantly and cause you severe pain or loss of mobility in the hand, surgery may be recommended as the best long-term treatment option.
- Pain medication: There are many medicines available that help to relieve pain. Before taking any medicine, you should ensure it is safe for you to do so. If you are unsure, please consult your Circle doctor or pharmacist for advice.
An over-the-counter painkiller such as paracetamol can often help to manage mild arthritic pain in the hand. If the pain worsens, your doctor may suggest using a non-steroidal anti-inflammatory drug (NSAID). As well as reducing pain, this type of medication also helps to reduce inflammation in the joint. Some NSAIDS can be purchased over the counter from your local pharmacy, while others will need a prescription.
- Physiotherapy: Helps you maintain movement and function in your hand and wrist. Our Circle physiotherapists will teach you specific hand and wrist exercises, stretches and movements that help to strengthen the muscles and keep the joints as mobile as possible. They will also show you how to modify certain hand and wrist movements to reduce your arthritic pain. This is known as ‘activity modification’.
- Splinting: When your hand movements cause pain in a joint, splinting (or strapping) your finger or thumb to stop it moving can reduce the pain. A plastic splint is used, and you may sometimes be advised to wear this overnight, especially if you tend to have pain or stiffness in the joint first thing in the morning. Your Circle physiotherapist will show you how to use your splint correctly.
- Corticosteroid injections: By injecting a corticosteroid directly into the affected joint, joint pain can be relieved. This is a good treatment option for hand arthritis pain for a number of reasons. While it may take about a week or more to feel the full pain-relieving benefits, they can last for a good length of time, up to 6 – 9 months in most cases. If this injection does relieve the joint pain, it confirms that the pain is being caused by that particular joint, which is useful for your doctor to know. Corticosteroid injections can be repeated, although they may become less effective over time.
For many people with arthritis in their hands, being free of pain is such a relief. Experiencing a month or two without the constant ache or pain of arthritis in the hand is liberating. Whether pain relief is achieved through splinting, pain medication, physiotherapy or corticosteroid injections into the joint, your Circle team will help ensure that you continue to receive the best help and support available.
Surgical treatments for hand arthritis
Where non-surgical treatments have stopped working, or when pain or stiffness in the joint has increased significantly, your doctor may recommend hand surgery as the best way to relieve your symptoms. There are a variety of surgical options available, ranging from operations that help to preserve movement in the joints to ones that fix joints permanently in place. Your Circle doctor will talk with you about the best surgical option for you.
- Arthroplasty: This describes surgery to change or modify a joint, and there are three common options:
- Excision: part of the joint is completely removed, with nothing put in to replace it.
- Interposition: involves positioning another tissue, such as a piece of tendon, to keep arthritic joint surfaces apart.
- Replacement: An artificial implant is used to replace the joint surface on one or both sides.
- Arthrodesis: An operation to fuse the bones in a joint together. Using metal plates or pins, this stabilises the joint and makes it incredibly sturdy. Other joints, such as in the wrist and elbow, can often compensate for the lack of movement in the joint that has been fixed in place.
- Arthroscopy: A form of keyhole surgery, a thin metal tube about the size of a pencil, is placed into your wrist joint through a small cut. This tube is known as an arthroscope and has a light and camera on one end, allowing the surgeon to clearly see inside the joint itself. Additional small surgical tools can be introduced into the joint to help the surgeon clear out any floating bone fragments (known as ‘loose bodies’) and to smooth out or ‘trim’ the articular cartilage on the ends of the bones to relieve friction when the bones move against one another.
Following some types of surgery, you will normally need to wear a custom splint for a few weeks. You will see your Circle consultant and physiotherapist at certain intervals to assess your healing and recovery.
Complications of surgery for hand arthritis
Any type of surgery carries certain risks and complications. Common complications include:
- Anaesthetic reaction: You may have an allergy to the type of anaesthetic drugs used. This is avoidable if you know which ones you may have an intolerance to.
- Infection: We have a number of protocols in place to reduce the risk of infection. Most of our operating theatres have a special type of air circulation known as ‘laminar flow’. In addition, unlike large acute hospitals Circle hospitals do not admit infectious or trauma patients, which helps to further reduce the risk of infection.
- Bruising: Usually clears within a week or two of the surgery.
- Lightheadedness: This normally clears with a couple of days.
There are some specific complications of hand surgery to be aware of:
- Residual pain: It is possible that surgery may not eliminate all discomfort.
- Nerve injury: Although very rare, there is a small risk of damage to the nerves in your hand and/or wrist during surgery. This may cause numbness in a finger or part of the hand. This is mostly transient but rarely can be permanent.
- CRPS: Complex regional pain syndrome is a very rare condition, affecting around 1 in 1,000 people. It leads to chronic pain in the hand or wrist.
If you are suffering from arthritis in your hand, you will be acutely aware of the difference it is having on your life. While many people may tolerate a certain level of discomfort or stiffness in the hand for a while, long-term and/or severe pain or lack of mobility in the hand joint should be properly assessed by a doctor. Delaying an assessment only extends the time you are in pain, while a thorough assessment, accurate diagnosis and effective treatment can help get you out of pain.
We believe that you’ll find no better place to have your hand arthritis treated effectively than at Circle Health. Each one of our hospitals offers state-of-the-art equipment, superb facilities and some of the most experienced hand surgeons in the country. Contact Circle today to book a consultation with one of our hand specialists at a time of your choosing.An overview of hand arthritis