December 7, 2010
Every day, you use your hands for dozens of precise movements from tying your shoes, to buttoning your clothes to feeding yourself. Because of our constant reliance on our hands, pain, stiffness and swelling in them is especially disruptive to our daily lives. Frequently the cause of that discomfort is arthritis.
Studies show that 80 to 90 percent of adults over the age of 75 have arthritis, and women are more severely affected than men. The most common form of arthritis in the hands is osteoarthritis. Arthritis occurs when the cartilage that provides a cushion in our joints begins to wear away. In reaction, the joints produce fluid. However, the fluid causes swelling in the joint, which results in pain. Without treatment, the bones in the joint may lose their normal shape.
Osteoarthritis develops most frequently at the base of the thumb, at the joint closest to the finger tip and at the middle joint of the finger. Bony knots may form at the joints. Symptoms include a dull or burning sensation in the joints, swelling, joints that are warm to the touch and grating or grinding in the joints. When arthritis is found in the base of the thumb, nearby joints in the thumb may become more mobile than usual.
Dr. Robert Bass, a hand surgeon on the medical staff at Centennial Medical Center, explained that doctors diagnose arthritis by examining the hands and taking X-rays. “Medications may treat painful symptoms, but they cannot reverse the damage,” he said. “Some of the most common drugs used are anti-inflammatory medications, such as Tylenol or Advil and prescription medications such as Celebrex.”
In some cases, doctors inject the affected joints with an anesthetic and a steroid, which may provide relief for months. However, these injections can be used a limited number of times because of the potential side effects. Some patients also wear splints on fingers or on their wrists.
Surgery usually is not an option unless more conservative treatments are unsuccessful, Dr. Bass said. There are several types of surgery, including joint fusion in which the arthritic surface is removed and the bones are fused together, eliminating motion. During another type of surgery called joint reconstruction, the damaged joint surface is removed and may be replaced with soft tissue, such as a tendon or a joint replacement implant.
Dr. Bass added it’s important to talk with your doctor about what medications or treatments are the best options if you suffer from arthritis. “Because each case is complicated, it takes serious consideration to determine whether surgery will ensure you the best outcome,” he said.
In addition to osteoarthritis, another form of arthritis that may affect the hands is rheumatoid arthritis. It can affect the whole body, usually on both sides. Other causes are injuries, infection, gout and psoriasis.
To find a doctor who can talk with you about treatment options or risks for arthritis, please call Centennial Medical Center’s physician referral line at 1-800-330-3819.