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What is arthritis?

 

Arthritis is a disease affecting various tissues inside your joints, the point at which two or more bones meet.  Arthritis may occur as a result of inflammation in a joint and surrounding soft tissues.  This may either be acute (short term) or chronic (ongoing).   It can also be a result of trauma to your joint (such as a broken finger) or may also occur from genetic or environmental causes.

 

With arthritis, joints typically continue to wear down as cartilage (tissue that lines joints) wears down.  This may cause structural changes that can be seen on X-rays. Surrounding soft tissues, including the tendons, ligaments, muscles, nerves, blood vessels, skin, fat, and synovial membranes, may also deteriorate.

 

 

 

What are the types and causes of arthritis?

 

Osteoarthritis (also known as "degenerative arthritis") - This is the most common type of arthritis, and may affect one or more joints anywhere in the body.  Osteoarthritis usually occurs later in life and often affects hands and larger weight-bearing joints, such as hips and knees. This type of arthritis can cause pain, deformity, and limit your range of motion in the joint.

 

A number of factors are thought to be important in the development of this disease. Mechanical considerations (eg, joint stability and alignment) affect the distribution of forces across the joint and therefore impact the joint’s life span. Also, certain substances (ie, biochemical factors) in the cartilage itself are thought to play a role in the eventual abnormal changes of this tissue.

 

Risk factors for osteoarthritis include:

 

• Age

• Traumatic injuries (such as a broken wrist)

• Joint infections

• Possible overuse

 

Some may also inherit the tendency to develop osteoarthritis, however this is not well understood. Typically, those affected by heredity see an onset at an earlier age.

 

 

Rheumatoid arthritis

 

Rheumatoid arthritis is an inflammatory, presumed autoimmune disease.  This form of arthritis affects the entire body, especially the joints. Rheumatoid arthritis typically begins in the hands, wrists, ankles and feet. It often affects the same joints on each side of the body. Many other joints are eventually also affected. The cause of rheumatoid arthritis is unknown, however genetic factors are thought to have a critical role.

 

 

Arthritis Symptoms

 

Symptoms of arthritis from any cause can include:

 

• Pain in the joint itself

• Loss of motion in the joint

• Joint motion that is accompanied by grinding, clicking, or cracking as the cartilage continues to wear down.

• Joints that swell and often become red and tender to the touch

• Weakness that results from joint pain, loss of motion, and joint deformity

 

 

Non-surgical treatments for arthritis

 

Formal occulational therapy can help to maintain motion and reduce pain.

 

Some other first-line treatments for osteoarthritis include:

 

• Cutting back or ceasing activities that are causing pain

• Splinting the affected joint for short periods of time

• Applying heat or ice to reduce pain and swelling

• Acetaminophen and anti-inflammatory medications to reduce pain and swelling

• Injecting joints with a cortisone preparation to relieve symptoms 

• Exercising the joints – gently -- through the full range of motion on a daily basis

 

 

Surgical treatment options for arthritis

 

When non-surgical options no longer relieve the pain, or when deformity prevents functional use of the hand, surgery may be considered.   Loss of motion, chronic pain, and deformity are the main reasons for surgery.

 

Surgical options include a variety of reconstructive procedures as well as joint fusion.

 

Reconstructive surgery - For osteoarthritis involving the base of the thumb, reconstructive surgery is commonly performed and highly effective.  This procedure provides excellent pain relief, allows for a good range of motion, and restores function to the thumb.

 

Joint fusion (also called arthrodesis) - This surgical method is used to treat arthritis in many hand and wrist joints. For example, the joint at the tip of the finger is frequently affected by osteoarthritis. So, this surgical method would involve fusing this joint with the joint below it to stabilize and straighten the joint, which eliminates pain. However, this procedure also prevents the fused joint from bending.

 

Joint replacement - This procedure is recommended for ‘low-demand’ patients, especially those with rheumatoid arthritis that involves joints at the base of the fingers. In these cases, joint replacements may improve the range of motion, making the fingers more useful. Pain is improved, as is use of the hand.  These artificial hand joints, however, do not provide the same stability as joint fusion and they will, in time, wear down.

 

While arthritis in the hands and wrists is common and can be a painful and a functionally limiting disorder, many treatments are available to reduce symptoms and help patients. Newer medications available for the treatment of the rheumatoid arthritis have led to a significant reduction in the severe hand deformities that these diseases, when untreated, can cause. Surgical treatments for osteoarthritis and rheumatoid arthritis can provide pain relief and allow patients to return to many of the activities they enjoy.

 

For more information about arthritis in fingers and hands, as well as the simple, safe, and effective treatments that are available, schedule an appointment with Dr. Sagini by calling 239-337-2003.