Your doctor will ask you about your symptoms and do a physical exam. They will test the range of motion in your wrist and hand. They may order X-rays and blood tests to check for arthritis. These include rheumatoid factor and anti-citrullinated protein/peptide antibodies to identify RA.
Some doctors recommend eating a diet that is low in acidic fruits and nightshade vegetables. Others recommend avoiding certain activities that can worsen symptoms.
Medications
The wrist is a complex joint where several bones come together. Smooth and slick cartilage covers the ends of the bones to protect them from each other, but age and certain health conditions can cause it to wear away, leaving bone rubbing against bone instead, leading to pain, swelling and stiffness. The more severe types of arthritis pain that develop in the hand and wrist are caused by rheumatoid arthritis, lupus and other inflammatory conditions.
The more common types of arthritis that affect the wrist can be controlled with medications and other treatments. For example, doctors may prescribe disease-modifying antirheumatic drugs (DMARDs) to slow down the progression of RA, or pain-relieving medications like nonsteroidal anti-inflammatory drugs, such as aspirin, naproxen and ibuprofen.
There are also analgesics, which are purely designed to relieve pain and are often used for hand and wrist pain, such as acetaminophen or opioids, which are available by prescription. Topical medications such as salves, creams and gels that contain analgesics can also be applied directly to the skin.
Other treatment options include splinting to support the wrist, or physical therapy and exercise, such as doing specific wrist exercises approved by a doctor or a physical therapist, to improve range of motion in the joint. In some cases, surgery is done to remove damaged parts of the bone or fuse bones in the wrist to decrease pain and increase function.
Over-the-Counter Treatments
The wrist is a complex joint. It has 19 bones (14 in the hand and five in the wrist) arranged in two rows, with 14 phalanges, or finger bones: three in each of the index, middle, ring and pinky fingers and two in the thumb. These bones move together with muscles, tendons and ligaments to help you grasp objects and make movements with the thumb and fingers.
There are several treatment options to relieve pain and prevent further damage to the joints in the wrist and hand. Medications, splinting and exercise can all be helpful.
For rheumatoid arthritis, doctors generally prescribe tablets called disease modifying anti-rheumatic drugs (DMARDs). These medications ease the symptoms of the condition and slow its progression by blocking the effect of chemicals in the body that cause inflammation. The first medication prescribed is usually methotrexate, followed by sulfasalazine or leflunomide. If these do not control the symptoms, doctors may add a short course of steroids (corticosteroids) to reduce inflammation. Biological treatments, such as adalimumab, etanercept and infliximab, are newer medicines that stop specific chemicals in the blood from activating your immune system to attack your joints.
Nonsteroidal anti-inflammatory drugs, which are available over-the-counter in such brands as Aspirin and ibuprofen, can also help with pain and swelling. Glucosamine, an amino acid that can promote cartilage growth, is another option.
Splinting
Your wrist is a complex joint that allows you to move the bones of your hand and forearm. When you are healthy, the bones glide easily over each other during movement because they’re protected by a layer of smooth cartilage that coats the ends of the bones. But when you have arthritis, the cartilage is damaged or worn away and bone rubs against bone, causing pain and stiffness.
Medications can help control the symptoms of arthritis, including pain and inflammation. Nonsteroidal anti-inflammatory drugs — such as aspirin and ibuprofen — decrease inflammation and can be taken by mouth or applied topically to the wrist. Doctors may also prescribe cortisone injections to reduce pain and swelling.
A working splint is a flexible support that helps keep the wrist in a natural position, decreasing stress on painful joints and reducing pain and tenderness. These splints are available from medical supply stores or physiotherapy and occupational therapy departments.
Osteoarthritis is the most common form of arthritis in the wrist. This type of arthritis develops from normal wear-and-tear and usually occurs as people age. It can also develop as a result of an injury to the wrist. When other treatments aren’t effective, your doctor may recommend surgery to repair the damage to the wrist joint. Surgical procedures can include removing the damaged cartilage and fusing the ends of the bones together.
Surgery
If you have tried a variety of conservative treatments and have no relief, it is time to consider surgical treatment. However, it is best to try every conservative approach first.
Your doctor will start by asking about the onset, location, nature, and severity of your wrist pain. He or she will then perform a physical exam. If necessary, a blood test can determine if you have rheumatoid arthritis.
The wrist is a complex joint that connects the hand to the forearm. Eight small bones make up the wrist, called carpal bones. They are arranged in two rows and each bone has a joint surface covered by articular cartilage that helps the bones move smoothly against one another.
Wrist pain occurs when the articular cartilage breaks down and bone surfaces grind against each other. This is often the result of repetitive motions or trauma, but can also occur due to wear and tear over time.
Depending on the type of arthritis and how you use your wrist, surgery may be required to alleviate the pain and improve mobility. Usually, this involves reducing or eliminating bone-on-bone contact, and there are several procedures that your doctor can recommend.
Proximal row carpectomy: In this procedure, your surgeon removes the three most prominent carpal bones in the row closest to the forearm. This will reduce your pain but will also limit your wrist movement. Wrist fusion: In this procedure, your doctor replaces the painful cartilage with pins, plates, or screws to fuse the bones together so they no longer touch. This will prevent the painful bone from grinding against other bones.
