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A complex network of bones, joints, tendons, nerves, and muscles make up your hand and wrist, all of which precisely coordinate to allow for fluid synchronisation of fine motor movements. The prevalence of wrist and hand arthritis increases with age and can be unpleasant and incapacitating. A cortisone injection in the hand may be an option in complicated circumstances.
The wrist and hand are made up of a total of 27 bones. Carpals, metacarpals, and phalanges make up the bones. Since cartilage covers every joint, movement is painless and without friction. However, arthritis results in cartilage loss, which causes movement of the bones against one another. Because these joints lack cartilage, movement of them causes pain.
Symptoms of wrist and hand arthritis
Pain with prolonged use, such as a full day of gardening or tennis, is the initial indication. Simple tasks like opening a door or typing on a keyboard can become painful as arthritis worsens. Morning stiffness is another typical symptom. Swelling, pain when moving, warmth, and cysts or nodules on the finger are examples of general symptoms. In osteoarthritis, these nodules are known by their distinctive names, Bouchard and Heberden’s nodes.
It’s critical to differentiate between osteoarthritis and less prevalent inflammatory forms of arthritis, such rheumatoid illness. For instance, rheumatoid arthritis, MCP joint swelling, finger drifting away from thumb, and nail changes are some typical rheumatic changes.
How can we diagnose hand or wrist arthritis?
In general, we perform three types of tests:
- Blood tests are often crucial if inflammatory arthritis is suspected.
- X-rays of the wrist and hand provide information about the type of arthritis. Sometimes, ultrasound or MRI can give extra information.
- Clinical assessment: Looking for and feeling for hand and wrist joint swelling can give clues to the diagnosis.
Treatment options
- Lifestyle modifications: Pain can be significantly reduced by just slightly changing your daily routines.
- Wrist and finger splints: Splinting can offer support and make it painless for you to carry out basic tasks.
- Hand therapy: For assistance with exercises, seeing a therapist is crucial. You can purchase inexpensive yet efficient hand gadgets to maintain joint mobility and increase finger and wrist strength.
- Medication: Regular use of topical lotion to painful wrist or finger joints is a great pain reliever. Creams contain flexiseq or ibuprofen.
- Injection therapy: For a few months, a cortisone injection can aid with pain relief and movement improvement.
- Surgery: The last option is frequently fusion of the wrist or fingers.
What is a cortisone injection?
Cortisone has potent anti-inflammatory properties and eases arthritis pain. You should be aware of any potential issues with cortisone injections, though. It is undoubtedly not a choice for all arthritis sufferers.
Cortisone injections under ultrasonography are typically recommended to increase accuracy and minimise side effects such skin thinning and tendon injury. See the illustration below to see how ultrasonography can accurately guide the needle into a wrist joint.
What about other options?
Other methods exist, however there is little proof of their wrist and hand-related usefulness.
In bones and joints, hyaluronic acid is an organic acid chemical. A hyaluronic acid injection lessens pain in the joint. Additionally, we speculate that it could work as a lubricant to lessen pain.
Platelet-rich plasma, or PRP, is made from whole blood. The blood is first spun to separate the cells from the plasma. The plasma is then taken out of the cells and injected into the joints. Although use in knee arthritis is well supported by research, wrist and hand arthritis are less well supported. Nevertheless, when patients desire to avoid surgery, some doctors use PRP in the hand.
Conclusion
Overall, as we age, arthritis in the wrist and hand becomes more prevalent. We combine topical anti-inflammatory medication, cortisone injections (steroid injections), and hand therapy. In general, we advise an ultrasound-guided injection to increase effectiveness and minimise side effects. Make sure the person administering the injection has a medical degree and ultrasonography experience.
