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The hand and the wrist are two small masterpieces of nature: in fact they have small joints that work together to produce the correct movement and, in it, also the most precise and delicate. However, when the joints are affected by arthritis, typical activities of daily living can suddenly become very difficult.
Over time, in particular, if thearthritis is not treated, the bones that make up the joint can lose their normal shape, resulting in more pain and further limiting movement.
The origins of arthritis
When arthritis occurs due to a disease, the onset of symptoms is gradual and the cartilage evolves slowly. The two most common forms of disease arthritis are osteoarthritis and rheumatoid arthritis.
L'osteoarthritis it is much more common and generally affects older people. Also known as "wear and tear" arthritis, osteoarthritis causes - in fact - the deterioration of the cartilage.
L'rheumatoid arthritis instead, it is a chronic disease that can affect many parts of the body, causing swelling of the joint lining, which in turn causes pain and stiffness in the joint. Rheumatoid arthritis most often begins in the small joints of the hands and feet, and usually affects the same joints on both sides of the body.
However, sometimes arthritis can be generated due to a trauma. In particular, fractures, and especially those that damage the joint surface, and dislocations, are among the most common injuries that lead to arthritis. Even if treated correctly, an injured joint is more likely to become arthritic over time.
What are the symptoms of arthritis
The first symptoms of arthritis of the hand they include joint pain or a "burning" sensation. Pain often occurs after periods of increased joint use, such as after a strong grip. The pain may not be present immediately, but it can occur hours later or even the next day. Morning pain and stiffness are two other typical symptoms.
As the cartilage is consumed and there is less "material" to absorb the shocks, the symptoms occur more frequently. In advanced disease, joint pain can wake you up at night.
The pain can also get worse with use and relieved by rest. Many people with arthritis complain of increased joint pain with rain and humidity. And even activities that were once easy, like opening a jar or turning on the car, become difficult with pain. To prevent pain in the arthritic joint, the way of using the hand could therefore be changed.
When the affected joint is subjected to greater stress than it can bear, it can also swell in an attempt to prevent further use of the joint.
In patients with advanced arthritis of the base of the thumb, nearby joints may become more mobile than normal. Among other symptoms there is also the heat felt in the arthritic joint and, sometimes, even the formation of cysts.
Read also: Osteoarthritis, treatment and prevention
Diagnosis of arthritis in the hand
A doctor generally can diagnose arthritis of the hand examining the hand and taking x-rays. Specialized studies, such as magnetic resonance imaging, are usually not necessary, except in cases where Keinbock's disease is suspected (a condition in which the blood supply to one of the small bones of the wrist, the lunate, is interrupted).
How arthritis is treated
The doctor's goal will be to prevent arthritis from affecting the patient's life too much. In this regard, it is important to seek help early so that treatment can begin and you can go back to doing what you usually do.
Generally, treatment options for arthritis of the hand and wrist include medications, splinting, injections, and surgery, and are determined based on how far the arthritis has progressed, how many joints are involved, age, level of activity to be performed and other medical conditions, and again whether the dominant or non-dominant hand is affected by the problem, personal goals and the ability to comply with a therapeutic program.
Regarding i medications, the medicines - evidently - are able to treat the symptoms but are unable to restore joint cartilage or damage to the reverse joint. The most common drugs for dealing with arthritis are anti-inflammatories, which prevent the body from producing chemicals that cause swelling and pain in the joints. Examples of anti-inflammatory drugs are drugs such as naproxen and ibuprofen.
When first-line treatment with anti-inflammatory drugs does not produce the expected results, you can move on to injections, which typically contain a long-lasting anesthetic and a steroid that can provide pain relief for weeks or months. The injections can be repeated, but only a limited number of times, due to possible side effects, such as thinning of the skin, weakening of tendons and ligaments and infection.
If non-surgical treatment doesn't provide relief, that's usually done surgical. There are evidently many surgical options, and the path chosen should be the one that has a reasonable chance of providing long-term pain relief and allowing the joint to function painlessly.
When the damage has progressed to the point that the surfaces no longer function, a joint replacement or fusion (arthrodesis) is performed.
After each type of joint reconstruction surgery, there is a recovery period. It is for this reason that the patient will be referred to a rehabilitation specialist.
The duration of the recovery time varies greatly and depends on the extent of the surgery performed and on multiple individual factors.