What is arthritis?
The word arthritis comes from the Greek word for joint, “arthron,” and the suffix “-itis,” meaning inflammation. Osteoarthritis is the most common form of arthritis. It is also called Degenerative Joint Disease (DJD). Arthritis can affect any joint in the body. Osteoarthritis is especially common in load-bearing joints, such as the knees.
While generally, cartilage inside the joint allows it to function smoothly, arthritis wears away at this cartilage, making movement painful and difficult. The onset of arthritis occurs slowly because of this gradual wearing away of the cartilage.
In the hand, arthritis can wear away at any of the 29 bones of the hand, wrist, and fingers. Osteoarthritis generally only affects people over the age of 40.
What are the signs and symptoms of osteoarthritis?
One of the earliest symptoms of osteoarthritis is pain in the affected joint. This pain may feel like a dull or burning sensation. This pain often occurs after a lot of usage of the joint, such as heavy lifting or grasping. This pain may not begin immediately after use of the joint, but may show up hours later or even the next day. As the disease develops, the pain may become more severe and more frequent.
When the joint is subjected to more stress than it can handle, it may also swell up and become inflamed. This is your body’s way of attempting to stop you from using your joint. The joint will also become stiff and hard to move.
Another symptom of arthritis in the hand is warmth, due to the inflammation of the joint. The joint may also become deformed, or may even affect the joints surrounding it.
People with arthritis also complain about their joints getting worse with changing weather, most likely due to changes in air pressure.
How is osteoarthritis diagnosed?
A doctor generally diagnoses arthritis first by asking the patient questions about their hands and/or other joints. The doctor will then examine the affected areas to see how they look and function. He may press on the joint to check for pain.
After this, the patient usually has x-rays to examine the bones and joints. These x-rays may reveal a loss of normal joint space or other abnormalities, like bone spurs. Other tests are generally unnecessary except in special cases, such as when a general inflammatory disease is suspected.
How is osteoarthritis treated?
Before surgical options should be considered, there are many non-surgical treatments which may help with osteoarthritis. The goal of treating arthritis is to minimize pain and to allow the joint to function. Treatment options for arthritis are based on the following factors:
- How far the arthritis has progressed
- How many joints are involved
- The patient’s age
- The patient’s medical history
- How active the patient is
There are other possible factors that can weigh into deciding what treatment is best as well, such as whether the arthritis affects the dominant or non-dominant hand and the patient’s personal goals.
Medicinal treatments for osteoarthritis include anti-inflammatory agents, such as ibuprofen. These can help with the symptoms of arthritis, but cannot restore the lost cartilage or reverse damage to the joint. One temporary treatment is injections which include long-lasting anesthetics and steroids. These can only be used a limited number of times, as they can eventually lead to unwanted side effects, such as lightening of the skin and weakening of tendons and ligaments.
Other treatments to help deal with side effects can include heat, such as heating pads and paraffin baths. This can help ease the pain and make the joints more mobile.
Rigid splints can also be used to ease stress on the affected joint. These should be small enough as to not limit movement outside the treated joint. Wearing these for too long in a period of time, however, can cause muscular atrophy/degeneration and more stiffness.
If none of these non-surgical options provide relief, surgery should be looked into. There are several different surgical options available to the patient, and the patient should always be the one to tell the doctor when they are ready to consider surgery.
If there is any way to restore both pain-free function and movement to the joint, this option should always be taken. Joint reconstruction removes the rough joint surface and replaces it with a soft tissue implant, like tendon.
When the arthritis has progressed to the point where the joint cannot be fixed, either joint fusion or replacement may work.
Joint fusion provides total pain relief but will stop motion in the joint. This surgery removes the worn cartilage and fuses the bones on either side. Because the bones are fused, the joint can no longer move. However, this relieves the pain, as the worn cartilage is no longer an issue.
Joint replacements both provide pain relief and restore function. These are generally made out of material similar to that of the load-bearing joints, such as ceramic or long-wearing metal and plastic. These help with function and longevity in the hand. Most joints in the hand and wrist can be replaced with prosthetics at this point in time.
What Dr. Henley’s Osteoarthritis Patients Are Saying
by Pam Brown
I had surgery on my hand due to arthritis. Had I known what outstanding work Dr. Henley does, I would have had it done sooner. I had very little pain and recovery was fantastic. If the need occurs, I will definitely use him again for other surgeries. Very, very pleased!!! Recommend him highly!!
My osteoarthritic thumb had bothered me for over 2 years, getting worse and worse. I had tried topical analgesics, cortisone shots and was wearing a brace most of the time. I was at the point where I could not unscrew any lids, hold vegetables in my hand to chop them or hold dishes to wash them.
I had already visited a doctor that does surgery for this, and then found out that Dr. Henley only does hand surgery and had a different procedure for this problem. I made an appointment with Dr. Henley. My husband, also a physician, went with me for the appointment and we both knew he was the right doctor for my surgery. As Dr. Henley told me what to expect after surgery, he didn’t sugar coat anything about it, but I was tired of not being able to do things for myself any longer and booked my surgery.
The first 2 weeks I was not able to get my hand wet at all or do anything with it, not that I would have wanted to! The next 2 weeks were a little better, but I still could not do much, except wiggle my fingers on that hand. Physical therapy started after that and it was a relief to finally start moving my fingers and thumb a little.
After 3 ½ from surgery, I have an ache once-in-awhile in my hand or wrist. It is nothing like the pain I had before surgery! I have full movement of my thumb, I can open jars!!! And chop veggies and wash dishes again. I am working on gaining more strength in my hand / wrist.
Dr. Henley was up-front in telling me that the recovery would take 3 months plus. I am glad that I had the surgery, as I was not able to do much before surgery and I had a lot of pain most of the time. My husband and I recommend Dr. Henley, who is so nice, to anyone looking for a hand surgeon. Dr. Henley has an office in Fayetteville and in Bentonville, Arkansas, so it is easy to make it to get in to see him.