Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Wrist Osteoarthritis

What is Wrist Osteoarthritis?

Osteoarthritis of the wrist is the degeneration of the joint surfaces that connect some or all of the eight small bones that comprise the wrist and join with the forearm and hand. The smooth cartilage surfaces of each bone can be damaged or worn out, causing rough surfaces to rub against each other and cause pain, stiffness, and inflammation. The arthritis may be localized to just a few of the bones, or all of the wrist can be involved in advanced cases.

The most common complaints heard from patients with osteoarthritis of the wrist are pain and stiffness involving daily activities.

Characteristics and Clinical Presentation of Wrist Osteoarthritis

Pain and swelling are common initially. As the arthritis worsens there may be stiffness and difficulty using the hand and wrist. Most arthritis-related diseases are chronic, though severity of symptoms can vary. Osteoarthritis is known to develop due to normal wear and tear in the wrist, especially those who have a known family history. It is also common to develop Osteoarthritis of the Wrist in following injury and autoimmune disorders.

Commonly, prior trauma of the wrist can cause damage to the cartilage surfaces at the time of injury, setting the wrist on the path to developing arthritis.  Ligament injuries may cause bone misalignment and leads to premature wear of wrist joint surfaces.

Untreated fractures and irregular fractured surfaces can also cause arthritis. In addition, a lifetime of heavy use of the wrist can cause overloading of some of the joint surfaces and lead to arthritis. Some people likely have a genetic predisposition to wearing out the wrist and will develop osteoarthritis without any other known factor. Different bones in the wrist are more commonly affected by osteoarthritis depending on the cause.

Common symptoms of osteoarthritis of the wrist may include:

  • Pain
  • Swelling
  • Reduced range of motion or stiffness
  • Weakness in the joint
  • Joint instability
  • Deformity or change in appearance

Getting a Diagnosis for Wrist Osteoarthritis

Drs. Pruzansky will perform a physical examination of the hand or wrist to test for reduced range of motion, point tenderness, instability in the joint, or any swelling or deformity to the wrist. Finger and thumb mobility will also be tested, in addition to nerve function, to assess whether or not another condition may be affecting the wrist.

Diagnostic tests such as X-rays and blood tests can also contribute to diagnosis. X-rays provide detailed images of bones and joints, which can provide insight into the severity of your condition. Blood tests can help determine which type of arthritis you may have, which is important to distinguish between conditions like rheumatoid and other inflammatory arthropathies.

Treatment Options for Wrist Osteoarthritis

Osteoarthritis of the wrist does not have curative treatments. However, there are treatments available to manage symptoms and relieve pain. Patients might also limit activities in their daily routine to ease pain in the wrist, if at all possible. A splint may be beneficial in some situations, especially during resting periods.

Conservative Treatments

More mild cases may be managed with conservative treatment involving anti-inflammatory medication, occupational therapy, splinting, and perhaps a cortisone injection. The wrist joint is not responsible for major weight bearing in most people, so it can generally tolerate the presence of arthritis better.

A conservative treatment regimen may be able to help to reduce inflammation and pain while preserving motion so that you may continue to enjoy using your hand for work and hobbies.

Surgical Treatments

Cases with significant pain unresponsive to conservative treatment may benefit from surgery.  Surgical treatment can include arthroscopic debridement or partial wrist fusion (arthrodesis) if only part of the wrist is involved. Fusing part of the wrist can reduce or eliminate pain, while generally reducing wrist motion by at least half. Sometimes ligament repair is all that’s required.

In situations where ligamentous or bony injuries underlie the arthritic process, repairing them in a timely fashion may improve the arthritic condition. When the entire wrist joint is severely degenerated, surgical treatment requires either complete wrist fusion or total wrist replacement.

Some surgical methods include:

  • Proximal row carpectomy: three carpal bones are removed in the wrist, designed to reduce pain while retaining wrist motion.
  • Fusion: fusion may be recommended if motion is the primary source of pain, essentially “welding” bones together to minimize further pain.
  • Total wrist replacement (arthroplasty): the damaged cartilage and bones in the wrist are removed and replaced with new metal or plastic, designed to restore function in the joint.

Preventing Wrist Osteoarthritis

Although Osteoarthritis is sometimes a disease with genetic indicators, there are some lifestyle choices you can make in order to delay deterioration or improve your outcome.

Making some of these changes can improve your overall joint health and may help to reduce Osteoarthritis of the Wrist. Maintaining a healthy lifestyle with low-impact exercise and work with plenty of rest is useful.

Additionally, while many patients develop this condition with age, you should still seek treatment immediately if you begin to notice a pattern of chronic pain in the wrist area.

Some modifiable factors include:

  • Managing occupational risks that involve repetitive movements in the wrist.
  • Utilize low-impact exercise with activities that include painless strength training and stretching.
  • Maintain a healthy weight, as excess stress via weight transfer can speed up deterioration of the joint cartilage.
  • Get adequate amounts of rest

Prognosis for Wrist Osteoarthritis

If your condition requires surgical intervention, there may be a healing period of a few weeks to months depending on the surgery and other factors.  Periods of immobility promote healing, so individuals who do not require surgical intervention may be advised to wear a hand splint during resting periods to ease stress on the joints of the hand and wrist.

Rehabilitation of the hand and wrist area may be recommended.

If You Believe You Have Wrist Osteoarthritis, Contact HandSport Surgery Institute.

Please contact us as soon as possible to schedule an appointment with our talented team. People who have wrist pain ought to be evaluated to try and reduce further damage and mobility issues.

If you have been injured, it’s important to be evaluated by a highly skilled hand surgeon. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.