Could the pain in your hands or wrists be arthritis?

• Do you feel a dull pain or a burning sensation during or after activities that involve heavy gripping or grasping?
• Does joint pain in your hands or wrists wake you up at night?
• Do you feel pain in your hands or wrists more during rainy weather?

If so, you could have arthritis.

How can arthritis affect the hands and wrists?

Arthritis can affect many of the 29 joints in the hand. Dr. John Krebs of the Center for Orthopedics is fellowship-trained in hand surgery and performs advanced procedures including wrist and even finger joint replacement.

Dr. Krebs answers questions about hand and wrist arthritis

Basal joint arthritis affects the base of the thumb

I have pain at the base of my thumbs. Could this be arthritis?

“Yes. You could have basal joint arthritis in the carpal-metacarpal (CMC) joint at the base of the thumb. If you do things that require a lot of pinching motions—whether knitting, plumbing or factory work—the CMC joint is more prone to this type of wear-and-tear arthritis.

What are the symptoms of basal joint arthritis?

“Basal joint arthritis produces pain at the base of the thumb, almost at the wrist. Every time you go to pick up something, you feel a sharp, stabbing pain.”

Who is most likely to get basal joint arthritis?

“The older you are, the more common arthritis is—although patients can be as young as in their 40s. We see a lot of older women who sew and do intricate hand work that wears down the joint at the base of the thumb. I saw a 50-year-old plumber a few days ago whose thumb was destroyed from his work.”

Is basal joint arthritis often mis-diagnosed?

“Yes. Sometimes patients come in for treatment of carpal tunnel syndrome and tell me their pain is at the base of the thumb. Then I ask what else is bothering them. For example, do they have numbness?

“Patients often tell me, ‘I may have numbness every now and then, but the pain at the base of my thumb is killing me.’ Or they may say, ‘Dr. So-and-So gave me a cortisone shot in my carpal tunnel and it helped a little bit, and he did an EMG test and it said I have carpal tunnel syndrome.’

“I tell these patients, ‘You may have carpal tunnel syndrome, but symptomatically that's not your problem. If you want to get rid of your pain, you've got to figure out what's bothering you more—your pain or your carpal tunnel. Because if I release your carpal tunnel, you're still going to have pain.

“By having a conversation like that, I can tell why patients are having pain. A lot of times, patients will have components of carpal tunnel syndrome—they'll have symptoms, but they're also having pain. Then it's their decision: Do they want to take care of the pain and the numbness, or just take care of the numbness and see if the pain goes away?”

How is basal joint arthritis treated?

“We start with conservative therapy—pain relievers, cortisone shots, physical therapy to maintain range of motion. We don't recommend immobilizing your thumb because it will make the arthritis worse.

“If the cortisone shot doesn't work, patients usually come back in three to six months for another cortisone shot or to discuss surgery. Nearly seven out of 10 patients with basal joint arthritis eventually opt for surgery.”

Can the basal joint be replaced?

“Yes. Carpal-metacarpal, or CMC arthroplasty is surgery to replace the joint at the base of the thumb.”

Arthritis can also affect the finger joints

Who is most likely to get arthritis in their fingers?

“Patients with rheumatoid arthritis are more likely to get finger arthritis than are those with osteoarthritis. However, these days, I see more finger arthritis patients with osteoarthritis simply because rheumatoid arthritis patients are able to control their condition well with prescription medications.”

Can arthritic finger joints be replaced?

“Yes. Finger joint replacement surgery can restore normal joint function and relieve pain by resurfacing arthritic joints.”

Arthritis can strike the wrists

What are some common causes of wrist arthritis?

“Wrist arthritis may be brought on by:

• Post-traumatic arthritis following a wrist injury
• Wrist instability, which wears away the cartilage of the wrist joint
• Rheumatoid arthritis or RA—a systemic autoimmune condition"

What are the symptoms of wrist arthritis?

“Common symptoms of wrist arthritis are:

• Wrist pain
• Swelling around the joint
• Difficulty gripping objects

“Inflammation or bone spurs can also irritate the nerves surrounding the wrist, causing tingling and numbness in your fingers—a condition known as carpal tunnel syndrome

How is wrist arthritis treated?

“If you have wrist arthritis, it may help to modify your activities to avoid certain movements such as lifting and carrying heavy items.”

Other conservative treatments include:

• Wearing a splint to support your wrist
• Applying heat
• Taking NSAIDs such as ibuprofen to reduce inflammation
• Cortisone injections

Can surgery treat wrist arthritis?

“Yes. Wrist fusion surgery can relieve the pain of arthritis—but it leads to loss of motion in the wrist. Wrist replacement surgery can relieve pain while maintaining normal motion in the hand and wrist.”