Many options to treat hand and wrist arthritis

By the age of 85, 50% of all women and 25% of men will have osteoarthritis (OA) of the hands or wrists. When you consider how much a person uses their hands throughout their lives, these statistics are not surprising.

“The joints are like ball bearings,” explains Dr. Jhade Woodall, a hand and wrist surgeon practicing at Eastern Idaho Regional Medical Center.  “They can wear out for a lot of reasons. Some of the joints in the hand get very worn out or misaligned. Idaho is a place where the hardworking population just wears out their ball bearings, but we are able and willing to help them. We have great outcomes.”

Osteoarthritis is a degenerative disease that, over time, breaks down the protective cartilage on the end of bones, causing them to rub together at the joints. Most people are familiar with the common symptoms of OA: joint stiffness, swelling, and pain. While there is no cure for arthritis, there are still benefits to seeking medical care early on, and there is a wide range of treatment options available to control symptoms and get relief. 

“Typically, in the early stages of arthritis, we start treatment with acetaminophen gel, rest, and physical therapy,” says Dr. Woodall. “Steroid injections are common and effective, especially when combined with physical therapy. Some people can get years of relief with a single steroid injection.”

There are also new, minimally invasive surgical options.

“The newest thing I offer is joint denervation—cutting the nerve that provides peripheral sensation to the joint,” explains Dr. Woodall. “It’s mainly used to treat wrist arthritis, but it’s starting to be used in knuckles too.”

“The procedure is minimally invasive—a small skin incision. Healing time is much shorter than the months of recovery needed after a joint replacement. Patients just take it easy for a couple weeks and then they are back to full function. If there is true joint destruction, no matter the type of arthritis, denervation is a reasonable treatment option to explore.”

As OA progresses in the hands and wrists, functionality is affected. Patients lose strength and dexterity. It is common for the fingers to bend and twist, and for nodules to form on the bones, deforming the fingers and hands. Even so, says Dr. Woodall, surgical treatment to reduce pain and preserve motion is still an option for some patients.

“Bones can be removed. Joints can be fused to reduce pain, or joints can be replaced to retain mobility. The treatment is tailored to the patient. I talk to the patient, find out what they can and cannot do with their hand to determine how aggressive to be with procedures. For instance, joint fusion removes motion, but it can result in stronger grip strength because of reduced pain.

“Some people shy away from surgery, believing that surgery will make the pain worse. Often, however, once patients have surgery performed on one hand, they return to have surgery on the other hand. Surgery can significantly reduce pain for a long period of time.”

Dr. Woodall is enthusiastic about helping his patients. “I like to make people feel better. Arthritis patients often think they have to live with the pain, that nothing can help them. But that’s not the case. People don’t have to live with debilitating arthritis.”