Wrist arthritis involves inflammation and degeneration of the wrist joint, leading to pain and stiffness.
The wrist is made up of numerous small bones and joints working together, which means arthritis here can arise from several different processes. Osteoarthritis is wear of the joint surfaces, often related to a previous injury that has altered how the bones fit together. Rheumatoid and other inflammatory forms of arthritis instead involve inflammation of the joint lining that can progressively damage the joint surfaces over time.
Wrist arthritis often follows a previous wrist fracture or ligament injury, particularly involving the scaphoid or the end of the radius bone, that has altered the normal alignment and mechanics of the joint over time, known as post-traumatic arthritis. It can also develop from general age-related wear without a specific prior injury, or as part of rheumatoid or other inflammatory arthritis affecting the wrist joints.
Common symptoms of wrist arthritis include:
Where wrist arthritis follows a previous injury, symptoms may not develop until years after the original event, as the altered joint mechanics gradually lead to wear.
Assessment includes examination of wrist movement and grip strength, together with X-rays to assess the pattern and severity of arthritis across the various wrist joints.
Non-surgical treatment is the starting point for most patients: activity modification, splinting, anti-inflammatory medication, and a corticosteroid injection to settle a particularly painful period.
For persistent symptoms, surgical options depend on the pattern and severity of arthritis. Earlier disease with mechanical symptoms may be helped by wrist arthroscopy. For more advanced arthritis, options include proximal row carpectomy, removing a row of arthritic wrist bones while preserving some movement, or wrist fusion, which reliably relieves pain and restores strength at the cost of wrist movement.
Symptom relief with treatment matched to the severity of arthritis is generally good. Wrist fusion, when needed, reliably relieves pain and restores grip strength, though this comes at the cost of wrist movement, an important trade-off that is discussed in detail before this surgery is recommended. Earlier-stage arthritis treated with arthroscopic clean-up can provide good symptom relief while preserving movement, though it does not reverse the underlying wear.
Wrist arthritis, whether from wear, previous injury or an inflammatory condition, is a manageable cause of wrist pain and stiffness. Non-surgical treatment helps many people for a considerable period, and where surgery is needed, options range from arthroscopic clean-up to wrist fusion, with an important trade-off between pain relief and preserved movement to discuss for the more advanced procedures. Persistent wrist pain, stiffness or reduced grip strength is worth having assessed.
