The hand is comprised of many small joints that enable the hand to make very particular and accurate movements. Without good use of these joints, activities such as threading a needle or writing with a pen are very difficult. The hand joints are lined with cartilage, which provides a cushion between the bones.
It is estimated that one out of every five Americans suffer from arthritic pain and it frequently affects the hand. When a patient experiences pain and lack of mobility in the hand, it is usually caused by arthritis. The cartilage can become damaged or lost over time and there is no longer a cushion between the bones. This can be very painful. In addition, the body produces fluid called synovial fluid, which attempts to make up for missing cartilage. This can cause swelling and discomfort.
Two types of arthritis can be found in the joints of the hand:
When arthritic pain severely limits day-to-day activity or when motion in these joints becomes close to impossible, a total joint replacement surgery of the hand might be a good treatment option. Because replacement surgery is not the solution for all hand pain, meeting with an orthopaedic surgeon specializing in joint replacement of the hand is the best course of action.
Symptoms and Diagnosis
A physician that specializes in hand conditions, such as Dr. Leah Urbanosky of Hinsdale Orthopaedics, will perform a thorough visual and manual examination of the hand. He or she may also recommend an x-ray to determine the source of pain.
Some signs of arthritis include:
There are many nonsurgical options for treating pain associated with arthritis in the hand joints. The first course of action is usually anti-inflammatory medication. Though anti-inflammatory medication does not repair damage done within the joint, it can provide relief. A second step is usually steroid injections which can only be administered a limited number of times to avoid possible side effects. Another non-invasive treatment is a splint that may provide enough support to ease the joint pain when it becomes unbearable.
If the pain continues without improvement for an extended period of time, joint replacement surgery may be an option. With this procedure, the diseased joint is replaced by an implant that is meant to mimic the natural movement of the hand. These implants may be made of silicone for maximum motion of the finger.
Doctors are working on new types of implants that more closely resemble the implants used in other weight bearing joints, such as hips and knees. These implants are commonly made from metal or plastic, and are more similar to the actual joint than the silicone implants. Doctors are using this knowledge to improve the surgery. There are some risks of surgery, including infection and the possibility that the implant will come loose or not reduce any long-term pain. Though they should be seriously considered before choosing replacement surgery, these risks are commonly associated with all implant surgeries.
Post-surgery, a splint will most likely be worn in order to support the healing hand. A hand therapist may create a specific physical therapy plan in order to strengthen the treated area. Many patients are able to return to full functioning activity within three months, though it depends on the specific joint replaced and the patient’s overall health.
Click here to view a brochure from Ascension on joint replacement of the hand
If you are experiencing hand pain and would like to schedule a consultation with Dr. Leah Urbanosky, please call her office at: (815) 462-3474
Cysts & Tumors
De Quervain's Tenosynovitis
Carpal Tunnel Syndrome
Traumatic Hand Injuries
Joint Replacement of the Hand
Mallet Finger (Baseball Finger)
Swan Neck Deformity
UCL Tear of the Thumb
Osteoarthritis of the Thumb