Hand Arthritis

What is hand arthritis?

Arthritis can be divided into osteoarthritis and inflammatory arthritis. Osteoarthritis is commonly referred to as degenerative or “wear and tear” arthritis. Inflammatory arthrits is considered an autoimmune disease where the body attacks itself. Common examples of inflammatory arthrits are rheumatoid arthritis, lupus, gout, scleroderma, and psoriatic arthritis.

How does hand arthritis occur?

In osteoarthritis, articular cartilage degenerates and results in weakening of the cartilage and eventual death of cartilage. Cartilage is the smooth gliding surface between bones.  Dr. Kavi Sachar likes to think of it as two sheets of ice with fluid in between acting as a lubricant. In osteoarthritis, this “ice” melts and patients are eventually left with the bones rubbing against each other like two pieces of concrete. This can result in pieces of bone breaking off and the bone softening and collapsing. Osteoarthritis is divided into 4 stages based on x rays.

• Grade 0: Normal appearing joint with no cartilage loss
• Grade 1: minor Joint space narrowing with small bone spurs
• Grade 2: definite joint space narrowing with bone spurs
• Grade 3: moderate joint space narrowing with large bone spurs and possible deformity
• Grade 4: severe joint space narrowing with bone-on-bone contact, large bone spurs and deformity

Inflammatory arthrits occurs when the body attacks itself. This is considered a systemic disease that can affect not just joints, but organs, ligaments, and other tissue as well. Each form of inflammatory arthritis is different and often requires a medial doctor or rheumatologist to be involved in management and treatment.

Diagnosing hand arthritis

Both osteoarthritis and rheumatoid arthritis may present with pain and swelling. Patients will have difficulty with activities such as lifting and twisting. They may notice weakness and may frequently drop things. Typically, rheumatoid arthritis may be more painful in the morning whereas osteoarthritis may get worse as the day goes on.

In the hand, patients may notice deformity of the fingers and thumb. The fingers can angulate and twist. They may intermittently swell. Patients with have difficulty with things like opening jars and holding onto heavy objects.

Nonsurgical treatment of hand arthritis

When treating arthritis, Dr. Kavi Sachar likes to describe a spectrum of treatment that ranges from conservative treatment to surgery. Many conservative treatments may be offered because patient response can be variable. Sometimes, the simplest treatment may work, helping to avoid surgery.  Conservative treatment consists of rest, splint immobilization, anti inflammatories, therapy, cortisone injections and biological injections. There are some holistic remedies such as diet modification that can help some patients (link to arthritis sheet).  Therapy can help build the muscles and help strengthen the joint. Cortisone injections can temporarily help with the pain. Platelet Rich Plasma (PRP) is a treatment where a patients’ own blood is drawn, and the platelets are concentrated via centrifuge to isolate Platelet Derived Growth Factor which can help in tissue healing. Favorable results have been reported in some patients.

In the hand, nonsurgical treatment of arthritis may include all the above options. Patients often benefit from a brace to protect and immobilize the thumb if it is involved. Therapy ca be helpful to teach modified lifting techniques.

Surgically treating hand arthritis

When conservative treatment fails, some consideration is given to surgical treatment. The surgery offered will vary on the specific body point and joint involved. Typically, surgery involves either a joint replacement, a joint reconstructing, or a joint fusion.

In the hand, one of the most common procedures performed is an arthroplasty of the thumb. This involves removing the arthritis and reconstruction with tendons from the hand. No tendons must be removed with the suspensionplasty technique performed by Dr. Kavi Sachar. In arthritis of the fingers, either a joint replacement or fusion is performed. Dr. Kavi Sachar will evaluate you and determine which treatment is indicated.

Recovering from hand arthritis surgery

Depending on the surgery performed, Dr. Kavi Sachar’s goal is to make you as functional as possible after surgery. Many surgeries require short term immobilization to allow for tissue healing. As soon as motion and strength are possible, Dr. Kavi Sachar will advance you to allow for activity, function and getting you back to what you like to do.

Schedule a consultation

Board-certified and fellowship-trained hand surgeon Dr. Kavi Sachar is widely regarded as one the nation’s leading experts on arthritis. Dr. Sachar has three office locations in Vail, Aspen, and Frisco, Colorado. If you or a family member suffer from arthritis, contact Sachar today. Dr. Sachar is part of the world-renowned Steadman Clinic. Dr. Sachar and his team are here to help.