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Wrist Arthritis Specialist
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is Wrist Arthritis
Wrist arthritis is a condition characterised by inflammation and degeneration of the joints within the wrist. It leads to the deterioration of the cartilage, the smooth covering at the ends of bones where they form a joint. As cartilage wears away, bones may rub against each other, causing pain and limiting movement. Since the wrist is necessary for hand movements and dexterity, wrist arthritis can impact daily activities.
Types of Wrist Arthritis
Wrist arthritis can manifest in several forms, each with unique characteristics.
Osteoarthritis
Often related to age, osteoarthritis occurs due to the wear and tear of cartilage over time. It is common in individuals over the age of 50.
Rheumatoid Arthritis
This is an autoimmune disorder where the body’s immune system attacks its own tissues, including the joints. It can affect the wrist joints and often involves both wrists.
Post-Traumatic Arthritis
This type develops following an injury to the wrist, such as a fracture or sprain, which may damage the cartilage and lead to arthritis over time.
Psoriatic Arthritis
Associated with the skin condition psoriasis, this type can affect the wrist and cause joint inflammation.
Gout
This is caused by the buildup of uric acid crystals in the joint. It is a painful form of arthritis that can occasionally affect the wrist.
Symptoms
The symptoms of wrist arthritis can vary depending on the type and severity of the condition.
- Pain: A primary symptom, often aggravated by movements such as gripping, lifting, or during periods of inactivity like sleeping.
- Stiffness: The wrist may feel stiff, especially in the morning or after periods of rest.
- Swelling: Inflammation can lead to noticeable swelling in the wrist.
- Reduced Range of Motion: Difficulty moving the wrist as freely as before, affecting activities requiring wrist flexibility.
- Crepitus: A grinding sensation or sound in the wrist joint during movement.
- Weakness: A general feeling of weakness in the wrist, impacting the ability to hold or grip objects.
Causes and Risk Factors
Several factors can influence the development of wrist arthritis:
- Age
The risk increases with age, particularly for osteoarthritis. - Genetics
A family history of arthritis can increase susceptibility. - Gender
Certain types, like rheumatoid arthritis, are more prevalent in women. - Previous Wrist Injuries
Injuries such as fractures or ligament tears can lead to post-traumatic arthritis. - Occupational and Recreational Stress
Repetitive wrist movements and heavy usage can contribute to the development of arthritis. - Systemic Diseases
Conditions like rheumatoid arthritis, psoriasis, and gout affect the whole body and can specifically target the wrist joint. - Obesity
Excess weight can increase joint stress, although this is more common in weight-bearing joints.
Diagnosis
Diagnosing wrist arthritis involves a combination of clinical evaluation and diagnostic tests.
- Medical History: Understanding the patient’s symptoms, family history, and previous wrist injuries or conditions.
- Physical Examination: Assessing the wrist for tenderness, swelling, warmth, deformities, and range of motion.
- Imaging Tests: X-rays are used to identify changes in the joint, such as narrowing of joint space, changes in bone quality, or the presence of bone spurs. An MRI can provide detailed images of both bone and soft tissues and is useful in assessing the early stages of arthritis or confirming a diagnosis when X-ray results are inconclusive.
- Blood Tests: Particularly relevant for rheumatoid arthritis and other systemic conditions, to detect markers of inflammation or antibodies.
- Joint Fluid Analysis: In some cases, fluid from the wrist joint may be extracted to rule out infection.
Non-Surgical Treatment Options
Non-surgical treatments for wrist arthritis focus on relieving symptoms and improving joint function.
Medications
- Pain Relievers: Over-the-counter medications like acetaminophen can alleviate pain.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These reduce both pain and inflammation. They are available over-the-counter or in stronger prescription forms.
- Corticosteroid Injections: Injected directly into the wrist joint, these can provide relief from pain and swelling.
Splints or Braces
Wearing a wrist splint or brace can stabilise the joint, alleviate pain, and prevent further damage, especially during activities.
Physical Therapy
A tailored exercise program can strengthen the muscles around the wrist, improve range of motion, and reduce stiffness. Physical therapists may also employ techniques like heat or cold therapy and ultrasound.
Occupational Therapy
Helps patients learn new ways to accomplish daily tasks with less pain and stress on the joints.
Lifestyle Modifications
- Activity Modification: Avoiding or altering activities that exacerbate symptoms.
- Weight Management: Reducing weight decreases stress on joints.
Alternative Therapies
- Acupuncture: Some find relief from pain through acupuncture.
- Nutritional Supplements: Supplements like glucosamine and chondroitin sulfate are popular, though their effectiveness is still a topic of research.
Surgical Treatment Options
When non-surgical treatments are insufficient in managing symptoms or when wrist arthritis is particularly severe, surgical options may be considered.
Arthroscopic Debridement |
A minimally invasive surgery where small incisions are made, and a camera (arthroscope) is inserted into the wrist joint. The surgeon can clean the joint area, removing loose cartilage, inflamed tissue, or bone spurs. |
Joint Fusion (Arthrodesis) |
In this procedure, the bones of the joint are fused. It provides pain relief but may reduce mobility of the wrist. It’s often considered for severe arthritis where motion is already limited. |
Total Wrist Arthroplasty (Wrist Replacement) |
This involves replacing the affected joint with artificial components. Wrist replacement can relieve pain and preserve more wrist motion than fusion, but it may not be suitable for everyone, especially those with high physical demands. |
Proximal Row Carpectomy |
This surgery involves removing some of the carpal bones from the wrist, which can relieve pain while maintaining some level of wrist motion. |
Denervation |
This involves cutting the nerves around the arthritic joint to alleviate pain. It does not address the underlying arthritis. |
Prevention Strategies
While it’s not always possible to prevent wrist arthritis, certain strategies can reduce the risk and possibly slow the progression of the disease.
- Maintain a Healthy Weight - Reducing stress on the joints by maintaining a healthy weight is beneficial, particularly for weight-bearing joints.
- Regular Exercise - Regular physical activity strengthens the muscles around the joints and can help maintain flexibility.
- Ergonomic Adjustments - For those involved in repetitive hand and wrist movements, ergonomic adjustments at work and in daily activities can reduce strain.
- Protecting the Wrist - Use protective gear during sports and avoid unnecessary strain on the wrist.
- Balanced Diet - Consuming a balanced diet rich in vitamins and minerals supports joint health. Some foods have anti-inflammatory properties that may benefit joint health.
- Avoiding Smoking - Smoking can exacerbate inflammatory conditions and negatively impact overall health.
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew (傅圣耀) is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
What are the early signs of wrist arthritis?
Early signs include joint stiffness, particularly in the morning, mild pain during activities, and occasional swelling in the wrist.
Can wrist arthritis be cured?
While there is no cure for arthritis, the symptoms can be managed effectively through various treatments and lifestyle changes.
How can I differentiate between wrist arthritis and carpal tunnel syndrome?
Wrist arthritis typically causes pain and stiffness in the wrist joint, whereas carpal tunnel syndrome causes numbness, tingling, and weakness in the hand. A medical evaluation is necessary for an accurate diagnosis.
Are there any dietary changes that can help with wrist arthritis?
A diet rich in anti-inflammatory foods like omega-3 fatty acids, fruits, vegetables, and whole grains may help reduce inflammation and joint pain.
Can wrist arthritis lead to disability?
Severe, untreated wrist arthritis can lead to pain and loss of function, potentially impacting daily activities. Early treatment can help prevent disability.
How long does it take to recover from wrist arthritis surgery?
Recovery time varies depending on the type of surgery and individual factors, but it generally ranges from several weeks to several months.