Pacific Rim Orthopedic Surgeons

Arthritis in the Hands and Wrist

Arthritis is a disease that attacks the tissues of the joints, of which there are three in the wrist and twenty-seven in the hand. Joints are where two bones meet, and when arthritis develops, the smooth covering at the end of the bones (cartilage) begins to break down and exposes the bones, causing them to wear down over time.

Types of Arthritis that Affect the Hands and Wrist

Arthritis comes in different forms, several of which more commonly develop in the joints of the hands and wrist, including:

  • Osteoarthritis (OA): The most common form of arthritis. It occurs when the protective cartilage at the ends of the bones wears down over time. In the hand, osteoarthritis can affect the base of the thumb and the joints of the fingers.
  • Rheumatoid Arthritis (RA): An autoimmune disease where the immune system attacks the lining of the joints, leading to inflammation and joint damage. This form of arthritis typically affects joints on both sides of the body, so if one wrist or hand is affected, the other one usually is too.
  • Psoriatic Arthritis: Associated with the skin condition psoriasis and can cause joint pain and swelling, along with skin rashes.
  • Post-traumatic Arthritis: Develops after an injury to the hand or wrist, such as a fracture or dislocation. The injury may damage the cartilage and/or disrupt how the joint functions, leading to wear and tear over time.
  • Reactive Arthritis: Develops in response to an infection elsewhere in the body, such as a gastrointestinal or genitourinary infection. 
  • Infectious (Septic) Arthritis: Caused by a direct infection of the joint by bacteria, viruses, or fungi. This type of arthritis is less common but can severely damage the joint if not treated promptly.
A patient experiencing pain at the tips of their fingers.

Symptoms of Arthritis

Arthritis symptoms can be divided into early signs and symptoms that develop in later stages:

Early Symptoms of Arthritis

  • Morning pain and stiffness in the hands
  • Swollen joints in the hands
  • Burning or a dull joint pain, usually occurs hours or a day after higher hand use than normal.

Later Symptoms of Arthritis

  • Early symptoms occur more often
  • Pain in the hand and wrist joints may wake a person up at night
  • Pain may change from a dull ache to a sharp pain
  • Tissue surrounding the affected joints may become red and tender
  • Pain may cause change in how hands are used in everyday life
  • Feeling gating, cracking, grinding, or clicking when bending fingers
  • Fingers can’t open or close fully
  • Small bony nodules form on the middle joint of the fingers or at the top joints of the fingers
  • The finger joints become large and deformed, abnormally bent, with hands becoming weakened to the point that everyday tasks are difficult.
Rheumatoid arthritis seen on an x-ray in the hands of a child.

Risk Factors for Arthritis

Arthritis can develop from several causes, and while not everyone is fully understood, there are risk factors for developing the disease in the hand and wrist joints:

  • Inherited genes that make developing arthritis more likely
  • Being overweight
  • Women are more likely than men to develop arthritis
  • Caucasian people and those of Northern European descent are more likely to develop arthritis

Osteoarthritis is commonly seen in patients over the age of fifty while rheumatoid arthritis can first appear between the ages of thirty-five and fifty.

Hand and Wrist Arthritis Treatments

Arthritis treatments depend on the type of arthritis in the hands and wrist, as well as the severity of it. Treatment options include a range, from medications (both over-the-counter and prescribed) to surgery and lifestyle adjustments:


  • Pain Relievers (Analgesics): Over-the-counter pain relievers like acetaminophen (Tylenol) or, for more severe pain, prescription painkillers.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) to help reduce both pain and inflammation.
  • Disease-Modifying Antirheumatic Drugs (DMARDs): Used primarily for rheumatoid arthritis, these medications include methotrexate and hydroxychloroquine.
  • Corticosteroids: Medications like prednisone can reduce inflammation and suppress the immune system.


Used when other treatments don’t provide relief. Depending on the type and location of arthritis, surgical procedures that may be recommended include:

  • Joint fusion: Used mainly for smaller joints in the wrist and fingers, where two bones are fused together.
  • Joint replacement: Damaged parts of the joint are replaced with plastic or metal components.
  • Tendon repair or transfer: In cases where tendons around the joint are affected.
  • Removal of the joint lining (synovectomy): For rheumatoid arthritis when the joint lining is inflamed.


  • Physical Therapy: Therapists might suggest exercises to strengthen the muscles around the joint and improve the range of motion to better help maintain joint function.
  • Occupational Therapy: Teaches ways to perform daily activities with less stress on painful joints.

Splints and Braces

  • To provide support for affected joints and reduce pain.

Joint Injections

  • Steroids or hyaluronic acid can be injected into the affected joints to reduce pain and inflammation.

Lifestyle and Home Remedies

  • Exercise: Specific exercises can help keep joints flexible.
  • Assistive devices: Using tools and devices designed to take the stress off affected joints, like jar openers and wider pens.
  • Rest: Taking breaks between activities can help reduce pain and prevent further joint damage.

Make an Appointment with our Orthopedic Surgeons

We at Proliance Pacific Rim Orthopedic Surgeons strive to help our patients achieve a return to normal activity through compassionate and exceptional care using evidence-based medicine in a patient-friendly environment. We are committed to bringing you a high standard of care that is patient-focused, with the goal of improving your quality of life.