Hand and Finger Arthritis

Degenerative arthritis is the final common pathway for all forms of arthritis, including osteo-, psoriatic (associated with the skin disease psoriasis) and rheumatoid to name a few.

There are 19 bones in the hand and fingers, each of which is separated by small but important joints that, acting together, enable the dexterous movement of the hand. Each of these joints is covered in cartilage that ensures smooth movement. These joints may be affected by degenerative arthritis over time if the cartilage wears out. The bone plate beneath the worn-out cartilage is richly supplied with nerve endings that activate as the bones grind against each other, creating the pain of arthritis.

Any of these small joints may succumb to arthritis, the end result of which is often painful, swollen and stiff wrists or fingers.



  • Management
Management

Non-operative

Non-operative management is directed to try and delay surgical intervention as long as is reasonably possible without significantly affecting daily life. These include avoiding activities that give pain, rest, paracetamol and anti-inflammatories to still the pain and advice on the correct exercises to maintain mobility and strength in the hand. In some cases, a steroid injection is indicated to relieve very severe pain. A good response to this injection is likely indicative of a subsequent good surgical outcome.

Operative

Operative management is tailored according to which joint is affected, but the principle is either to replace or fuse the joint, all aimed at taking the pain away and maintaining optimal function for each patient as their needs require. Finger joint replacement originated 80 years ago, and modern designs provide sustained relief and good function in the majority of patients.

Conditions Managed



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