Osteoarthritis in the Hand, Wrist, Arm, Elbow and Shoulder

Arthritis can affect any joint in the body. This includes the joints of the shoulder and elbow and the joints between the 29 bones of the wrist, hand, and fingers. Osteoarthritis, also known as “wear and tear” arthritis, is a degenerative joint disease in which the smooth cartilage that covers the bone surfaces at the joints wears down over time, leading to pain, stiffness and swelling. Osteoarthritis typically affects people who are middle-aged or older.

Orthopaedic surgeons at Brigham and Women’s Hospital (BWH) are experts at diagnosing and treating osteoarthritis. They provide non-surgical treatment options, including splinting, anti-inflammatory medication and injections. They also provide innovative surgical approaches such as arthroscopy, osteotomy, joint fusion and joint replacement.

Causes

Causes of osteoarthritis include:

  • Degenerative cartilage
  • Gout
  • Heredity
  • Injury and overuse
  • Infection

Symptoms

Symptoms of osteoarthritis can include:

  • Deformity
  • Pain
  • Stiffness
  • Swelling
  • Bony nodules at the finger joints (Bouchard’s or Heberden’s nodes)
  • Weak grip
  • Weak pinch

Diagnosis

Your orthopaedic surgeon will evaluate your medical history and may conduct a variety of tests to determine if you have osteoarthritis:

  • Physical examination
  • X-ray
  • Rarely, an MRI or other test may be needed

Treatment

Non-surgical Treatment

The goals of osteoarthritis treatment are to relieve pain and restore function.  The majority of patients are treated without surgery.  Non-surgical treatments include:

  • Anti-inflammatory medication
  • Assistive devices
  • Exercise and stretching
  • Splint
  • Lifestyle modifications
  • Pain medication
  • Physical and occupational therapy
  • Steroid injection

Surgical Treatment

If non-surgical treatment does not relieve your symptoms, surgery may be recommended. Surgical approaches include:

  • Arthroscopy involves using small incisions and an arthroscope (thin, fiberoptic instrument) to remove bone spurs, cysts, damaged lining or loose fragments in the joint.
  • Osteotomy involves realigning the long bones of the arm to take pressure off the joint.
  • Joint fusion involves removing worn cartilage and fusing the bones on each side of the joint together.
  • Joint reconstruction involves removing the worn joint surface and replacing it with your own soft tissue or with an implant.
  • Joint replacement involves removing parts of the bones and creating an artificial joint with metal or plastic components.

Recovery

The length of recovery varies for each individual. Our physical therapists and occupational therapists can help speed your recovery following joint surgery through range of motion, strength and flexibility exercises.

Learn more about osteoarthritis – BWH Health Library

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