Fair Oaks Orthopedics

Do you feel pain at the base of your thumb, your knuckles, in the joints of your fingers? These are common sites for hand arthritis treatments. Osteoarthritis, rheumatoid arthritis, and psoriatic arthritis are the common types of arthritis that most patients have.

Arthritis can be disabling, especially when it’s in your hands and fingers. It can prevent you from carrying out normal day-to-day activities.

Arthritis is a disease that attacks the tissues of your joints in your hands.  Arthritis can attack the lining of your joints or the cartilage, breaking it down. When the ends of your bones become exposed, they rub against each other and wear away. You have many joints in your hand, making it, unfortunately, a common site for arthritis treatment attacks.

This disease causes joint pain and stiffness that can increase with time. Arthritis Treatment options depend on the severity of your symptoms. They can include splints/braces, medications, steroid injections, etc. If surgery is necessary, this may include joint fusion, joint replacement, and tendon transfer. 

hand ligament injury, Dupuytren's Contracture Treatment

If you are experiencing arthritis in your hands, fingers or thumb and need treatment, please contact us at Fair Oaks Ortho. Dr. Stephen W. Pournaras & our professional medical staff has a vast knowledge of the complex network of blood vessels, nerves, muscles, ligaments, tendons, and bones that make up your hand and wrist and can help you to recover by simply contacting us today.

What Is Arthritis?

The joints in your hands are constantly exposed to stressors due to everyday life, and in most cases your body repairs the damage naturally. With arthritis, this is not the case. The three forms of arthritis that affect the hands are: 

Osteoarthritis effects the protective cartilage that covers the ends of the bones in your hands and effects the joints by gradually breaking it down and wearing it away. Cartilage is a very tough, shock-absorbing material that allows the bones in a joint to glide easily during motion and when gone, causes pain and injury.

The loss of the cartilage causes painful bone-on-bone rubbing. Other symptoms of arthritis include immobility, swelling, and the formation of bony growth spurs in the affected area.

Rheumatoid Arthritis (RA) is a chronic inflammatory disease, leading to hand deformity and loss of function. The protective membrane called synovium that covers joints, secrete a lubricant called synovial fluid, which acts as a cushion between the joints and ligaments to reduce friction between the bones and prevent “wear and tear.” RA causes the synovium to become inflamed, which prevents it from working properly.

Psoriatic arthritis causes pain, swelling and stiffness in  and around the joints in your hands, It affects about 1 in 4 patients who already have the skin condition psoriasis. Some patients may develop psoriatic arthritis before the skin condition psoriasis is even present. 

Psoriatic arthritis and psoriasis are both autoimmune conditions, caused by an issue in your immune system.

Your immune system protects you from illness and infection. But in autoimmune conditions, the immune system becomes confused and attacks healthy parts of the body, often causing inflammation.

Patients with psoriasis can get other types of arthritis, such as osteoarthritis  or rheumatoid arthritis. These conditions are not linked to psoriasis though.

Arthritic Symptoms of the Hands
  • Pain your hands and fingers
  • Swelling in hand/wrist joints
  • Stiffness in joints & hands
  • Hand weakness 
  • Dull or burning joint pain, appearing hours or  after increased use of your hands.
  • Morning pain and stiffness in your hands.

Symptoms Of Prolonged Arthritis

  • Pain changes from dull ache to sharp throbbing sensation.
  • Pain causes you to wake up at night.
  • Pain changes how you use your hands.
  • The tissue surrounding your joint becomes red and tender to the touch.
  • There is grating, grinding, cracking or clicking (crepitus) when you bend your fingers.
  • Your fingers can’t fully open and close.
  • Small bony nodules form on the middle joint of your fingers (Bouchard’s nodes) or at the top joints of your fingers (Heberden’s nodes).
  • Your finger joints become large and abnormally bent.
  • Your hands are weak and less able to do everyday tasks.

Depending on the type of your hand arthritis, and the stage of which it is in, what joints are affected, your age, activity level, which hand is affected (if it’s your dominant hand) and your other existing medical conditions the arthritis treatment options vary.

These options may include splinting/bracing, medications, injections, and non-drug approaches such as:

Splinting/braces

Splits or braces can support and protect your affected joints, reducing the chances of deformity, as well as providing joint stability, relieving the strain, and promoting proper joint alignment.

Medications

Prescription medications can help to reduce your joint pain and swelling and, in the case of rheumatoid or psoriatic arthritis, to prevent damage to your joints. 

  • Acetaminophen. Helps relieve pain.
  • Nonsteroidal anti-inflammatory drugs. Reduces pain and swelling in your affected joints. Examples include ibuprofen, diclofenac, naproxen, celecoxib. Topical NSAIDs are the first topical treatment of choice for osteoarthritis.
  • Disease-modifying antirheumatic drugs. These medications slow the progress of rheumatoid arthritis and relieve symptoms. Examples include methotrexate, hydroxychloroquine, sulfasalazine (Azulfidine®), leflunomide (Arava®).
  • Corticosteroids. Can be taken by orally, injected into your muscle or given by IV, these medications reduce inflammation and other symptoms of rheumatoid arthritis. Examples include prednisolone, prednisone, triamcinolone and methylprednisolone.
  • Immunosuppressive drugs. These medications slow down the progress of rheumatoid arthritis and reduce damage to bone surrounding the affected joints. Examples include azathioprine and cyclosporine.
  • Biologic agents. These medications can slow joint damage in rheumatoid arthritis. Examples include adalimumab (Humira®), etanercept (Enbrel®), infliximab (Remicade®), tofacitinib (Xeljanz®), tocilizumab (Actemra®), abatacept (Orencia®), rituximab (Rituxan®).

Steroid injections

Steroids reduce inflammation and relieve pain. Steroids are usually used if medications don’t manage the inflammation or if the inflammation is limited to a few joints. Injections are added directly into the affected joint. 

Other strategies

  • Exercises — to strengthen and stretch, reducing symptoms and improve hand, fist, finger and thumb function. One of our hand therapists can work with you to give you the best exercises to help your hand arthritis.
  • Hot and cold packs. Cold can help reduce pain and swelling. Heat can help reduce stiffness.
  • Rest. Regular rest periods can help relieve pain and inflammation in your joints.
  • Healthy eating and managing other health conditions that affect your arthritis such as diabetes and high cholesterol levels.
  • Weight loss 
  • Stop Smoking as it increases the risk of developing arthritis.
  • Occupational therapy is offered.

There are several surgical options based on the type and severity of your arthritis and your overall health. Dr. Stephen W. Pournaras Jr., will discuss options & help you decide which is best for you.

The most common surgical procedures are:

  • Synovectomy- involving the removal of diseased or damaged lining of the joints
  • Osteotomy- is the realignment of the bones in a joint
  • Arthroplasty- joint replacement surgery, most common for advanced arthritis

Most hand surgeries are followed by hand therapy to strengthen the muscles and improve function. We offer this therapy as well.

Surgery is recommended to our patients with severe symptoms such as pain, swelling, significant sleep interference, muscle weakness, the beginning of joint deformity. If you haven’t had any relief of your symptoms with at least 6-8 weeks of the non-surgical treatment options please contact us.

Hours:

Mon 8:00 am – 4:30 pm
Tue 8:00 am – 4:30 pm
Wed 8:00 am – 4:30 pm
Thu 8:00 am – 4:30 pm
Fri 8:00 am – 4:30 pm
Sat Closed
Sun Closed

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Fair Oaks Orthopedics

For over 30 years, Virginia Board Certified Physician, Dr. Stephen W. Pournaras, Jr. has provided excellent healthcare and treatment for his patients. As a multi-specialty orthopedic practice, offering the best for you medically to treat, heal and lead you to optimum recovery. We are dedicated to using state-of-the-art technology while building nurturing relationships with each of our patients.

Contact Us Today.

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