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5. Top 10 Hand Arthritis Questions: Dr. Calfee

Top 10 Hand Arthritis Questions

Arthritis is a loss of cartilage which is the smooth surface that covers the bone, allowing joints to move and glide.

2. Are there different types of arthritis?
Yes. The most common types of arthritis are Osteoarthritis and Rheumatoid arthritis. Osteoarthritis is a process where joints essentially get worn out. This may be the result of using joints over a lifetime, but also is related to genetics as arthritis will run in certain families. On the other hand, Rheumatoid arthritis is an immune process where one’s body makes excessive inflammation in and around the joints, eventually destroying the joints. There are other less common inflammatory processes like this, including joint problems associated with gout, lupus, and psoriasis.

3. How do you tell the difference between Rheumatoid and Osteoarthritis?
Although there are blood tests that can be helpful in diagnosing Rheumatoid arthritis, we can usually tell the difference between Rheumatoid and Osteoarthritis based on examining your hands. Osteoarthritis typically affects the joints out in the fingers and at the base of the thumb. Meanwhile, Rheumatoid arthritis mainly affects the joints that link the hand to the fingers.

4. What treatment options are available for arthritis?
There are multiple treatments that you and your doctor can discuss. All of the treatments are designed to decrease painful inflammation associated with arthritic joints.

Conservative Treatment Options

• Heat therapy
• RICE (Rest, Ice, Compression, Elevation)
• Exercises
• Bracing
• Oral and topical anti-inflammatory medications
• Oral or injected steroids
• Activity modification

Surgical Treatment Options

• Replacements and fusions
• Removing bone (at the base of the thumb)

5. If I have arthritis, am I going to get worse every year?
If you have arthritis, you are not necessarily going to get worse over time. Pain associated with arthritis can get better or worse at times, requiring treatment. Despite how arthritis may look on an x-ray, some patients actually become less painful over time. The joints themselves may continue to lose cartilage, but this may stiffen joints and actually result in less pain.

6. Am I continuing to damage my hands with use?
I do not believe that you are damaging your hands by using them if you have arthritis. If joints are somewhat worn, use may result in the hands causing pain. However, this does not mean you are not “doing damage” to your hands.

7. Can arthritis be reversed?
Currently, we do not have a treatment to reverse arthritis or re-grow cartilage. Rheumatoid arthritis can be treated with strong medications that suppress the immune system, but do not reverse joint damage.

8. Can glucosamine or acupuncture help arthritis?
Possibly. I do not believe that either can actually reverse arthritis, but patients have reported pain relief with each method. I have no problem with patients trying these alternative treatments to see if they provide relief.

9. Why would you fuse a joint?
Surgeons may recommend fusing arthritic joints. This does result in a joint that doesn’t move, but typically provides long-standing pain relief in a joint that already has limited motion. One advantage is that a fused joint will stand up to a lot of activity over time.

10. How do I know when I need surgery?
That is a decision that is best made between you and your treating physician. Typically surgery is only considered if conservative treatments fail and the pain from arthritis continues to limit your activity or cause pain that is intolerable.

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