Wrist Arthritis
Wear or inflammation in the joints of the wrist that can cause pain, stiffness, swelling, weakness and reduced motion.
The wrist is made of several joints that work together, so arthritis can affect movement in more than one direction. It may develop with age, after an injury, or as part of an inflammatory condition.
The appearance of an X-ray and the amount of pain do not always match. Treatment is based on the pattern of symptoms, the joints involved and what the hand needs to do.
Loading anatomy
Common symptoms
- Wrist pain with gripping, lifting or putting weight through the hand
- Stiffness and reduced wrist motion
- Swelling or tenderness around the wrist
- Weakness that makes everyday activities difficult
- Clicking, grinding or a feeling of instability
Causes and contributing factors
- Age-related cartilage wear
- A previous wrist fracture, ligament injury or dislocation
- Inflammatory arthritis such as rheumatoid arthritis
- Arthritis that develops after an old injury changes how load crosses the wrist
- Avascular or other bone problems that alter joint mechanics
How it is evaluated
Evaluation identifies which movements and loads cause pain, how much motion remains, and whether the symptoms come from the wrist joint or a nearby tendon, nerve or forearm joint.
- Assessment of wrist motion, grip and pinch strength
- Examination of each carpal region and the distal radioulnar joint
- X-rays to assess joint space, alignment and old injury
- CT or MRI when a specific bone, ligament, cartilage or tendon problem needs more detail
- Blood tests or referral when inflammatory arthritis is suspected
Nonsurgical treatment
Many people manage wrist arthritis with a combination of load reduction, support, therapy and treatment of the underlying inflammatory condition when one is present.
- Activity modification and ergonomic changes
- A wrist brace for painful activities or periods of flare
- Hand therapy for motion, strength and joint-protection strategies
- Anti-inflammatory medication when appropriate and safe
- A corticosteroid injection in selected joints
- Treatment of inflammatory arthritis with the appropriate medical specialist
Surgical treatment
Surgery is considered when pain and loss of function remain significant despite nonsurgical treatment. The choice depends on which joints are involved, how much motion is useful, and the demands placed on the hand.
- Wrist arthroscopy or debridement in selected conditions
- Limited fusion to stabilise and relieve pain in selected parts of the wrist
- Total wrist fusion when pain relief and stability outweigh the loss of wrist motion
- Wrist replacement in selected patients and patterns of arthritis
- Treatment of a specific old fracture, ligament injury or distal radioulnar-joint problem when it is driving the arthritis
Clinical detail
Wrist arthritis is not one operation or one X-ray pattern. Motion-preserving and motion-sacrificing procedures have different trade-offs, and the plan is matched to the joints involved and the patient’s functional priorities.
Recovery
Recovery depends on whether the procedure preserves wrist motion or stabilises the wrist by limiting it. Therapy is used to protect the repair, maintain available movement and restore useful strength.
- A period of splinting or casting when the bones or joints need protection
- Progressive motion and strengthening guided by healing
- A gradual return to lifting and weight-bearing
- Ongoing management of arthritis in other joints or the opposite hand
When to seek urgent care
Seek immediate medical attention - an emergency department - if you experience:
- A new deformity or severe pain after a wrist injury
- A cold, pale or newly numb hand after trauma
- Rapidly increasing redness, warmth, swelling or fever
This list is not exhaustive. If something about your hand worries you, have it looked at.
Frequently asked questions
Does wrist arthritis always need surgery?
No. Bracing, therapy, activity changes, medication and selected injections help many people. Surgery is considered when pain and functional loss remain substantial despite those measures.
Can wrist arthritis develop after a fracture?
Yes. A fracture or ligament injury can change joint alignment or load distribution, and arthritis may develop later. The current symptoms and the specific joints involved determine what can help.
Related conditions
Wrist Fractures
Breaks involving the end of the forearm bones or the small bones of the wrist, most often after a fall onto an outstretched hand.
Thumb-Base Arthritis
Wear of the joint at the base of the thumb, where the thumb meets the wrist, causing pain with pinching, gripping and twisting.
Carpal Tunnel Syndrome
Pressure on the median nerve where it passes through a narrow tunnel at the wrist, which can cause numbness, tingling and weakness in the hand.
Discuss wrist arthritis with Dr. Champagne
A consultation begins with understanding your symptoms, how they affect what you do, and what has already been tried.