Restore Comfort and Motion to Your Hands
Do you struggle to open jars, turn doorknobs, or even hold a coffee cup without pain? You might be living with wrist arthritis. At California Pacific Orthopaedics in San Francisco, we specialize in helping patients manage pain and regain function. Whether you are an artist, a tech professional, or simply want to play with your grandchildren, our expert hand surgeons are here to help.
Overview: What is Wrist Arthritis?
Your wrist is a complex joint made up of eight small bones (carpal bones) and the two long bones of your forearm (radius and ulna). In a healthy wrist, the ends of these bones are covered in a smooth, slippery substance called articular cartilage. This cartilage allows the bones to glide against each other easily, like ice on ice.
Arthritis essentially means “joint inflammation.” It occurs when that smooth cartilage wears away or gets damaged. Without this protective cushion, the rough surfaces of the bones rub directly against each other. This bone-on-bone friction causes pain, swelling, and stiffness.
While there is no cure for arthritis, it is very treatable. With the right care, many patients can manage their symptoms and continue doing the things they love.
The Three Main Types of Wrist Arthritis
- Osteoarthritis (OA): This is the “wear and tear” type. It happens gradually over time as cartilage naturally wears down. It is common as we age.
- Post-Traumatic Arthritis: This happens after an injury. If you broke your wrist or tore a ligament years ago, the joint may not have healed perfectly smooth. This uneven surface wears out the cartilage faster than normal.
- Rheumatoid Arthritis (RA): This is an autoimmune disease where your body’s immune system attacks its own tissues. It often affects both wrists at the same time and can cause severe swelling.
Common Symptoms
Wrist arthritis doesn’t always hurt the same way for everyone. Some people have “good days and bad days,” while others have constant pain.
Signs you should see a doctor include:
- Pain: The most common symptom. It may feel like a deep ache inside the wrist or sharp pain when you move your hand.
- Stiffness: You might notice your wrist feels “rusty” in the morning or after sitting still for a while.
- Swelling: The wrist may look puffy or larger than the other one.
- Weakness: You may find your grip strength is gone. Dropping things or struggling to turn keys is common.
- Clicking or Grinding: You might feel or hear a crunching sensation (crepitus) when you rotate your wrist.
- Limited Motion: You cannot bend your wrist as far back or forward as you used to.
Causes and Risk Factors
Why did this happen to you? Understanding the cause is the first step toward treatment.
Common Causes
- Aging: Just like the tread on a tire wears down over miles of driving, our cartilage wears down over decades of use.
- Past Injuries: A broken wrist (distal radius fracture) or a torn ligament (scapholunate tear) changes the mechanics of the joint. Even if the injury was 20 years ago, it can lead to arthritis today.
- Kienböck’s Disease: A condition where blood supply to one of the small wrist bones is interrupted, causing the bone to collapse and leading to arthritis.
Risk Factors
Certain things make you more likely to develop wrist arthritis:
- Age: It is most common in people over 50.
- Family History: If your parents or siblings had arthritis, you are more likely to have it.
- Gender: Women are more likely to develop osteoarthritis and rheumatoid arthritis than men.
- Activity Level: High-impact activities or heavy manual labor over many years can speed up the wear and tear on your joints.
Diagnosis: How We Find the Problem
At California Pacific Orthopaedics, we don’t just look at your wrist; we look at how the condition affects your life. Our diagnosis process is thorough but simple.
Physical Examination
Your doctor will talk to you about your medical history and examine your hand. They will move your wrist to see where it hurts and how much motion you have lost.
Imaging Tests
- X-rays: This is the most useful tool. X-rays clearly show the space between your bones. If you have arthritis, that space will be narrow or gone completely. We may also see bone spurs (small, bony bumps) or cysts.
- MRI or CT Scans: Sometimes we need a more detailed picture to check the condition of the bones and soft tissues, especially if we suspect a specific bone issue like Kienböck’s disease.
- Blood Tests: If we suspect Rheumatoid Arthritis or another inflammatory condition, we may order blood work.
Treatment Options
Our goal is always to relieve your pain with the least invasive treatment first. We use a “ladder of care,” starting with simple steps and moving up only if necessary.
Non-Surgical Treatments
For many patients, these steps are enough to manage the pain for years.
- Activity Modification: We help you identify which motions hurt (like doing push-ups on your palms) and find ways to avoid them (like doing push-ups on your knuckles).
- Splinting: Wearing a rigid wrist brace supports the joint and stops the bones from rubbing together. This is especially helpful at night or during heavy activity.
- Medications: Anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can reduce swelling and pain.
- Hand Therapy: A certified hand therapist can teach you exercises to keep your wrist flexible and strong without causing more damage.
- Injections:
- Cortisone: A steroid shot can provide powerful, long-lasting relief from inflammation.
- Lubricant Injections: In some cases, we may discuss other injection therapies designed to soothe the joint.
Surgical Treatments
If non-surgical treatments stop working and your pain is affecting your quality of life, surgery may be the best option. San Francisco is a hub for advanced medical care, and our surgeons are leaders in these techniques.
- Proximal Row Carpectomy (PRC): In this procedure, the surgeon removes three small bones from the wrist. This simplifies the joint and removes the arthritic surfaces.
- Best for: Patients who want to keep some wrist motion and get back to activities quickly.
- Partial Wrist Fusion: The surgeon fuses (joins together) only the specific bones that are damaged, leaving the healthy bones alone.
- Best for: Preserving some motion while eliminating pain in the worst part of the joint.
- Total Wrist Fusion: The surgeon connects the forearm bone to the hand bones using a metal plate. The bones heal into one solid unit.
- Best for: Severe arthritis. It completely eliminates pain because the joint no longer moves. You will lose the ability to bend your wrist, but you will have a very strong, stable, and pain-free hand.
- Total Wrist Replacement: Similar to a knee replacement, the damaged bones are removed and replaced with metal and plastic components.
- Best for: Patients with Rheumatoid Arthritis or lower-demand lifestyles who prioritize keeping motion over heavy lifting.
What to Expect During Recovery
Recovery depends heavily on whether you have non-surgical or surgical treatment.
With Non-Surgical Care: You can usually continue your daily life, using splints and medication as needed. It is about “management,” not a “cure.”
With Surgery:
- Immobilization: You will likely wear a cast or splint for 4 to 6 weeks to let the bones heal.
- Therapy: Physical therapy is crucial after surgery (except for full fusion) to regain movement.
- Timeline: Most patients return to light activities after 6 to 8 weeks, with full recovery taking several months.
Why Choose California Pacific Orthopaedics?
Your hands are your livelihood. Whether you are typing code, performing surgery, cooking for your family, or playing an instrument, you need hands that work without pain.
Local San Francisco Experts We are proud to serve the Bay Area community. Our surgeons are fellowship-trained in hand and upper extremity surgery. This means they have completed extra years of specialized training specifically for the complex anatomy of the hand and wrist.
Customized Care Plans We know that a 25-year-old athlete with post-traumatic arthritis needs a different plan than an 80-year-old with osteoarthritis. We don’t use a “cookie-cutter” approach. We listen to your goals and build a treatment plan that fits your life.
Advanced Techniques From the latest biologic injections to precision surgical fusions, we use the most up-to-date medical technology available.
Ready to Stop the Pain?
You don’t have to live with a painful wrist. If arthritis is slowing you down, let us help you get moving again.
Schedule a consultation today with one of our San Francisco hand specialists. Call us at (415) 668-8010 to make an appointment.
