Osteoarthritis In The Wrist

Learning The Signs Because Early Diagnosis Is Key...

The Short Answer – Would you know the difference between a pain in the wrist and osteoarthritis in the wrist?

Early diagnosis is key to successful treatment, so your wrist pain is not something to ignore, especially if you have a family history of osteoarthritis.

In this article we look at the potential causes and early symptoms of osteoarthritis, so you wont miss it if it start developing in your wrist…

Why Does The Wrist Get Osteoarthritis?

Your wrist is actually a prime target for osteoarthritis, because it is isn’t one single joint, but rather a complex web involving multiple joints.

Indeed, according to The Journal of Hand Surgery 

“osteoarthritis of the wrist is one of the most common conditions encountered by hand surgeons”

Osteoarthritis is a disease that essentially relies on eroding the cartilage that would normally provide padding between two joints. This ‘padding’ allows smooth movement of the joint (together with a pocket of synovial fluid).

Remove or greatly reduce the padding (cartilage), and you will eventually end up with bone rubbing on bone in your joint.

This in turn will cause infinite amounts of damage to the function of your wrist.

The fact that there are three joints in each of your wrists that all rely on the same structure (unlike a knee joint for example), means that there are many more tiny supporting structures that are also vulnerable to damage.

And as modern science has now shown us, although osteoarthritis is a condition that still results in a wearing down of the joint, it isn’t solely caused by wear and tear.

We now understand that damage to any part of the entire matrix of the joint (including supporting muscles, tendons, ligaments etc – can all trigger the beginning of osteoarthritis.

All of this can leave your wrist highly vulnerable to developing osteoarthritis. Unfortunately, because it isn’t weight bearing, the pain if often managed in the early days very easily.

This may sound like a real advantage – but in reality it means osteoarthritis in the wrist often doesn’t get picked up. That is until it is much more advanced than would be the case in areas where your body weight makes the pain much greater at a much earlier stage.

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Causes Of Osteoarthritis In The Wrist –

As pointed out in The Journal Of Orthopaedics and Trauma (Brown et al), wrist osteoarthritis can simply occur without any obvious reason whatsoever. 

Injuries. Whether this a sprained or fractured wrist, both can cause abnormal joint movement, leading to stress and damage on your articular cartilage (the technical term for cartilage present in joints).

This unbalanced joint movement will lead to extra force being exerted on specific areas of your joint, leading to osteoarthritis developing.

Age. Statistically, women are more likely to develop osteoarthritis than men. Whether this is down to a different strength in the joint supporting matrix, hormonal changes or something else, is unclear.

However, in much older individuals, the difference levels out to affect both men and women in equal measure.

Infections. Any infection can cause inflammation, an abnormal joint balance and ultimately lead to the beginning of osteoarthritis.

Genes. It is not really understood as to why you can inherit a much greater likelihood of developing osteoarthritis, but unfortunately you can. Furthermore, this is often evidenced by a much higher likelihood of people with a family link actually developing osteoarthritis before they are old.

Early Signs/ Symptoms Of Osteoarthritis In The Wrist –

There are a number of key warning signs, unique to osteorthritis in the wrist. These can be listed as…

  • Swelling of the wrist
  • Cracking sound when using your wrist (also known as crepitus)
  • Stiffness in the wrist, that loosens after less than 30 minutes
  • Fluid around the wrist joints
  • Weakness in your wrist
  • A Stiff wrist that is less flexible in the morning, but becomes easier during the day
  • While mobility increases during the day, so does the pain. Getting gradually worse throughout the day
  • Numbness
  • Pain in your hand
  • Knobbly look as bone spurs (extra bone growths) start to form on your joint

What Will Osteoarthritis In The Wrist Feel Like?

Mild Osteoarthrits –
This is likely to feel like an occasional pain in your wrist. You may notice that your wrist just feels strange when trying to do things around the house.

Your overall movement may feel a bit restricted and simple activities such as opening doors, jars or even gripping a golf club may feel strange and painful.

This is the time you need to get to a doctor, get a definitive diagnosis and form a treatment/ management plan.

Moderate Osteoarthritis –

By this stage, the pain in your wrist is likely to be a constant low-level throbbing, even when you are resting. You are also likely to experience flare-ups when your pain levels spike. These episodes are likely to become more frequent as the disease progresses.

You are likely to be restricted in doing simple daily tasks and just to carry them out at all will be tricky. Your wrist is also likely to have become painful just to touch.

To your doctor, the signs of the damage from inflammation will also be present, with a loss of space in the joints the likely outcome.

Severe Osteoarthritis –

Any activity or movement of your wrist hurts. The pain is now constant, because the permanent damage done is substantial.

A physical deformity is quite likely to be noticeable and you may need high strength medication to manage the pain.

A frequent side effect to this form of chronic, severe osteoarthritis, is anxiety and depression – caused in part by the dramatic changes to your lifestyle and overall quality of life.

Diagnosing Wrist Osteoarthritis –

Medical History. Your doctor will particularly be looking to hear about any past injuries. They are also likely to take into account your age, bodyweight and whether you could have an inherited predisposition to the disease.

Physical Examination. In the case of potential osteoarthritis in the wrist, your doctor first be looking for any abnormalities (bone spurs) in your wrist. They will then most locally conduct an analysis of where the pain is located and how mobile your wrist is (does is crunch when being flexed etc).

Blood Tests. If they are unsure about which type of arthritis you may be presenting with, they can order blood tests. These will not determine if you have osteoarthritis, but can rule out other forms such as rheumatoid arthritis.

X-Rays. The next step is to go for some x-rays. This should help your doctor to assess the level of damage to your wrist including a narrowing of the space between joints as a result of damaged cartilage.

MRI/CT Scans. These will only ever be considered if the x-rays of your wrist come out inconclusive. This is very unusual with x-rays of the wrist.

The Final Word –

As noted by Laulan et al in ‘Orthopaedics & Traumatology: Surgery & Research’, the wrist has a very unique set of biomechanics and these give it a high predisposition to developing osteoarthritis.

We know osteoarthritis has no cure and the effects, once established, are not reversible – so the only tools we have to fight this disease is early diagnosis and a varied treatment plan.

Not ignoring the early pain or swelling in your wrist is essential in achieving this.

Hopefully, this has given you the fullest picture of what to look for if you think you might have osteoarthritis in the wrist. The best advice is don’t take a chance – if you think you do have it, then get down to your family doctor for tests.

And then read our article on treatments for osteoarthritis in the wrist for how to stop the disease progressing and help to relieve the pain.

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References Used –

1. Krista E. Weiss and Craig M. Rodner, MD. (May 2007). Osteoarthritis of the Wrist. The Journal of and Surgery.
2. Daniel Brown, Saif Ul Islam and Graham Cheung. (Jan 2019). Management of osteoarthritis of the wrist and hand. Orthopaedics and Trauma Journal
3. J.Laulan, E.Marteau and G.Bacle. (Feb 2015). Wrist osteoarthritis. Orthopaedics & Traumatology: Surgery & Research.

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