Hand and Finger Arthritis
Dr. Steven Rueda is one of the most sought after surgeons for hand and finger arthritis in Palm Beach. Osteoarthritis, commonly known as arthritis, can occur in any of the joints of the hand. Most commonly it is present in the joints of the fingers and thumb. The word “arthritis” means inflammation in the joint. The symptoms can be very debilitating and limits people from doing basic every day activities.
Hand and Finger Arthritis Symptoms and Diagnosis
The symptoms arising from hand and finger arthritis are caused by the bone-on-bone rubbing as well as the inflammation inside the joint. The two most common joints involved in finger arthritis are the “distal interphalangeal joint” and the “metacarpophalangeal joint”. Some of the most common symptoms include:
- Pain in the fingers with bending
- Pain in the fingers joints with activity
- Swollen and puffy finger knuckles and joints
- Cracking and popping when moving the fingers
- Decreased range of motion with finger movement
In some cases patients present with all of the symptoms, and in some cases only with some of them. Other conditions like a finger sprain and finger synovitis can cause similar findings.
The diagnosis of finger arthritis is usually performed by clinical examination, history, and xray imaging. Dr. Rueda uses xrays to confirm the diagnosis and verify that there is loss of cartilage and bone-on-bone contact.
WHAT CAUSES Hand and Finger Arthritis?
The cause of arthritis is poorly understood. It is however more common with age and after trauma. The normal joint anatomy consist of the two ends of a bone covered by a cartilage cap or cartilage surface; the space between the two surfaces is covered with joint fluid that assist in lubrication. In arthritis, the cartilage in the surface wears out leading the bone to be in contact with bone (See Image). This rubbing of bone-on-bone leads to the pain and inflammation seen in arthritis. The joints affected by hand and finger arthritis are called distal interphalangeal joint (DIP joint), the proximal interphalagngeal joint (PIP joint), and the metacarpophalangeal joint (MCP joints).
Hand and Finger Arthritis Treatment Options
There are three main ways to treat finger arthritis: braces and splints, steroid injections, and surgery. Modern medicine has not found a cure for arthritis, however, there are excellent ways to manage it. The main goal of arthritis treatment is to control pain, and remains the focus of all interventions. A secondary goal is to increase the range of motion of the joint.
Braces and splints do not cure arthritis but help control pain and inflammation with immobilization of the joint. This minimizes the rubbing and grinding of the bone-to-bone interface. Splints are typically not very well tolerated by patients like are wrist splints because of the increasing need to move the fingers in daily tasks and activities like writing, texting, etc.
Steroid injection is an alternative that reduces the inflammation and improves pain in the joint. It is done in the office setting and is very well tolerated. In most cases it provides symptoms relief from days to months, and in some rare situations even years. The injections can be repeated when symptoms resume, but this is not recommended sooner than every 6-8 weeks.
Surgery is indicated for patients who have failed treatment with steroid injections.
Hand and Finger Arthritis Procedure
There are three main types of hand and wrist arthritis surgery: wrist denervation, wrist fusion, wrist replacement (arthroplasty). Dr. Rueda is an expert in all of these procedures, and has presented on the subject in national meetings. Some of the differences across the types of surgery are listed below:
There is a single longitudinal incision in the back of the finger
There is a zig-zag hidden incision centered on the joint in
There is a single longitudinal incision in the back of the finger
Goals of Surgery
• Joint denervation:
Removes the nerves of the affected finger joints to reduce symptoms of pain
• Joint Fusion:
Fuses or joins the two raw bones that are rubbing together in the joint using wires, plates, or screws; it avoids pain by eliminating movement at site of the joint
• Joint Replacement:
Replaces the ends of the bones with implants; it avoids pain by now having implant-to-implant contact and no longer bone-on-bone while preserving motion.
RECOVERY AND DOWNTIME
• Joint Denervation: Outpatient procedure. Most patients are actually surprised at having less pain that they expected. There is tightness, swelling and bruising for first few days after surgery. An elastic bandage is applied and removed in fives days. The patient begins therapy to gradually increase the movement in the finger joint.
• Joint Fusion and Replacement: Outpatient procedures. Patients receive a nerve block to minimize pain after surgery. There is tightness, swelling and bruising for 2-3 weeks after surgery. A splint is worn for 4-6 weeks. The patient begins therapy to gradually increase the movement in the fingers after splint removal.
• Joint denervation: Most patients generally return to work in 1 week when the incision is healed. Weight lifting and heavy manual exercise is not allowed until 3 weeks after the surgery.
• Joint Fusion and Replacement: Return to work depends on the activity and profession. Those whose labor requires strong manual activity usually return to work for basic tasks in 2 weeks.
Why Choose Precision Hand Center for your Hand and Finger Arthritis Procedure?
Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for hand and finger arthritis. Successful results in this procedure requires a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in expert peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best hand and finger arthritis treatment Palm Beach can offer.
FREQUENTLY ASKED QUESTIONS (FAQ)
Patients with classic history, symptoms, and exam who have failed conservative treatment are good candidates for the procedure.
Fortunately the treatments are all excellent at getting rid of the pain. Most patients feel the arthritis pain “gone” after the procedure while they recover from the different “procedure pain”. There will be some loss of finger motion after the procedures compared to before.
Complications in arthritis surgery are specific to every procedure. Dr. Rueda will discuss these with you personally. Fortunately these procedure are safe and enjoy very high success rates with low complication rates.