Arthritis of the Wrist
Wrist arthritis is most frequently caused by osteoarthritis or wear and tear arthritis. It may also be the result of inflammatory autoimmune processes such as rheumatoid arthritis. Osteoarthritis is a progressive arthritic process where the cartilage that separates the bones to the wrist degenerate and may lead to distraction of the bones. Typical findings are wrist pain, stiffness, and weakness may occur or swelling. Depending upon wear in the wrist, the arthritis or degeneration that occurs may have different symptoms as the wrist is composed of many different bones. The bones of the wrist proper may be affected where articulation with the bones of the forearm or radius and ulna takes place or where the bones of the wrist meet the bones of the fingers most commonly the thumb or metacarpophalangeal joint arthritis. Often, treatment is initially symptomatic, controlled with medications, reduction in activity that might be predisposing the arthritis or exacerbating it, or even immobilization of the wrists or joints with splints may help to control swelling and joint pain in an active phase. Therapy may have a place as well as corticosteroid injections into the symptomatic area. However, the long term effect is that it can be progressive and continue to degenerate and this is the hallmark of arthritis and unfortunately, treatments aimed at this are symptomatic. Surgical options including removal of the arthritic cartilage or bone or joint replacement or fusion has obvious drawbacks and patients are often looking for alternatives to surgical intervention. Regenerative medicine techniques such as platelet-rich plasma and stem cell therapy offer opportunities to diminish the symptoms of degenerative arthritis with a regenerative approach. Platelet-rich plasma (PRP) and stem cell therapy have gained popularity in other areas including in sports medicine for athletic injuries. However, the same principles can be applied to arthritis of the wrist. Dr. Lox incorporates a regenerative and rehabilitation approach to the treatment of patients with disorders of the wrists. If degenerative arthritis is of concern, laboratory testing or radiographic studies in addition to complete history and physical examination are warranted.
Dr. Lox notes that obviously catching the degenerative process early before joint distraction occurs leads for a better outcome especially when looking for alternative therapy such as platelet-rich plasma (PRP) or stem cell therapy. Modification of exacerbating factors is important, Dr. Lox notes, and a comprehensive program should be incorporated for each individual patient.