Relief for hand or wrist arthritis: Finding the right treatment to keep life moving

Opening a jar. Buttoning a shirt. Turning a key in a lock. Holding a coffee mug. Most of us perform these tasks without a second thought. But for people living with arthritis in their hands or wrists, these simple daily activities can become frustrating, painful challenges. The good news? Arthritis doesn't have to mean giving up the activities you enjoy.

During a recent Boulder Community Health lecture, orthopedic surgeon Dominik Rog, MD, of Boulder Medical Center, and occupational therapist Jared Alme, OTR/L, of BCH Outpatient Rehabilitation Center, discussed the many treatment options available for hand and wrist arthritis — from medications and therapy to advanced surgical procedures.

While arthritis is one of the most common causes of hand pain and stiffness, Dr. Rog emphasized that many people can successfully manage their symptoms and maintain an active lifestyle.

"Most symptoms due to osteoarthritis can be treated effectively without surgery," Dr. Rog said. "These treatments do not reverse arthritis or halt its progression, but are meant to be ways to try to live with it."

Understanding hand and wrist arthritis

Arthritis is a broad term that refers to inflammation or disease affecting a joint. There are many different types, including rheumatoid arthritis, psoriatic arthritis, gout and infectious arthritis.

The most common type affecting the hands and wrists is osteoarthritis.

Osteoarthritis develops when the smooth cartilage that cushions the ends of bones gradually breaks down. As cartilage wears away, bones begin rubbing against one another, leading to pain, stiffness and loss of function.

Common symptoms include:

• Joint pain

• Stiffness or loss of motion

• Swelling

• Decreased grip strength

• Changes in joint appearance

• Bone spurs or enlarged joints

Many people assume arthritis is simply a result of aging or years of wear and tear. While age can play a role, genetics often contribute significantly, particularly in arthritis affecting the finger joints.

"Some of these forms of arthritis have a very strong genetic contribution," Dr. Rog shared.

When everyday tasks become difficult

Hand arthritis can affect multiple joints throughout the hand and wrist.

For some people, symptoms begin with stiffness in the fingertips. Others notice pain at the base of the thumb when opening jars, gripping tools or carrying grocery bags. Wrist arthritis may make activities such as gardening, golfing, yoga or lifting weights increasingly uncomfortable.

As symptoms progress, many people begin compensating without realizing it. They avoid using certain fingers, modify how they grip objects or stop participating in hobbies they once enjoyed. Unfortunately, avoiding movement altogether can create additional problems. That's where therapy often plays a critical role.

Treatment doesn't always mean surgery

Many patients are surprised to learn how many nonsurgical options are available.

Depending on the severity of symptoms and the joints involved, treatment may include:

• Topical anti-inflammatory medications

• Oral anti-inflammatory medications

• Acetaminophen

• Splints or braces

• Occupational or hand therapy

• Corticosteroid injections

• Acupuncture

• Activity modification

• Joint protection techniques

Dr. Rog also discussed supplements commonly used by patients with arthritis.

While research results vary, glucosamine, chondroitin and turmeric are among the most frequently used options.

"These are difficult topics to study," he said. "That doesn't mean they're not effective. They're just difficult to prove efficacy."

For patients seeking additional options, emerging treatments such as platelet-rich plasma (PRP), stem-cell-based therapies and hyaluronic acid injections continue to be studied. Although some have shown promise, they may not be covered by insurance and often require further research.

The role of cortisone injections

One of the most common questions patients ask involves cortisone injections.Corticosteroids are powerful anti-inflammatory medications that can temporarily reduce pain and swelling inside a joint. For many patients, injections provide meaningful symptom relief and can delay the need for surgery.

However, Dr. Rog noted that treatment decisions should always be individualized. Factors such as diabetes, overall health, severity of arthritis and the specific joint involved all influence whether cortisone injections are appropriate.

"They can be very effective for decreasing (arthritis) pain," he said.

Why thumb arthritis deserves special attention

Among all the forms of hand arthritis, arthritis at the base of the thumb is one of the most common reasons patients seek treatment. The thumb carpometacarpal (CMC) joint allows the thumb to move in multiple directions and perform opposition — the motion that lets us pinch, grasp and manipulate objects. Because this joint experiences significant stress throughout life, it is particularly vulnerable to arthritis.

Dr. Rog noted that thumb CMC arthritis affects up to one-third of women in their 50s and 60s and can begin even earlier.

Patients often experience:

• Pain with pinching or gripping

• Weakness when opening jars

• Difficulty turning keys

• Loss of hand endurance

• Changes in thumb appearance

As the condition progresses, the thumb may gradually collapse inward, altering the mechanics of the entire hand. Fortunately, both conservative and surgical treatments can provide significant relief.

Splints can make a difference

For patients with thumb arthritis, a well-designed splint can reduce stress on the joint while allowing continued use of the hand. Some patients benefit from custom-made splints created by occupational therapists, while others find relief using off-the-shelf braces. The key is finding a solution that provides support without overly restricting function. A properly fitted splint can reduce pain during daily activities and help patients continue participating in work, hobbies and exercise.

When surgery becomes the best option

Although many patients manage arthritis successfully without surgery, there are situations when surgical treatment offers the greatest improvement in quality of life. The right procedure depends on which joint is affected, the severity of arthritis and the patient's goals.

For finger joints, options may include:

• Joint fusion

• Joint replacement

For thumb arthritis, one of the most common procedures involves removing a small wrist bone called the trapezium and reconstructing the joint to relieve pain while maintaining function.

For wrist arthritis, procedures may involve removing arthritic bones, fusing portions of the wrist or, in select cases, replacing the joint entirely.

Advances in surgical techniques have allowed many patients to regain function while significantly reducing pain.

Movement is medicine

While surgery often receives the most attention, both speakers emphasized that movement remains one of the most powerful tools for managing arthritis.

"Movement is medicine," Alme emphasized.

Gentle movement helps:

• Lubricate joints

• Improve circulation

• Reduce stiffness

• Maintain flexibility

• Strengthen supporting muscles

• Activate natural pain-relieving mechanisms within the body

Many people avoid movement because they fear worsening their arthritis. In reality, appropriate exercise often helps people feel better.

Alme demonstrated several simple exercises designed to improve mobility and maintain hand function, including wrist movements, finger stretches, thumb mobility exercises and gentle grip strengthening. View the full lecture in the video at the bottom of the page.

A small amount of discomfort during exercise is often acceptable.

"I don't want you screaming while you're doing these," Alme joked.

Applying heat before exercise can also help reduce stiffness and make movement more comfortable.

Strength matters, too

While flexibility is important, strength plays an equally important role. The muscles surrounding arthritic joints act as stabilizers. Stronger muscles can help reduce stress placed on damaged joints during everyday activities. However, both experts cautioned against overdoing it.

Too much strengthening — especially in severely arthritic joints — can aggravate symptoms.

Working with a hand therapist can help patients find the right balance between maintaining strength and avoiding unnecessary irritation.

Joint protection strategies can help preserve function

Occupational therapy goes far beyond exercise. Therapists also teach patients how to modify activities to reduce stress on painful joints.

These strategies may include:

• Using larger joints instead of smaller finger joints

• Modifying grip patterns

• Taking frequent breaks during repetitive activities

• Using adaptive equipment

• Improving workstation ergonomics

• Wearing supportive splints when appropriate

These small adjustments can make a significant difference over time.

Schedule an appointment

If hand or wrist pain is interfering with your daily activities, you don't have to simply live with it. Whether you're interested in conservative treatment, hand therapy or learning if surgery is right for you, help is available. To schedule an appointment with Dr. Dominik Rog at Boulder Medical Center, call 303-440-3036. To schedule an occupational therapy evaluation with Jared Alme, OTR/L, at BCH Outpatient Rehabilitation, call 303-415-4340.

Watch the full lecture below.