Hand & Wrist Arthritis
Arthritis of the hand and wrist is one of the most common reasons adults seek orthopedic care. It causes progressive joint pain, stiffness, swelling, and loss of grip strength — interfering with everyday tasks like opening jars, typing, or turning a key. At Maryland Orthopedic Specialists, our hand surgeons treat the full spectrum of hand and wrist arthritis, from early-stage disease managed with splints and injections to advanced cases requiring joint reconstruction or fusion. With offices in Bethesda and Germantown, we offer prompt evaluations and individualized treatment plans so you can get back to doing what matters.
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What is hand & wrist arthritis?
Hand and wrist arthritis is progressive inflammation and wear of the joints in the hand and wrist. The most common form, osteoarthritis, results from gradual loss of cartilage, while rheumatoid arthritis is an inflammatory type. Symptoms include pain, stiffness, swelling, and weakened grip that worsen over time.
Arthritis means inflammation and progressive deterioration of one or more joints. In the hand and wrist, several distinct types occur:
Osteoarthritis (OA) is the most common form, caused by gradual wear and loss of articular cartilage. The basal joint of the thumb — the carpometacarpal (CMC) joint where the thumb meets the wrist — is the single most frequently affected joint in the hand. Osteoarthritis also commonly affects the DIP (distal interphalangeal) joints of the fingers, where it may produce bony nodules called Heberden's nodes.
Rheumatoid Arthritis (RA) is a systemic autoimmune disease that targets the synovial lining of joints, leading to inflammation, cartilage destruction, tendon damage, and characteristic deformities such as ulnar drift, boutonnière, and swan-neck deformity. RA typically affects the MCP (metacarpophalangeal) and wrist joints and is managed in coordination with a rheumatologist.
Psoriatic Arthritis can produce asymmetric joint involvement and "sausage digit" (dactylitis) and often accompanies skin psoriasis.
Calcium Pyrophosphate Deposition (CPPD / Pseudogout) occurs when calcium pyrophosphate crystals deposit in joint cartilage and synovium. In the wrist, CPPD can cause acute inflammatory flares that mimic infection, as well as chronic degenerative changes, particularly around the scapholunate ligament (pyrophosphate arthropathy).
Post-Traumatic Arthritis develops years after a fracture, ligament injury, or dislocation that altered joint mechanics and accelerated cartilage breakdown.
Understanding which type of arthritis is present — and which joints are involved — guides treatment decisions.
Treatment options
Treatment follows a stepwise ladder, escalating only when conservative care is insufficient.
Non-Operative
A splint worn during aggravating activities — particularly a thumb spica for CMC joint pain — reduces stress on the joint and is often the first step. Hand therapy, anti-inflammatory medications, and topical gels help manage pain and maintain movement. Corticosteroid injections into the affected joint can provide weeks to months of relief and are a good option before considering surgery.
Proximal Row Carpectomy
Motion-preserving wrist salvage procedure that removes the scaphoid, lunate, and triquetrum, allowing the capitate to articulate directly with the lunate fossa. Relieves arthritic pain while preserving meaningful wrist motion in SLAC and SNAC wrist.
Click for more Surgical ProcedureWrist Arthroscopy
Diagnostic and operative arthroscopic evaluation of the wrist joint to assess and treat TFCC tears, scapholunate ligament injuries, synovitis, and loose bodies with minimal disruption to surrounding structures.
Click for moreFrequently Asked Questions
Can arthritis be cured?
Is surgery my only option for thumb arthritis?
Will a cortisone shot damage my joint?
What is the difference between OA and RA?
I have CPPD — does that need surgery?
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Related conditions
References
- Spaans AJ, van Minnen LP, Kon M, Schuurman AH, Schreuders AR, Vermeulen GM. Conservative treatment of thumb base osteoarthritis: a systematic review. Journal of Hand Surgery (American Volume). 2015;40(1):16–21.e6. doi:10.1016/j.jhsa.2014.08.047
- Vermeulen GM, Slijper H, Feitz R, Hovius SE, Moojen TM, Selles RW. Surgical management of primary thumb carpometacarpal osteoarthritis: a systematic review. Journal of Hand Surgery (American Volume). 2011;36(1):157–169. doi:10.1016/j.jhsa.2010.10.028
- Halim A, Weiss AP. Total wrist arthroplasty. Journal of Bone and Joint Surgery (American). 2017;99(8):681–693. doi:10.2106/JBJS.16.00901
- Sharma S, Brown GD. Rheumatoid arthritis of the hand and wrist. Journal of the American Academy of Orthopaedic Surgeons. 2014;22(10):618–628. doi:10.5435/JAAOS-22-10-618
- McCarthy DM. Calcium pyrophosphate deposition disease — update on pathogenesis and treatment. AAOS OrthoInfo, 2022. https://orthoinfo.aaos.org