When to see a hand surgeon for arthritis pain

If you’ve noticed you have difficulty with simple tasks like opening jars or turning keys, you may wonder if it’s arthritis or another hand condition like tendonitis or carpal tunnel syndrome.

Arthritis can occur in any joint in the body, including the fingers, thumb and wrist. It’s the wearing down of cartilage — the smooth surface that allows joints to move freely and painlessly. As we age, this cartilage can deteriorate, leading to joint pain and stiffness.

Arthritis develops gradually and feels dull and achy. Symptoms may be worse in the morning but can improve throughout the day. The base of the thumb is a common site of pain, especially during pinching, grabbing or twisting motions.

In contrast, tendonitis is often triggered by overuse or strain. It causes sharp, burning pain and develops quickly. Carpal tunnel syndrome is characterized by numbness and tingling in the hand due to nerve compression.

While arthritis isn’t curable, its symptoms can be managed. If you’re experiencing pain in your hands, the best thing to do is start a discussion with your primary care provider. They will likely order an X-ray to confirm the diagnosis and assess the severity.

Lifestyle changes and medications

“If you’re diagnosed with arthritis, you’ll want to start avoiding the activities that bring about pain and change the way you do certain things,” says Justin Barker, MD, with MultiCare Rockwood Clinic.

If you’re having trouble opening a jar, for instance, you might get an under-cabinet or hand-held appliance that helps open jars.

Your primary care provider might recommend taking over-the-counter anti-inflammatory medications like ibuprofen or Aleve (naproxen).

When those aren’t effective, your provider may prescribe prescription medications such as diclofenac, celecoxib or meloxicam, which are gentler on the stomach but may require periodic lab monitoring.

“We don’t always make every patient try every single one of these approaches; we do what’s best for the patient, their symptoms and their needs.”

Other nonsurgical treatments include topical creams or gels that can be applied directly to painful joints, as well as splints and braces that can help support and stabilize joints.

If medications, activity modifications or topical treatments fail to provide relief, scheduling an appointment with a hand surgeon may be your next logical step.

At this stage, the surgeon will review your history and discuss additional options, including cortisone injections, which deliver anti-inflammatory medication directly into the joint.

“Cortisone injections are like taking a whole bottle of aspirin and putting it right in the joint — without the GI side effects,” Dr. Barker adds. “They can be very effective.”

Steroid injections sometimes offer relief for three to nine months. They can be repeated, but are typically spaced at least three months apart.

Surgical options for advanced arthritis

“If a patient has exhausted all the various approaches, we then start talking about surgery,” Dr. Barker explains.

The surgical approach you and your surgeon decide to take depends on the severity of symptoms and your needs. Common procedures include:

• Joint replacement: The damaged joint is replaced with an artificial one.

• Joint fusion: The arthritic joint surfaces are removed, and the joint is fused using pins, screws or plates to eliminate movement and pain.
• Bone removal: The bone causing pain is surgically removed to relieve symptoms.

“If surgery is recommended, it’s usually very successful.” Dr. Barker adds. “It takes care of the pain, it’s unlikely the patient will need to do more treatments, and most people are very happy with the result.”