Hand Arthritis Treatments

Hand Arthritis Treatments – Rheumatoid Arthritis & Osteoarthritis

This is a transcript of a Dr. Jay Show broadcast on 1560TheGame and this section of the Show covers hand arthritis treatments. Dr. J. Michael Bennett is a Board

A hand affected by rheumatoid arthritis (Photo credit: Wikipedia)

Certified Orthopedic Surgeon and a Fellowship Trained Sports Medicine Physician serving patients from Katy,Fort Bend County, Metro Houston and Southeast Texas from offices in Houston, near the Galleria and Sugar Land, TX. Call 281-633-8600 for an appointment. Our special guest for this Show is Dr. Alan Rodgers, who is a hand specialist practicing in the Katy area.

Here’s the transcript of the third portion of the Show:

Dr. J. Michael Bennett: So we’re going to go back to talking a little bit more about the arthritic issues. We kind of covered nerve pain – the carpal tunnel syndrome is the big issue with the nerve pain and that’s one of the other categories of hand pain we mentioned. Now going back to the arthritic issues real quickly, we were talking about rheumatoid arthritis and that kind of pain that you have with it. Dr. Rodgers, in patients who develop arthritis in their hands and get deformities in their hands, how do they know if they have rheumatoid arthritis by just looking at their hands?
Dr. Alan Rodgers: You can never be certain but it goes along with family history and when you look at the hands of a rheumatologic patient, you’ll notice the fingers start to angulate toward the small fingers, away from the thumb, and that’s a very classic finding. As the joints become arthritic, they push the tendons over to the little finger side and then you tend to see the fingers deviate in that direction. And what that does is it ultimately makes their grip very weak, and it gives them very poor tendon function. And that’s one of the things we look for. Also with rheumatoid arthritis, you look at their wrist; their wrist is often very affected and you have two long bones in your wrist and, again, the one on the small finger side can start to protrude toward the top of the wrist, or where your watch face would be, and that can actually put undue strain on your tendons, and oftentimes even lead to rupture if left untreated. As I said earlier, we’re seeing a lot less severe deformities because medication has come such a long way, but when we do see it, patients have to know that they are at risk for developing tendon ruptures and surgery really should be in their consideration.
Dr. J. Michael Bennett: I think that that’s key. If you have deformities in your hands, obviously you need to have someone look at it. There are an incredible number of treatments out there that can actually take care of a lot of these things medically and bypass the need for surgery, but you have to get out there and see a physician. You need to have it looked at and make sure that you have that diagnosis and sometimes for the diagnosis we have to do some blood work to see if you do have rheumatoid arthritis. It’s something you don’t want to ignore because it’s something that can actually prevent it from getting worse and prevent it from getting to the point where you have a tendon rupture and need some sort of surgery. Going to osteoarthritis now, the wear and tear type of arthritis, what kinds of things are they doing now for this? I know there are replacement options on these joints, where patients get their middle finger joint replaced much in the same fashion as someone having a knee operation.

Severe osteoarthritis and osteopenia of the carpal joint and 1st carpometacarpal joint. (Photo credit: Wikipedia)
Dr. Alan Rodgers: There’s been a lot of improvement lately in the management of osteoarthritis, of course, as he mentions, the wear and tear arthritis. The joints that are involved in osteoarthritis are different than the ones involved in rheumatoid arthritis. And if you look at your fingers you have two joints in each finger, except your thumb of course, and these are the ones that are affected mostly in osteoarthritis, as well as the base of the thumb.
There are new materials that we are replacing these joints with, but it is very patient specific. Not everyone is clearly a candidate for this. But as long as you have good tendon function, good supple skin on the joint, no history of trauma or fractures to the bones, replacing these joints is like doing a knee replacement. The longevity of these new joints still has to be evaluated; they are relatively new but we’ve had very good results and patients seem very happy with them, they are very good at relieving pain, but again if your hobbies include massive construction or lifting heavy objects, you have to weigh the options because these joints are never going to be as strong as native joints.