What is wrist arthritis?
Wrist arthritis refers to the degeneration or inflammation of the cartilage within the wrist joint, leading to pain, stiffness, and reduced function. The wrist is a complex structure composed of eight small carpal bones arranged in two rows, which articulate with the radius and ulna of the forearm. These bones are connected by a network of ligaments that provide stability while allowing a wide range of motion.
In a healthy wrist, the ends of the bones are covered with smooth articular cartilage that enables frictionless movement and absorbs mechanical stress. In arthritis, this cartilage gradually wears down or becomes damaged, resulting in increased friction between bones, joint inflammation, and progressive loss of motion. Over time, this can lead to structural changes in the joint, including deformity and instability.
Causes
Wrist arthritis can develop from a variety of underlying conditions. The most common cause is osteoarthritis, which results from gradual wear and tear of the joint over time. This type of arthritis is more frequently seen in older individuals or in those with a history of repetitive wrist use.
Previous trauma is another important cause. Fractures involving the wrist joint—particularly those affecting the distal radius or carpal bones—can disrupt the normal joint surface and lead to post-traumatic arthritis, even many years after the initial injury. Ligament injuries, such as scapholunate ligament tears, may also cause abnormal joint mechanics and accelerate cartilage degeneration.
Inflammatory conditions, including rheumatoid arthritis and other autoimmune disorders, can affect the wrist by causing chronic inflammation of the joint lining (synovium), leading to cartilage destruction and joint damage. Less commonly, wrist arthritis may result from conditions such as gout or infection.
Symptoms
Symptoms of wrist arthritis often develop gradually and may worsen over time.
Common symptoms include:
- Persistent or intermittent pain in the wrist, often aggravated by movement or weight-bearing activities
- Stiffness, particularly in the morning or after periods of inactivity
- Swelling around the joint due to inflammation or fluid accumulation
- Reduced range of motion, making it difficult to bend or rotate the wrist
- Decreased grip strength, which can interfere with daily activities such as opening jars, lifting objects, or typing
As the condition progresses, patients may also notice grinding or clicking sensations (crepitus) during movement. In more advanced cases, visible deformity or misalignment of the wrist may develop.
Diagnosis
Diagnosis of wrist arthritis involves a thorough clinical assessment combined with appropriate imaging studies.
Your surgeon will take a detailed history, including prior injuries, occupational or recreational activities, and the pattern of symptoms.
During physical examination, the wrist is assessed for tenderness, swelling, range of motion, stability, and strength. Specific tests may be performed to evaluate ligament integrity and pinpoint the location of pain.
Imaging
Imaging plays an important role in confirming the diagnosis and determining the severity of arthritis. X-rays are typically the first-line investigation and may show joint space narrowing, bone spurs (osteophytes), subchondral sclerosis, cyst formation, and changes in alignment of the carpal bones. CT scans provide more detailed information about bone structure and are particularly useful in evaluating complex fractures or subtle joint changes. MRI scans are helpful for assessing soft tissue structures such as cartilage, ligaments, and the synovium, and may be used when inflammatory arthritis or ligament injury is suspected.
Treatment
Conservative (Non-operative)
Management of wrist arthritis depends on the severity of symptoms, the underlying cause, and the patient’s functional needs. Initial treatment is usually non-surgical and focuses on relieving pain and preserving function.
Common conservative treatments include:
- Activity modification: Avoiding or reducing activities that place excessive strain on the wrist
- Splinting or bracing: Providing support and limiting painful movements
- Physiotherapy: Exercises to maintain mobility, improve strength, and support joint function
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
- Corticosteroid injections: Targeted injections into the joint to provide temporary relief of inflammation and pain
These measures can be effective in managing symptoms, particularly in the early stages of the condition.
Surgical
When conservative treatments are no longer effective and symptoms significantly impact quality of life, surgical intervention may be considered. The choice of procedure depends on the location and extent of arthritis, as well as patient-specific factors such as age, activity level, and functional goals. Options may include wrist arthroscopy, a minimally invasive procedure used to assess and treat joint problems such as inflamed tissue or loose fragments within the joint. Other procedures include partial wrist fusion, where selected carpal bones are fused to reduce pain while preserving some wrist movement, and total wrist fusion (arthrodesis), which involves fusing the entire wrist joint to eliminate pain, typically at the expense of wrist motion. In selected patients, wrist joint replacement (arthroplasty) may also be considered, where the damaged joint is replaced with an artificial implant to relieve pain and maintain function.
Recovery
Varies depending on the procedure, but the overall goal of surgery is to reduce pain, improve function, and enhance quality of life.