52017May

What to Expect if You Develop Small Joint Arthritis

Fingers are so useful that anything that interferes with their ability to move properly can derail everyday activities.  One of the disorders that affects how fingers work is small joint arthritis.

Overview of Small Joint Arthritis

The Arthritis Foundation notes that a joint in the hand is the meeting of two or more bones.  While the thumb contains two joints, every finger has three.  Cartilage covers the surfaces of bones where they converge to make joints.  This provides a gliding surface as bones move against each other.  A capsule lined with a thin membrane that secretes lubricating fluid encloses finger joints.

After significant wear or damage to cartilage, a joint sometimes loses its ability to function normally.  Pain and stiffness typically result.  The cause might be rheumatoid arthritis, gout, osteoarthritis, other inflammatory disorders, or trauma such as a fracture.

The American Academy of Orthopaedic Surgeons reports that more than 100 distinct types of arthritis exist.  When arthritis results from a disease process, cartilage level decreases at a slow rate, causing the gradual development of these joint symptoms:

  • Pain that is either dull or burning
  • Swelling
  • Sensation of grinding or grating
  • Development of small cysts
  • Obvious joint deformity

Diagnosis and Treatment

Physicians diagnose finger arthritis after a physical examination and the use of X-rays.  No treatment is necessary if the patient has no significant pain, even when there is a joint deformity.  Most individuals who do require treatment receive non-surgical therapy.

A hand doctor customizes treatment according to each patient’s needs.  Determination of the appropriate non-surgical treatment relies on:

  • Degree to which arthritis has advanced
  • Number of joints involved
  • Patient’s age, activity level, and other health issues
  • Involvement of the dominant or non-dominant hand
  • Patient expectations and ability to comply with a treatment

Non-surgical options include:

  • Medications.  The most frequently used are anti-inflammatories such as acetaminophen.  Some patients take supplements, most commonly glucosamine and chondroitin.
  • Injections.  They contain a combination of a steroid and an anesthetic designed to last over time.  If they prove effective, the physician can opt to repeat them after a period ranging from weeks to months.
  • Splinting.  A splint eases the stress a finger joint normally experiences from frequent use.  Most patients wear them only when they are experiencing pain.

Surgical options include joint fusion or joint replacement.  A majority of patients regain light use of the affected hand shortly after joint surgery.

Hand doctors choose to preserve or reconstruct a joint whenever possible.   However, when the joint no longer works, they recommend a fusion.  Although this procedure relieves pain, it removes the ability of the joint to move.

The objective of a joint replacement is two-fold:  relieving pain and restoring function.  Replacement components are usually ceramic or made of durable metal and plastic.