SPLINTING

Splinting of the wrist and thumb may be helpful in providing temporary relief from symptoms. Splints allow the arthritic joint to rest and keep it from moving. Inflammation is often decreased as a result and the surrounding area is allowed to heal.

Splints should be worn on a part-time basis--during heavy activities that bring on or worsen pain or during flare-ups. Ideally, a splint should be custom fitted. Wearing splints full-time (unless prescribed by your hand surgeon) may result in stiffness in the immobilized joint..

A wrist splint is not a substitute for good workplace design and proper body mechanics. Some experts advise against wearing a wrist splint while working, because doing so can strain the hand's tendons.

MEDICATIONS

Anti-inflammatory drugs, such as aspirin, may help relieve pain and reduce swelling. However they are generally used in association with other treatments, so the actual benefits are still unclear.
When the source of pain is something other than inflammation, use of anti-inflammatory medication is not recommended. Side effects can result from long term use. You should always consult a doctor before taking any medication.

CORTISONE INJECTIONS

Cortisone shots are injections of a naturally-occurring steroid that can provide temporary relief from arthritis symptoms. Injections can be administered directly to the affected area, helping to relieve swelling and pain. Side effects are generally minimal. Up to three injections may be given, each providing between a few weeks and a few months of effective pain management. However, individual patient results may vary.

ARTHROPLASTY

Candidates for hand, wrist or elbow joint replacement or arthroplasty suffer from pain, stiffness and loss of function due to arthritis. However, these procedures are not limited to joints worn out by years of wear-and-tear. Improperly-healed injuries, chronic illnesses and congenital deformities may cause pain and loss of mobility, necessitating surgical replacement.

The surgery is usually considered when other treatments have not provided adequate relief of symptoms. When necessary, it can be a very effective way to take away the pain of arthritis and regain the use of the joint, assuming that it does not need to bear heavy loads.

Wrist replacement surgery may enable you to regain wrist mobility while improving your ability to perform daily activities without pain. Results may be superior to bone fusion, another treatment, which limits movement in the joint.

In certain scenarios, soft tissue arthroplasty is recommended over traditional joint replacement. The process of arthroplasty consists of removing a small support bone and replacing it with a tendon that acts as a cushion to keep the bones separated. As healing progresses, a flexible connection forms between the bones-much like a natural joint.

WRIST ARTHROSCOPY

Arthroscopy is a surgical procedure used to visualize, diagnose and treat problems inside a joint. The word arthroscopy literally means "to look within the joint." In an arthroscopic examination, a small incision is made in the patient's skin and a pencil-sized instrument containing a small lens, camera and lighting system is inserted within the joint. The three-dimensional images are projected on a television monitor, enabling the surgeon to look directly inside the joint and identify the trouble. Tiny probes, forceps, knives and shavers can then be used to correct many problems at the same time.

Diagnostic arthroscopy may be used if your wrist pain is unresponsive to non-surgical treatment or the cause of your wrist pain cannot be identified. The wrist is a complex joint and arthroscopy allows detailed anatomic inspection, resulting in a more accurate diagnosis.

Several conditions can be diagnosed and treated using arthroscopic surgery. These include: ligament injuries, ganglion cysts and fractures. Wrist arthroscopy may also be used to smooth the bone surfaces and remove inflamed tissue.

After surgery, it is important to keep the area around the incision clean and dry to prevent infection. The wrist will need to be elevated for the first few days.

Rehabilitation exercises will be taught to regain range of motion, rebuild strength and reduce swelling. Applying ice to the wrist will also help prevent swelling.

A wrist splint is usually necessary, however one will be prescribed that fits the individual wrist and allows the fingers total mobility.

Postoperative pain is generally mild. Pain-relieving medication will be prescribed to help with any discomfort. The period rehabilitation, splinting and medication will vary depending on the severity of the case.