Rheumatoid arthritis of the hands is a chronic inflammatory disorder that affects the synovial membrane of joints, leading to swelling, pain, and loss of functionality over time.
As an autoimmune disease, it involves the body’s immune system attacking its own tissues. In Dubai, Prof Dr Robert Hierner emerges as a top-notch hand specialist and rheumatoid arthritis doctor in Dubai
offering comprehensive evaluations and recommending effective treatment methods for arthritis and joint pain.
Why rheumatoid diseases impact hands?
Rheumatoid arthritis can affect the synovium of all joints, and due to the numerous joint nodes in the hands, they are equally susceptible. Finger joint nodes are particularly prone to swelling, distortion, and constriction, resulting in the characteristic “crooked fingers and wrist” associated with rheumatoid hands.
The causes of these conditions can stem from both age-related degeneration and systemic inflammatory diseases that deteriorate synovium connective tissues earlier than usual, triggering joint inflammation and deformities.
Symptoms of rheumatoid diseases on the hand
The hand arthritis symptoms rheumatoid arthritis of the hand include
- Dull or burning joint pain, occurring hours or a day after increased hand use, is an early symptom.
- Morning pain and stiffness in the hands are common in the early stages of arthritis.
- Due to arthritis, hand swelling.
- As arthritis progresses, symptoms become more frequent, and the pain may change from a dull ache to sharp pain.
- Nighttime pain may disturb sleep as arthritis advances.
- The affected joint’s surrounding tissue may become red and tender to the touch.
- Grating, grinding, cracking, or clicking (crepitus) sensations may occur when bending the fingers. rheumatoid arthritis of the hand
Affected hand parts:
Rheumatoid arthritis of the hand can impact on various parts of the hands over time, including the wrist joint, metacarpal joints, metacarpophalangeal joint (MCPJ), and interphalangeal joints. Disturbances in these areas often lead to symptoms such as swollen finger nodules, joint pain, symmetrical inflammation, stiffness, contorted fingers, and restricted grip function.
- In advanced stages, fingers may lose their full range of motion, leaving them unable to fully open and close.
- The formation of small bony nodules (Bouchard’s and Heberden’s nodes) at the middle and top joints of the fingers, respectively, is common in long-standing arthritis.
- Finger joints may become enlarged, deformed, and abnormally bent, resulting in weak and less functional hands for everyday tasks.
Consequences of rheumatoid diseases on the hand:
The implications of rheumatoid diseases on hand function can vary depending on the extent of damage. Two primary hand functions, grip functions, and sensory functions (tactile gnosis), are typically impaired. Swellings and axial deviations also contribute to significant changes in the hand’s shape, causing aesthetic restrictions.
Treatment options for rheumatoid arthritis of the hand
The treatment of rheumatoid arthritis hand swelling is multifaceted and aims to control inflammation, alleviate pain, preserve joint function, and improve the overall quality of life for the affected individuals. The treatment approach is typically tailored to each patient’s specific needs, considering the severity of the disease, the extent of joint damage, overall health, and the patient’s preferences. Prof Dr Robert Hierner, a renowned hand specialist in Dubai, may recommend the following treatment options:
To effectively manage rheumatoid hand lesions, a comprehensive rheumatological workup is essential. Close cooperation with rheumatology is mandatory. Controlling the systemic disease is crucial, and treatment for the hands may involve conservative therapy, such as physiotherapy and occupational therapy, low grade radiotherapy, and surgical interventions. The treatment plan is customised based on the thorough diagnosis conducted by Prof Dr Robert Hierner, a highly experienced and esteemed hand surgeon in Dubai.
When is hand surgery an option for the treatment of rheumatoid arthritis in hands?
Prevention is the best treatment. Hand therapy/Physiotherapy is the basis of each and every treatment. Adequate Pain management preceeds surgical treatment.
Scenarios when surgery may be considered as a treatment option for rheumatoid arthritis in the hands:
- Severe joint deformities or contractures that impair hand function.
- Persistent pain and disability despite optimal medical management.
- Inability to perform daily tasks or activities due to hand joint limitations.
- Presence of synovial inflammation or nodules that do not respond to medications.
- Irreversible joint damage that affects hand movement and functionality.
- Joint instability or dislocation due to rheumatoid arthritis.
- Failure of conservative treatments to alleviate symptoms and inflammation.
- Significant damage to tendons or ligaments in the hands.
- Ganglion cysts causing pain or nerve compression.
Types of hand surgeries performed
When non-surgical treatments no longer provide relief, and the cartilage at the ends of your bones has worn away due to arthritis, surgery may be considered as an option. Several surgical approaches are available:
- Deformity preventive surgeries: Early removal of the inflamed Tendon and joint sheet (Synovia) is done to reduce the potention of nocive inflammation to tendons and joints
- Tendon Transfer: In cases of tendon rupture caused by ongoing inflammation from arthritis, a healthy portion of a tendon can be used to restore hand function.
- Soft tissue Balancing Surgeries: Deformities due to aberrant tendon displacement should be corrected early, as long as these deformities are still correctable
- Joint Fusion (Arthrodesis): This procedure involves using a plate and screws to fuse the bones of the joint together. While this creates a more stable and pain-free joint, it does limit flexibility and movement.
- Joint Replacement (Arthroplasty): Similar to other joint replacements, this surgery uses an artificial implant made of materials like plastic, ceramics, silicone, or metals to replace the damaged joint. However, it’s important to note that hinged finger implants may not fully replicate normal finger movement.
The choice of surgical approach depends on various factors, including your age, activity level, the affected joint(s), and the level of pain and deformity experienced. You and your surgeon will discuss the most suitable option for your specific hand condition.
Most commonly performed hand surgeries for specific joints affected by arthritis:
- Base of the Thumb: Surgical options for this area include removing part or all of the trapezium bone (located just below the thumb joint), tendon transfer, or joint fusion.
- Knuckles (Metacarpophalangeal Joints): Joint replacement is often considered for knuckle repairs as rheumatoid arthritis can cause severe damage and disability to these joints.
- Second Joint of the Finger (Proximal Interphalangeal Joints): Stiffness and loss of motion due to osteoarthritis are common in these joints. Joint replacement or fusion may be considered as treatment options.
- Top of Finger Joint (Distal Interphalangeal Joints): Arthritis in this joint is commonly treated with joint fusion.
Seeking the treatment of rheumatoid arthritis of the hand?
Choose Prof Dr Robert Hierner for treatment of rheumatoid arthritis of the hand for his extensive expertise in hand surgery and rheumatoid arthritis management.
With personalised care and a successful track record, he ensures pain relief, improved hand function, and enhanced quality of life for those seeking compassionate and effective treatment options.