What are the signs and
symptoms?
In the early stages of the disease, joint problems are
the most common symptoms. A general sense of being tired,
or just not feeling quite right, often happens before
the slow start of joint pain and swelling. Morning stiffness
is a frequent complaint. As the disease continues, symptoms
may include swelling of different joints in the hands,
wrists, elbows, shoulders, hips, knees, and feet. The
swelling usually takes place in the same joint on both
sides of the body, known as symmetrical swelling. Rheumatoid
arthritis may result in pain and deformity. Occasionally,
the disease affects other organs of the body, such as
the heart, eyes, and lungs.
How
does it affect the hand?
Generally,
the first and most common complaint is swelling of the
hand at the knuckles, that gives the fingers a spindle
shape. This swelling often happens in the wrist and
the large knuckles in the middle of the hand. The swollen
tissue may destroy the ligaments that hold the joints
together, and damage cartilage and bone. This can result
in certain deformities. The wrist may turn toward the
thumb side of the hand, causing “ulnar drift”
of the fingers (see Figure 1). The swollen tissue may
also produce damage, causing the tendons to rupture.
When the tendon ruptures, you may not be able to bend
or straighten your finger. Other problems that may happen
are swelling that causes pressure on the nerves (carpal
tunnel syndrome), or lumps (rheumatoid nodules) found
over various joints of the hand and elbow.
How is it treated?
Rheumatoid
arthritis is usually treated with medication. Surgery
may help when medicine does not control the disease.
A wide variety of non-steroidal, anti-inflammatory,
cortisone-like prescriptions are usually used. Education
for learning to live with the limitations caused by
this disease, such as aids for daily activities, splinting,
and information on how to avoid damaging the swollen
joints, can be provided by a hand therapist. Contact
your local Arthritis Foundation for resources and more
information about rheumatoid arthritis.
Click here to Read More about
Rheumatoid Arthrits and Hands.
Surgery
may only be considered when medical treatment does not
work. The goals of surgery are to: 1) reduce pain, 2)
improve function, and 3) improve appearance. Surgical
treatment may include removing the swollen tissue from
the joints or around the tendons, which may reduce pain
and prevent more tendon damage. If the tendon has already
been damaged, surgery may be done to repair the damage.
Rheumatoid nodules may be surgically removed to improve
appearance and comfort. In some cases, large knuckles
of the hand may be treated by arthroplasty, a procedure
where artificial knuckles (made of silicone rubber or
other material) are inserted. This may improve the use
of the hand and lessen pain. Surgical procedures performed
on the rheumatoid hand and wrist are often complex and
may require therapy.
Click here to read more about
Rheumatoid Arthritis
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