We use our hands to express ourselves, connect with loved ones, and navigate almost every aspect of our daily lives. When the joints in your hands become stiff, swollen, and painful, even the simplest tasks like turning a doorknob, opening a jar, or holding a pen, can become incredibly frustrating. A healthy joint is lined with smooth, protective cartilage that allows the bones to glide effortlessly against one another. Arthritis occurs when this protective cartilage wears away or is destroyed, causing the bones to grind painfully against each other. Our primary goal is to relieve your pain and restore your function using the most conservative, non-surgical methods possible. We will only discuss surgical intervention when conservative treatments are no longer keeping you comfortable and active.
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Pre-op
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Procedure
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Post-op
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We recommend rest, modifying your activities, taking medications like Tylenol Arthritis and, if possible, oral anti-inflammatories like ibuprofen, Naproxen, celecoxib, or meloxicam. Topical anti-inflammatories like diclofenac (e.g. Voltaren) and cannabis-based creams (e.g. Kalaya Cannabis Sativa) have also shown to be effective. Depending on joint, occasionally splinting can help provide relief (e.g. base of thumb arthritis). If these treatments are not effective, we would then consider steroid injections before surgery.
The joints in the hand are very small, so the idea of an injection can be intimidating. At our clinic, we use ultra-fine needles and often mix the cortisone with a local anesthetic to minimize pain. The joint may feel slightly "full" or ache for a day or two. The powerful anti-inflammatory effect of steroid can provide profound pain relief, but the effect varies between patients depending on the severity of your arthritis. It usually takes about 7-10 days to kick into effect.
We believe surgery is the absolute last resort. The "right time" is entirely subjective and depends on your quality of life. We consider surgical options only when conservative treatments like anti-inflammatory medications and cortisone injections are no longer providing relief, when the pain regularly wakes you up at night, or when you can no longer perform the daily activities you love, such as gripping a golf club, opening a jar, or holding a book.
The basal joint of the thumb is the most common site for hand arthritis. Surgical options include denervation (getting rid of the nerve signals causing pain) vs a trapeziectomy (getting rid of the bone causing pain) and ligament reconstruction with a nearby tendon. Each approach has its advantages, disadvantages, risks/complications, and varies in patient satisfaction. We would be happy to discuss this further with you during your visit with us.
For severe arthritis, other end stage surgical options include joint fusion or joint replacement. For joint fusion, we remove the damaged cartilage and permanently fuse the two bones together, meaning that specific joint will no longer bend,but the pain will be 100% gone, and the joint will be incredibly strong and stable. For joint replacement (arthroplasty), we remove the arthritic bone ends and insert specialized silicone implants, which relieves the pain while preserving your ability to bend the fingers.
Want to learn more? Drs. Mahoney and Yeung use the latest evidence-based practices to guide their care and achieve the best possible outcomes.
