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Conditions General Hands

What is the Difference Between Osteoarthritis and Rheumatoid Arthritis?

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There are many differences between osteoarthritis and rheumatoid arthritis. The symptoms are similar, but the conditions are actually very different. This is a closeup image of a doctor examining a patient's hand arthritis.

The differences between osteoarthritis and rheumatoid arthritis are significant, but the ability to identify one over the other can be somewhat elusive to the general public. A proper diagnosis is crucial for effective arthritis treatment.

The symptoms of these two common forms of arthritis may be similar, but the conditions are actually very different.

The word “arthritis” itself isn’t as much of a diagnosis as a description of more than 100 different types of ailments that involve joint pain or inflammation. Osteoarthritis and rheumatoid arthritis are two of the most common forms. According to the Centers for Disease Control, more than 32.5 million U.S. adults suffer from osteoarthritis. Rheumatoid arthritis affects more than 1.3 million adults in the U.S.

To help you communicate your concerns to Dr. Arora, we offer the following comparison as a guide.

What is Osteoarthritis?

In very general terms, osteoarthritis occurs when cartilage in a joint wears out. It usually begins in one joint and may never affect other joints.

The pain can be mild, moderate, or severe. Moderate or severe osteoarthritis pain can make it difficult for patients to complete everyday activities, such as buttoning a shirt or tying their shoes.

It is most common among women and occurs more frequently as people get older. Other risk factors for osteoarthritis include obesity, genetics, and joint injury or overuse.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune disease. When this occurs, the immune system essentially “malfunctions” and attacks the synovial membrane that encases and protects the joints. It frequently affect several joints at the same time.

Beyond the pain, inflammation, and swelling common in other forms of arthritis, rheumatoid arthritis symptoms may include fever, anemia, fatigue, and loss of appetite. Rheumatoid arthritis may also show signs in the skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow, and blood vessels. It tends to be symmetrical, so symptoms may occur on both sides of the body simultaneously.

This form of arthritis is a chronic condition. There is no cure, and it is likely to progress over time. However, treatment options can reduce pain, make the symptoms manageable, and prevent significant joint damage.

Women are more likely to develop RA than men are. RA can begin at any age but most commonly starts in middle age. Other risk factors for rheumatoid arthritis include family history, smoking, and excess weight.

4 Key Differences Between Osteoarthritis and Rheumatoid Arthritis

1. Number of Joints Affected

Osteoarthritis may only affect one joint. Rheumatoid arthritis may affect several at the same time.

2. Symmetry

Rheumatoid arthritis tends to be symmetrical, meaning it affects both elbows, for instance. Osteoarthritis is more centralized, so it might or might not affect both sides of the body.

However, both sides of the body may become affected due to the exertion of too much pressure on one side. For example, if you experience osteoarthritis pain in your left wrist, you may use your right wrist more often, eventually causing the right wrist to act up as well.

3. Duration of Symptoms

The duration and extent of the pain is different.

With RA, joint pain and swelling can come and go, but the disease never really goes away. The goal of rheumatoid arthritis treatment is to make you feel better and get your symptoms under control, known as “remission.”

Osteoarthritis is also permanent and the pain and swelling are similar, but the condition can improve over time.

4. Additional Symptoms

Rheumatoid arthritis may have symptoms such as fever, fatigue, anemia, and loss of appetite. Osteoarthritis is usually only pain, swelling, and some loss of flexibility in the particular joint that is affected at the time.

If you are experiencing arthritis pain in your hands, wrists, or elbows, it’s important to determine the type of arthritis in order to create the best treatment and prevention plan for you. For an evaluation, diagnosis, and arthritis treatment, make an appointment to see Dr. Arora in Warren, West Bloomfield, Howell, or Macomb Township.

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General Hands Treatments

Surgical Arthritis Treatment Recovery Time and Results

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Our hand patients have many questions about surgical arthritis treatment recovery time and results. In this image, a doctor wraps a patient's hand and wrist.

If you are scheduled for surgical arthritis treatment, you likely have many questions. Prior to your procedure, we will explain our preparation recommendations, the surgical procedure itself, and the recovery process, as well as address any of your concerns. The following overview also may help prepare you and answer some of the questions you have about surgical arthritis treatment recovery time and results.

Types of Hand Arthritis Surgeries

There are two main types of surgeries for hand arthritis: fusion (arthrodesis) and total knuckle replacement (arthroplasty).

  • Arthrodesis: This procedure involves fusing the bones of the joint together to create a more stable knuckle. It reduces the pain, but leaves the finger with little flexibility.
  • Arthroplasty: In this procedure, the hand surgeon will remove the damaged joint and replace it with a prosthetic implant. The goal is to relieve pain while restoring shape and some function in the hand.

The main goal is to reduce pain when other treatment options are not effective. Whether arthrodesis or arthroplasty is used depends on the location of the joint, the severity of the condition, and the patient’s age, activity level, and preference.

Preparing for the Procedure

There are a number of things you can do to prepare for your hand arthritis surgery. Taking these steps beforehand will facilitate an easier and more optimal recovery period. Following are only a few suggestions that may help.

  • If necessary, rearrange the living room and bedroom in a manner that will allow you to rest easily. For example, place a nesting table beside your sofa, and leave a throw blanket within easy reach.
  • Purchase any post-surgery recovery items you may need, or obtain them from our hand doctor’s office in Warren, West Bloomfield, Howell, or Macomb Township. These may include such things as hand splints; heating/cooling pads; over-the-counter medications; and additional bandages or gauze you may need.
  • Plan for a ride to and from the doctor’s office on the day of your surgery.
  • Shop for groceries ahead of time, buying foods that don’t need too much preparation.
  • If you live alone, see if a friend or family member can stay with you overnight on the first day. If you have young children who need your care, find a babysitter or caretaker who can help you for a few days.
  • Schedule time off work or school.
Surgical arthritis treatment recovery time and results depend on a variety of factors, including the type of hand surgery that was performed. In this image, a doctor examines a patient's hand.
Surgical arthritis treatment recovery time and results depend on a variety of factors, including the type of hand surgery that was performed.

Results and Recovery Time Following Surgical Arthritis Treatment

You will be advised to rest and avoid strenuous activity immediately following surgical arthritis treatment. Although you will likely be able to move around, you may feel drowsy, so you should take it easy on the day of the surgery.

If you were given a nerve block in your hand, the numbness may last up to 24 hours. You will also likely be given a prescription for pain medication. Start taking this medication as soon as you get home, and follow the directions that were given to you.  You may also be advised to take antibiotics.

To minimize pain and swelling, use a pillow to raise your hand above your heart level as you are sitting at home and during sleep. Do this as often as possible for the first few days.

You should also apply ice packs to your hands for the first several hours to reduce and prevent swelling.

Remember to keep the bandages on your hand dry, including during showering, and change the dressing according to the doctor’s directions.

Overall, it will take two to three weeks for your skin to heal and up to 12 weeks before you have full use of your hand. However, you should be able to resume relatively normal activities within a few days, with the exception of activities that involve extensive use of your hands.

Urgent Care After Surgery & Follow-Up Appointments

Most patients will be scheduled for a follow-up appointment within one week after surgery. At this time, Dr. Arora will evaluate your progress and provide you with any additional guidance.

Some pain, minor swelling, and general discomfort following surgical arthritis treatment is to be expected. However, you should call our office if you experience:

  • Excessive bleeding or pain
  • Wound drainage that lasts longer than four days
  • Bluish color in the fingers, excess swelling, coldness, or paleness
  • Nausea or vomiting that lasts more than one day
  • Numbness or tingling of the hand that lasts more than one day
  • Fever that is greater than 101 degrees Fahrenheit

Go to your nearest urgent care facility or emergency department if you need immediate care.

Physical Therapy After a Hand Arthritis Procedure

After your initial recovery period, you may be referred to a physical therapist or an occupational therapist who can tell you how to complete daily activities in ways that are safe for your joints.

Physical therapy will likely involve various exercises to further repair your hand and strengthen your muscles. You may also learn new methods for completing tasks if you have decreased mobility in your hands.

Most patients notice improvement as time goes on. You should take your physical therapy sessions seriously and remain dedicated to your own improvement. The more you train your muscles, the stronger they will become. Strengthening the muscles in your hands will help protect your wrists, elbows, and shoulders as well.

For additional information about surgical arthritis treatment recovery time and results or other treatment options, call one of our southeast Michigan offices.

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General

Thumb Arthritis Defined: What It Is and How It Can Be Treated

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In more serious cases, thumb arthritis can be treated by one of several medical procedures that are available.

Arthritis can affect nearly every joint in your body and your hands, but a very common area for arthritis is the thumb. Thumb arthritis tends to occur in your hands sooner than other forms of arthritis, but other than some minor stiffness, it may take several years before you experience any significant problems. If ignored, however, the arthritis may progress to a more serious level, perhaps even requiring surgery.

So why is a thumb so susceptible to arthritis? And is there any way to prevent it? Read on to learn more.

Arthritis Basics

Before we get into why arthritis affects thumbs more often than other parts of the hand, let’s start with the basic definition of arthritis.

In simple terms, the most common form of arthritis, called degenerative arthritis, occurs when the lubricating, cushioning cartilage at the ends of bones wears away. As a result, the bones rub against each other, causing stiffness, pain, and swelling.

The word “arthritis” is a general word used to describe joint pain or joint disease. In fact, there are more than 100 different types of arthritis, and they affect approximately 300,000 children and 50 million adults. It is more common among women, and risk factors include age, obesity, and lack of physical activity.

Why Thumb Arthritis is Common

The most common type of arthritis in the hands involves the last joint of each finger (nearest the tip), but the second most common is thumb arthritis.

It is also known as basal joint arthritis and occurs when cartilage at the base of the thumb wears away. At first, the symptoms can be so mild that you only notice the problem when you’re trying to do something like unlock a door, zip up your jacket, or snap your fingers, but the symptoms may get worse with time.

The simple reason why it is so common is because of how much we use our thumbs, as well as the fact that the thumb can move in different directions, causing more stress on the joint.  The saddle-shaped joint gives the thumb the ability to move down, up, and across the palm, as well as to pinch.

In addition to age, thumb arthritis is often brought on by injury and may be hereditary.

Thumb Arthritis Prevention, Remedies, and Treatments

You might not be able to completely prevent arthritis, but you may be able to delay it or reduce its effects. Some ways to avoid the progression of thumb arthritis, hand arthritis, or arthritis in other parts of the body include:

  • maintaining a healthy body weight
  • making efforts to protect yourself from injuries when participating in sports, games, or other activities that strain your hands, such as bowling, knitting, cooking, gardening, or home and automobile repair and maintenance.
  • eating a balanced diet rich in fruits, vegetables, whole grains, and spices that fight inflammation
  • taking precautions to avoid injuries when pulling, pushing, or lifting objects
  • using a wrist cushion and a special keyboard if you use your computer often
  • exercising your hands, just as you would other parts of your body, to keep your fingers flexible.

In more serious, acute cases, you can get temporary relief by applying ice to the area or using a heating pad. Both methods have been known to be effective, but it depends on the type of pain and swelling you’re experiencing. Ask your doctor what’s best in your case.

Other remedies may include taking medication, having a cortisone injection at the basal joint area, or having your doctor set the thumb with a splint.

If necessary, treating thumb arthritis may require surgical procedures, such as a trapeziectomy that involves removal of a bone in the wrist, an osteotomy that realigns the bones, or joint replacement with grafts from tendons.

If you are suffering from arthritis pain in your thumb or anywhere in your hands, schedule an appointment to come see us. We’ll help you identify the right treatments for you.

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Categories
Conditions General

A Deeper Look at Rheumatoid Arthritis

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Most are familiar with the term “arthritis,” but many of us do not know that there is more than one form of this condition, including rheumatoid arthritis. Generally, arthritis is meant to describe an inflamed joint (as that is what the word arthritis actually means), but there are a few different ways this can happen.

For example, there is osteoarthritis, there is arthritis that develops following an injury or trauma, and there is arthritis that can develop after an infection, due to gout, and from the skin condition known as psoriasis. There is also rheumatoid arthritis.

Though this does cause inflamed joints, rheumatoid arthritis is a systemic condition, meaning it can appear anywhere in the body – and even spread over time. In any sort of arthritis, the surfaces of the joint cease to move fluidly against one another. When it is rheumatoid arthritis, it can affect any of the bones in the hand, wrist and forearms. It will begin by attacking the synovial tissue, which is composed of cells that lubricate the joints. The synovium will be irritated, inflamed and swollen due to the condition, and this is going to quickly damage the bones and cartilage.

Though it is very common in the hands, it can happen anywhere, and is often found on both sides of the body. In the hands, it will cause the connective tissues between the bones to swell and stretch. This leads to deformity, but so too does inflammation that appears in tendons holding muscles to bones.

Recognizing Rheumatoid Arthritis

It is not difficult for a hand surgeon or expert to recognize the signs and symptoms of rheumatoid arthritis, and the sooner you begin addressing the condition the better your chances at managing it and maintaining range of motion in the hands.

Will you recognize the condition? Firstly, it tends to strike the knuckles of the fingers and the wrist area. It manifests as swelling and stiffness, but can also present some pain. The fingers will often swell, though not uniformly, and one finger may be far more swollen than others. (WebMD, 2015)

You might also notice that individual fingers are suffering some deformity. There are two ways this appears: as a Boutoniere deformity that forces the middle joint of the finger upward or the sway-back deformity that forces the middle joint into a bent position that forces the fingertip downward.

There will sometimes be a noticeable sound during movement, a “drifting” of the fingers in a direction away from the thumb, development of carpal tunnel syndrome (in which inflammation of tendons causes numbness when fingers are bent), tendon rupture, weakness or instability in joints, and a lump at the back of the hand that seems to move when you use the tendons of the hand.

Diagnosis and Treatment

Clearly, that is a long list of symptoms, and few patients can identify all of the signs. The first thing to do when you notice pain or swelling in the hands, or even one joint of the hand, is to visit your hand doctor. They can perform a thorough assessment and even order x-rays and/or blood tests to determine exactly what is going on.

Once a diagnosis of rheumatoid arthritis is made, the emphasis of the treatment is on retaining or restoring function while reducing pain. Medications and therapies are available, but the first, and most important step is the diagnosis and work with your hand doctor.

Categories
Conditions General Hands

Dealing with Psoriatic Arthritis of the Hand

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A lot of people know about osteoarthritis and rheumatoid arthritis, but not many realize that you can develop arthritis from the skin condition known as psoriasis. Psoriatic arthritis of the hand is somewhat rare, with around five to twenty percent of people with psoriasis developing arthritis related to it. However, it is common enough that it is very useful for anyone with psoriasis to learn about it, and its symptoms.

What Happens When You Have Psoriatic Arthritis?

If you have psoriasis, you are well aware of its appearance. Your skin takes on a very dry and scaly look, and it can often appear as if you have rashes in many areas of the body. The condition does tend to cause prolonged or even constant irritation to the skin, and it is this sort of irritation that eventually leads to the development of arthritis in the underlying bones and cartilage.

Because arthritis, which means “inflamed joint”, is something that can be due to chronic inflammation, it makes sense that psoriasis might eventually cause problems in the hands and wrists, where it is so prevalent. It does many of the same things that other forms of arthritis do when it does appear in the hands, and will lead to swelling, deformity of the joints, and a lack of stability in the wrist. The swelling of this condition, though, is more pronounced than any other form of arthritis (MayoClinic, 2015).

This is all due to the fact that the psoriatic arthritis is actually causing the lining of the joints to swell and to then degrade and allow bones to erode and rub against one another.

Many patients with psoriatic arthritis display many similar symptoms as those with rheumatoid arthritis. Their hands will appear swollen and with a red discoloration. They can be warm to the touch and will often have difficulty with stiffness and movement. However, unlike rheumatoid arthritis, psoriatic arthritis is usually asymmetrical (meaning it may appear on one hand and not the other), it causes skin lesions, and it tends to strike the PIP and DIP joint (the middle and end joints), rather than the middle joints or the wrist areas.

Diagnosing and Treating Psoriatic Arthritis

You must visit a hand doctor if you suspect that your psoriasis has now caused you to develop arthritis, especially if others in your family already have this condition. The physician will do a thorough history and exam. They may order a few tests and X-rays to determine if you do have the condition.

Should you be diagnosed with it, your doctor is going to focus on pain relief, alleviation of the swelling and inflammation, and function as the goals of treatment. This means you will work with more than just the hand doctor and may find yourself working with a therapist as well as other specialists. Medications and ongoing therapies are usually the most conservative treatments, and a hand doctor is likely to refrain from surgery until it is absolutely necessary. This is because it is a progressive issue, and surgery may be used as an intervention rather than an initial treatment of symptoms.

Dont hesitate to contact your doctor simply because the sooner you begin your treatment, the better the outcome.

Source

MayoClinic. Psoriatic arthritis: Symptoms. 2015. http://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/basics/symptoms/con-20015006

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.