Treatments for rheumatoid arthritis in the hands range from nonsurgical treatments such as anti-inflammatory medicines and lifestyle changes to a variety of surgical procedures designed to reduce pain and restore functionality to the affected areas in cases of severe pain and deformity.
Rheumatoid arthritis in the hands is a chronic autoimmune disease that causes inflammation of the joints. Autoimmune diseases occur when your body is attacked by its own immune system. Inflammation from rheumatoid arthritis can become so severe that the joints of your fingers are deformed, making it difficult to move them. Additionally, lumps known as rheumatoid nodules may form over the joints of your hands and wrist.
Nonsurgical treatments are initially recommended for less severe cases of rheumatoid arthritis. Rheumatoid arthritis actually is more often treated with medicine, exercise and lifestyle changes than with surgical procedures. These treatments can help relieve pain and swelling, slow down or prevent joint damage and increase your ability to function. Nonsurgical treatments may include:
- Anti-inflammatory medicine – Medicines such as ibuprofen and naproxen that reduce swelling can be given to control symptoms of rheumatoid arthritis.
- Pain relievers – Aspirin, codeine and hydrocodone are some examples of pain-relieving medicines.
- Steroids – Corticosteroids control flare-ups and help to manage the disease.
- Lifestyle changes such as:
- Diet – Special diets along with vitamin supplements can be prescribed to help with symptoms.
- Physical therapy
According to the American Society for Surgery of the Hand (ASSH), surgical interventions should be timed appropriately to maximize function and minimize the deformity caused by rheumatoid arthritis. Sometimes preventive surgery may be recommended, such as:
- Removal of nodules
- Removal of inflamed tissue (synovectomy) to decrease pressure on the joints and tendons
- Removal of bone spurs that may rub on tendons or ligaments
- Tendon transfers or grafts to repair ruptured tendons
In the most severe cases of rheumatoid arthritis, or when the patient doesn’t respond to nonsurgical treatment, these surgical procedures may be recommended:
- Joint replacement – Also known as an arthroplasty, a joint replacement relieves pain and restores motion by realignment or total reconstruction of the affected joint. In some cases all or part of the joint is replaced by metal or plastic parts. This particular surgical treatment for rheumatoid arthritis in the hands will not cure the disease, but it can provide pain relief and restore functionality in the affected areas.
- Joint fusions – Also known as arthrodesis, this surgery joins selected bones in the hand or wrist to relieve severe pain and nerve problems resulting from rheumatoid arthritis of the hands.
Recovery time can vary from two weeks to several months, depending on the type of surgery and the severity of the disease.