Medically reviewed by: Mark A. Yaffe(opens in a new tab), MD — Board-Certified Orthopedic Surgeon, Subspecialty Certified in Hand Surgery
Key Takeaways
- Wrist arthritis develops when the cartilage between the small bones of the wrist wears away, causing deep aching pain, stiffness, swelling, and a weaker grip.
- It most often follows an old wrist injury, such as a fracture that involved the joint surface, a scaphoid fracture, or a torn ligament, sometimes many years later, and it can also come from wear with age or inflammatory conditions like rheumatoid arthritis.
- Treatment usually starts with non-surgical care, including a splint or brace, anti-inflammatory medication, activity changes, hand therapy, and injections, which can reduce pain but can't reverse the arthritis.
- When pain continues despite non-surgical care, options may include a soft-tissue procedure called selective wrist neurectomy, other motion-preserving or fusion procedures, and in some cases joint replacement, depending on the exam and X-rays.
- Seeing a hand surgeon about persistent wrist pain, especially after a past injury, allows arthritis to be identified and treated before it limits everyday tasks.
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What Is Wrist Arthritis?
Wrist arthritis is a condition in which the smooth cartilage that cushions the joints of the wrist wears away, so the bones begin to rub against each other. The wrist is made up of eight small carpal bones and the ends of the two forearm bones, with many small joints between them, so arthritis can affect one joint or several.
In advanced cases, the damage involves more than one joint in the wrist, which is the focus of the page on advanced wrist arthritis(opens in a new tab). Wrist arthritis is part of broader hand and wrist(opens in a new tab) care, and treatment depends on how far the arthritis has progressed and how much it limits what you need to do.
What Causes Wrist Arthritis, and Who Is at Risk?
Wrist arthritis has several common causes:
- Past injury (post-traumatic arthritis): This is the most common cause. A fracture that involved the joint surface, such as a broken wrist(opens in a new tab), a scaphoid fracture(opens in a new tab) that didn't heal, or a torn wrist ligament can lead to arthritis years later. The page on old wrist injuries(opens in a new tab) explains how ligament injuries are treated.
- Wear and tear (osteoarthritis): The cartilage can thin gradually with age and repeated use.
- Inflammatory arthritis: Conditions such as rheumatoid arthritis can inflame the wrist joints and damage the cartilage.
- Other factors: Past infection, crystal conditions such as gout, and long-term heavy use of the wrist can contribute.
Arthritis is more common with age, and it often appears in a wrist that was injured long ago, which is why it's worth mentioning any past wrist injury at a visit.
Symptoms of Wrist Arthritis
Wrist arthritis tends to develop gradually, and symptoms often include:
- Deep, aching wrist pain with use, and sometimes at rest or at night as the arthritis advances
- Pain that gets worse with lifting, gripping, pushing up from a chair, or bearing weight through the hand
- Stiffness and limited bending or turning of the wrist
- Swelling and tenderness, often worse after activity
- Grinding, clicking, or catching when the wrist moves
- A weaker grip and trouble carrying, gripping, or using the hand for work and hobbies
Arthritis can also affect other parts of the hand at the same time. Pain at the base of the thumb may point to thumb base arthritis(opens in a new tab), while swollen, stiff finger joints may point to finger arthritis(opens in a new tab), and this article on the hand osteoarthritis signs(opens in a new tab) can help you recognize it.
How Is Wrist Arthritis Diagnosed?
Diagnosis starts with your history, including any past wrist injuries, and a hands-on exam to check motion, strength, and tenderness. X-rays show the pattern of joint wear and help determine how far the arthritis has progressed. Additional imaging, such as CT or MRI, may be used when more detail is needed. Blood tests can help when an inflammatory type of arthritis such as rheumatoid arthritis is suspected.
Several other problems can cause wrist pain and should be ruled out, including tendon irritation, ligament injuries, and fractures that were missed. If you have thumb-side pain, this article on thumb joint pain(opens in a new tab) explains how it differs from the wrist itself.
Non-Surgical Treatment for Wrist Arthritis
In many cases, non-surgical treatment is all that is needed, and it is usually where care begins. Common approaches include:
- Splinting or bracing: A wrist splint rests the joint during painful activities or at night, and custom splints made by Certified Hand Therapists can be more comfortable.
- Anti-inflammatory medication: Over-the-counter options such as ibuprofen or naproxen may ease pain and swelling for some people, as long as they are safe for you to take.
- Activity changes: Adjusting how you lift, grip, and work can reduce stress on the joint.
- Hand therapy: Therapists teach joint-protection techniques and exercises to keep the hand working well. This article on hand therapy(opens in a new tab) explains how rehabilitation helps.
- Injections: Corticosteroid and other injections can reduce inflammation and ease pain for some people, but relief varies and is often temporary, and injections don't repair worn cartilage.
These options can't reverse arthritis, but they can reduce pain and help you keep using your wrist comfortably, particularly in earlier stages. To learn more about injection options, see this overview of biologic injection therapy(opens in a new tab), along with these articles on biologic injections(opens in a new tab) and orthobiologic treatments(opens in a new tab).
Surgery for Wrist Arthritis
Surgery is considered when pain continues despite non-surgical treatment and limits what you need to do each day. The right procedure depends on which joints are affected, how advanced the arthritis is, and your goals. Options may include:
- Selective wrist neurectomy: A soft-tissue-only procedure that takes about 20 minutes and is aimed at relieving wrist arthritis pain by targeting the nerves that carry pain from the joint. It avoids bone fusion procedures and bone removal, and not every patient is a candidate. It is one of the practice's minimally invasive surgery(opens in a new tab) options.
- Bone procedures: Surgeons may remove part of the wrist or fuse bones together to reduce pain, and the choice depends on the pattern of arthritis. These are generally considered when other options are not enough.
- Joint replacement: Upper-extremity joint replacement surgery(opens in a new tab) options include the hand and wrist, and whether replacement is appropriate for your wrist depends on your exam and imaging.
What to Expect During Recovery
Recovery depends on the procedure performed. After a soft-tissue procedure, many people return to light activity fairly soon, while recovery after bone surgery or replacement is longer and involves a period of protection in a splint followed by hand therapy to regain motion and strength. Your surgeon will give specific instructions for protecting the wrist, wound care, when to start moving it, and when to return to your usual activities. For a general picture of what recovery involves, see this overview of hand surgery recovery(opens in a new tab). Recovery timelines vary from person to person.
Risks and Possible Complications
Every procedure has risks, including infection, stiffness, nerve irritation, ongoing pain, and the possibility that the benefit may not last. Fusion procedures reduce wrist motion by design, and implants can loosen or wear over time. Results vary by patient, and your surgeon will review the benefits and risks of each option before you decide.
When to See a Hand Surgeon
It's worth seeing a hand surgeon if wrist pain has lasted more than a few weeks, if it is worse with gripping or lifting, if you have stiffness, swelling, or grinding, or if you had a wrist fracture or ligament injury in the past. Seek an exam promptly for sudden severe pain, a bent wrist, or numbness after an injury, since these can point to a fracture. A hand surgeon can confirm the diagnosis with an exam and X-rays and explain which treatment fits your stage of arthritis.
Dr. Yaffe sees patients in Schaumburg(opens in a new tab), Elk Grove Village(opens in a new tab), and Buffalo Grove(opens in a new tab). To get started, schedule an appointment(opens in a new tab) online, and it helps to note any past wrist injuries and which activities hurt most.
Frequently Asked Questions
What is the main cause of wrist arthritis?
Wrist arthritis most often follows a past injury, such as a wrist fracture that involved the joint surface, a scaphoid fracture, or a torn wrist ligament, even many years later. It can also develop from general wear of the cartilage with age or from inflammatory conditions such as rheumatoid arthritis.
Can wrist arthritis be reversed or cured?
No. Worn cartilage can't be restored, so there is no cure for wrist arthritis. Treatment aims to reduce pain, protect the joint, and keep your wrist useful, and many people do well with non-surgical care for a long time.
Do injections help arthritis in the wrist?
Injections can reduce inflammation and ease pain for some people, but the relief varies and is often temporary, and they don't repair worn cartilage. A hand surgeon can explain whether an injection makes sense for you and which type, based on your exam and X-rays.
Does wrist arthritis always need surgery?
No. In many cases, non-surgical treatment such as splinting, anti-inflammatory medication, activity changes, hand therapy, and injections is all that is needed. Surgery is considered when pain continues despite those measures and limits daily activities.
What is selective wrist neurectomy?
Selective wrist neurectomy is a soft-tissue-only procedure that takes about 20 minutes and is designed to relieve wrist arthritis pain by targeting the nerves that carry pain from the joint. It avoids bone fusion procedures and bone removal, but not everyone is a candidate, and results vary by patient.
