Rheumatoid arthritis is an illness that can affect almost every organ in the body. It often attacks the tissues, called synovium, that line the joints and tendons. The tissue becomes swollen and covers the joints, destroying bone and cartilage. The exact cause of rheumatoid arthritis is not known. It affects about 1 percent of the population, women more than men.

What are the signs and symptoms of rheumatoid arthritis?
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 rheumatoid arthritis affect the hand?
Generally, the first and most common complaint is a swelling of 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. Certain deformities can then result. The wrist may turn toward the thumb side of the hand, causing "ulnar drift" of the fingers. The swollen tissue may also produce damage that causes the tendons to rupture. When the tendon ruptures, you may not be able to bend or straighten your finger. Other possible problems 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. 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 assistance with daily activities, splinting and information on how to avoid damaging the swollen joints—can be provided by one of The Centre, P.C.’s hand therapists.

When would surgery be a consideration?
Surgery may be considered only 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 performed to repair the damage. Rheumatoid nodules may be surgically removed to improve appearance and comfort. In some cases, the large knuckles of the hand may be treated by arthroplasty, a procedure in which artificial knuckles (made of silicone rubber or other material) are inserted. This option 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.

When surgery is required for rheumatoid arthritis, The Centre, P.C. recommends the use of the VitaMedica Surgery Program, a comprehensive pre- and post-surgery nutritional supplement system designed specifically for patients undergoing extensive surgical procedures.

The Centre, P.C. offers a comprehensive range of therapy services in our Rehabilitation department.

Contact our plastic surgeons to schedule your consultation about Rheumatoid Arthritis. The Centre, P.C. offers treatment for rheumatoid arthritis to patients in Elkhart and South Bend, Indiana, Michiana and the Southern Michigan area, and Chicago.

 

Elkhart Office

RiverPointe Medical Building
500 Arcade Ave., Suite 300
Elkhart, IN 46514
FAX: 574-293-1511

Chesterton Office

Duneland Health & Wellness Institute
810 Michael Drive, Suite K
Chesterton, IN 46304
Fax: 219.926.3534

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