Tuesday 19 November 2019

What Type of Doctor Treats Arthritis?

From health.clevelandclinic.org

While most primary care doctors can treat osteoarthritis, there are times a specialist is needed

If you have joint pain and think it might be arthritis, you may wonder what type of doctor you should see. Should you go to an orthopaedist or a rheumatologist or some other specialist?

The most common type of arthritis is osteoarthritis, and for that the place to start is with your primary care doctor. “If you have aching joints with activity or walking and it’s persisting, it’s probably osteoarthritis, says orthopaedist Michael Star, MD.
Here Dr. Star explains what various types of doctors can do to treat arthritis:


Primary care doctor – A primary care doctor can manage osteoarthritis with standard treatments, like anti-inflammatory pain medications and referral to a physical therapist. The doctor will probably order X-rays. “That’s usually all that is needed,” Dr. Star says. An MRI isn’t necessary.
If the doctor suspects there might be some other cause of joint problems besides osteoarthritis, a rheumatologist will be consulted. If your symptoms don’t improve or get worse, your doctor may send you to an orthopaedist or a rheumatologist for more intense medical management or an orthopaedic surgeon for surgery.

Orthopaedists – Orthopaedists are doctors who treat injuries and diseases of the musculoskeletal system, including osteoarthritis. For arthritis that gets worse despite treatment, they can perform injections of corticosteroids (powerful anti-inflammatory drugs) or hyaluronic acid (a substance that lubricates joints).
For severe arthritis that causes significant pain and seriously limits daily life, an orthopaedic surgeon can perform surgery, such as joint replacement.

Rheumatologists – Rheumatologists specialize in musculoskeletal diseases and autoimmune conditions. They treat all types of arthritis, including osteoarthritis, rheumatoid arthritis and psoriatic arthritis.

If there’s a chance you have something other than osteoarthritis, you will be sent to a rheumatologist. They provide treatment for joint diseases, including prescribing medications and giving injections. They do not perform surgery.

Other specialists – Sometimes the specialist you see will be dictated by the location of the problem. Some medical centres have specialized spine centres. This may be the place to go to be treated for osteoarthritis of the spine.

Most doctors, regardless of their specialty, will probably send people with osteoarthritis to a physical therapist. “That is the treatment that’s shown to have the greatest benefit,” Dr. Star says.
This article first appeared in Cleveland Clinic Arthritis Advisor.

https://health.clevelandclinic.org/what-type-of-doctor-treats-arthritis/

Sunday 17 November 2019

Q&A: What can I do to limit joint pain from arthritis?

From inquirer.com/health

Q: I was diagnosed with arthritis. What can I do to limit joint pain?

A: Arthritis occurs when the cartilage on the ends of bones that make up our joints becomes damaged and worn down. This happens when the cells in your cartilage release enzymes and free radicals, which lead to inflammation and degradation.

There are more than 100 types of arthritis affecting more than 50 million American adults, according to the Arthritis Foundation. Osteoarthritis, in which the cartilage wears down over time, is one of the most common forms of arthritis. Rheumatoid arthritis (RA), another common form of arthritis, is an autoimmune disease that causes the immune system to attack healthy cartilage tissue. Other common causes of arthritis include injury, gout, infection and aging.

Symptoms of arthritis include pain, swelling and stiffness, which may range from mild to severe.
Although people may think that exercising with arthritis leads to joint pain, exercise done in the right manner may actually help reduce arthritis symptoms. Low-impact exercise conditions muscles and increases joint mobility, which may help control pain and stiffness. Examples of low-impact exercise for those living with arthritis include bicycling, swimming, walking, and using an elliptical machine or rowing machine.

However, certain exercises may damage the joints and increase pain and swelling. High-impact exercises, such as running and squatting, are not recommended for those with lower extremity arthritis because they put excessive stress on the joints. Limiting participation in high-intensity sports may help relieve arthritis symptoms.

The most immediate arthritis treatment options involve lifestyle changes to reduce stress on affected joints. Those with occupations involving frequent or repetitive movements, kneeling, squatting and heavy lifting are encouraged to modify their work style to limit their arthritis symptoms.
Weight loss is another lifestyle change that may help reduce joint pain caused by arthritis. Excess weight places additional stress on the joints, potentially making symptoms worse. Losing weight may relieve stress on the joints, which may lessen pain and inflammatory flare-ups.
Additional at-home treatment options include:
  • Hot and cold therapy. For acute, arthritic flare-ups, ice may provide pain relief and control swelling. For baseline pain and stiffness, heat therapy may relax the surrounding tendons and muscles.
  • Walking aids. Canes, walkers and other mobility aids may offload painful, swollen arthritic joints.
  • Braces. Knee braces may offload knee joint stress.
  • Medication: Acetaminophen (Tylenol), anti-inflammatories (Advil, Aleve, ibuprofen, aspirin) and topical capsaicin may be effective for arthritic pain relief.
Other treatment options include physical therapy, acupuncture, injections (including steroids or platelet rich plasma) and joint replacement surgery.

If you are experiencing joint swelling, stiffness or pain, talk to your doctor immediately to find the best treatment option. Always consult with a physician before initiating any weight loss or exercise program.

https://www.inquirer.com/health/expert-opinions/joint-pain-arthritis-treatments-20191116.html

Wednesday 13 November 2019

Curcumin for arthritis: Does it really work?

From health.harvard.edu/blog
Robert H. Shmerling, MD
Faculty Editor, Harvard Health Publishing

Osteoarthritis is a degenerative joint disease that is the most common type of arthritis. Usually, it occurs among people of advanced age. But it can begin in middle age or even sooner, especially if there’s been an injury to the joint.

While there are treatments available — exercise, braces or canes, loss of excess weight, various pain relievers and anti-inflammatory medicines — these are no cures, and none of the treatments are predictably effective. In fact, often they don’t work at all, or help only a little. Injected steroids or synthetic lubricants can be tried as well. When all else fails, joint replacement surgery can be highly effective. In fact, about a million joint replacements (mostly knees and hips) are performed each year in the US.


So, it’s no surprise that people with osteoarthritis will try just about anything that seems reasonably safe if it might provide relief. My patients often ask about diet, including anti-inflammatory foods, antioxidants, low-gluten diets, and many others. There’s little evidence that most of these dietary approaches work. When there is evidence, it usually demonstrates no consistent or clear benefit.
That’s why a new study is noteworthy: it suggests that curcumin, a naturally occurring substance found in a common spice, might work for osteoarthritis.

A new study of curcumin for osteoarthritis of the knee

In the study, researchers enrolled 139 people with symptoms of knee osteoarthritis. Their symptoms were at least moderately severe and required treatment with a nonsteroidal anti-inflammatory drug (NSAID). For one month, they were given the NSAID diclofenac (50 mg, twice daily) or curcumin (500 mg, three times daily).
Why curcumin? It’s a naturally occurring substance, found in the spice turmeric, that has anti-inflammatory effects. Its use has been advocated for cardiovascular health, arthritis, and a host of other conditions. However, well-designed studies of its health benefits are limited.
Here’s what this study found:
  • Both treatments relieved arthritis symptoms and helped to a similar degree: 94% of those taking curcumin and 97% of those taking diclofenac reported at least 50% improvement.
  • People reported fewer side effects with curcumin. For example, none of the study subjects taking curcumin needed treatment for stomach trouble, but 28% of those taking diclofenac needed treatment.
  • Those taking curcumin lost, on average, nearly 2% of their body weight in just four weeks — that’s 3.5 pounds for a 175-pound person.

Ready to start taking curcumin?

Not so fast. It’s rare that a single study can change practice overnight, and this one is no exception. A number of factors give me pause:

     The study was small and only lasted a month.
  • Only osteoarthritis of the knee was studied. We should not assume that other types of arthritis or that osteoarthritis of other joints would respond similarly.
  • Curcumin was compared with only one possible dosage level of diclofenac (not the highest advisable dose). In addition, the diclofenac used in this study was uncoated (even though there is a coated formulation designed to be easier on the stomach). The results of this study might have been different if another NSAID or a different dose or formulation of diclofenac had been compared with curcumin.
  • The study was unblinded — that is, study participants and researchers knew who was getting curcumin and who was getting the NSAID. This can sometimes bias the results by changing expectations of side effects or benefit.
  • We don’t know how well curcumin would work, or if it would be safe, for the types of people excluded from this study. For example, this study enrolled adults ages 38 to 65 and excluded those with significant kidney or stomach disease. For younger or older people, those with other medical problems, or those taking multiple medications, the results might have been different.
  • Over-the-counter dietary supplements (“nutriceuticals”) are not tested or regulated the way prescription drugs are. So, information regarding purity, strength, and potential interaction with other medications or diseases is typically limited for treatments like curcumin. It’s worth noting that reports of lead contamination in turmeric have been recently published.
  • Weight loss as a side effect of taking curcumin might be a problem for those who are already lean.
  • The bottom line

    Studies of this sort are vitally important in trying to understand whether dietary changes can be helpful for arthritis. While this new study provides support for curcumin as a treatment for osteoarthritis of the knee, I’d like to see more and longer-term studies in osteoarthritis and other types of joint disease, as well as more extensive testing of its safety, before recommending it to my patients.

    https://www.health.harvard.edu/blog/could-a-naturally-occurring-substance-derived-from-a-common-spice-provide-relief-from-osteoarthritis-of-the-knee-a-new-study-suggests-curcumin-might-help-but-the-research-has-some-important-limitati-2019111218290

    Monday 11 November 2019

    From stigma to addressing invisible illnesses: Young people share what it’s like living with arthritis

    From metro.co.uk

    Arthritis can affect anyone, at any age. So why is it that adverts and leaflets frequently show images of greying, elderly people with the condition? The NHS states that around 15,000 children and young people in the UK are affected every year by arthritis. But that figure doesn’t take into account people in their 20s and 30s who are diagnosed, too. The winter months can be particularly difficult for those living with arthritis, as the cold weather can often cause ‘flare ups’ – particularly bad, painful episodes.

    We spoke to three young people living with arthritis, who shared their experiences of coping day-to-day, as well as their thoughts on the stigma around invisible illnesses.

    Hayley Woodland, a 27-year-old teacher, was diagnosed with juvenile idiopathic arthritis at the age of three. Doctors originally dismissed her swollen knee thinking it was just a bump – but when she returned to the hospital a year later, the arthritis had spread.

               Arthritis doesn’t just affect the elderly (Picture: Phébe Lou Morson for Metro.co.uk)

    Hayley tells Metro.co.uk: ‘In 1994 there was still a bit thing around the fact that it wasn’t a “young person’s disease” and it wasn’t very likely to be that. We were lucky that we found someone a bit more specialised and I started getting treatment from about the age of three – but by that point it had spread from a knee to literally everywhere.

    ‘Luckily, that isn’t the case now for children being diagnosed, as they are spotting it so much earlier. But back then it was ignored, which was frustrating. I have swan neck in my fingers. It’s a condition where the tendons in the fingers couldn’t develop properly because of the arthritis, so they are in the wrong place. So I can’t bend my fingers pretty much at all and that happened from very young age.

    ‘It’s now proven that no child being in that situation will get swan neck. There is no reason for that to happen anymore because they know how to stop it.

    ‘I do sometimes reflect back and think “Oh I’m angry that wasn’t the case at the time”, but that’s how medical research goes. You can’t always be lucky enough to be born at the time when things can be stopped. But I am lucky enough to still be young enough that we are able to find treatments.’

    Growing up Hayley says she was only in school around ‘30-40% of the year’, due to her arthritis. The rest of the time she was either in hospital or at home with her mum. Reflecting on her experience now, she says her school showed a lack of understanding towards her condition. She says: ‘I used to think it was the older teachers and older generation at the time who didn’t understand it – who saw it as “not a thing children get” and that my mum was exaggerating.

    ‘I think it was my Year 4 teacher – quite a young girl, probably a few years into teaching – she was atrocious to me. One day I had to go in in my wheelchair – I used it sometimes but that often – but I had to go in my wheelchair that day because I wasn’t feeling well. Then the next day it wasn’t so bad, so I didn’t need it and I went in as normal and she had a massive go at me. She was adamant that it was proof that we were lying about everything.

    ‘It’s that attitude that we face quite a lot – this idea of either you have it or you haven’t. There’s no awareness of the fact that that’s not how arthritis works. I think that’s something everyone with arthritis faces, people seem to find it hard to get their heads around the fact that it isn’t a consistent disease.’

    Hayley says advances in medicine – compared to when she was diagnosed in the 90s – make things a little more promising for those living with arthritis. She recently underwent a hip replacement – which was something she was told 10 years ago would never really be an option. Her new ceramic hip will last her around 30 years.

    Chloe Elliott was diagnosed with arthritis in 2013 – at the age of 23. She visited the doctor after suffering with severe body pain, leaving her unable to walk, lift her head or use her hands. Following a blood test and a session with rheumatologist, she was diagnosed with psoriatic arthritis – which develops from skin psoriasis. Chloe says: ‘I had to leave my job in fashion buying and move back home as I was completely unable to do anything for myself.

    ‘Now, I still have daily pain, some days are better than others. I take an anti-TNF injection once a month to help with my symptoms which include joint pain, extreme fatigue, and nausea. I try to keep as comfortable as possible, sleep as much as I can and as often as I need to. I’m lucky to be self-employed so I sleep when I can.

    ‘I have no idea how people in full time work – in an office for example – cope with having arthritis and not being able to rest when they need to. I also take pain relief which helps. ‘Keeping warm is absolutely vital too, as my body is definitely more likely to flare in cold weather.’

    In terms of day-to-day activities, Chloe says living with arthritis has changed aspects of her life, such as socialising with friends and exercising. She says: ‘It takes a lot of my social life away. I am forever having to cancel plans or rearrange because I never know how I’m going to feel on the day. ‘I’m unable to exercise like I used to – I still try but it’s really painful for the entire week after I do any exercise. ‘I think many people with arthritis will agree with me when I say that you can go out and do one nice thing you’ve really been looking forward to, and you then pay for it for a solid week because it has taken everything out of your body.’

    Chloe agrees with Hayley that more needs to done in terms of education around invisible disabilities, such as arthritis. She believes this is the best way to tackle the stigma and attitudes that the condition only affects ‘older people’.

    She says: ‘I have been challenged whilst sitting in the accessible seats on a train and I have a disabled person’s railcard. I have also been challenged when parking in a disabled bay and I have a blue badge. ‘Unless I use my crutch – which I have to use a lot of the time – people don’t see the illness so they automatically assume that one isn’t there. Being challenged on your illness is absolutely humiliating and a complete violation. You can not determine someone’s health at face value. ‘I think it’s about more education, more people talking about it and more people purposefully educating themselves about invisible illnesses. It’s not my job as a disabled person to educate you – you should be doing it yourself. ‘I must admit that I myself thought that arthritis was for the elderly before I was diagnosed with it.

    ‘I remember phoning my mum after I’d seen the rheumatologist and telling her I thought we needed a second opinion and it couldn’t be arthritis. Thankfully, marketing is finally changing to show a range of people with the condition thanks to charity Versus Arthritis. This isn’t a condition purely reserved for the elderly. ‘

    Paige Calvert’s arthritis derives from Crohn’s Disease – an auto-immune condition. At the age of 27, she was diagnosed with enteropathic arthritis – which causes inflammation surrounding the tendons and soft tissues around the joints. She has this in her wrists, knees, shoulders, elbow and lower back. The winter months can be particularly challenging for Paige, as her arthritis tends to flare up when the temperature drops.

                                        Paige was diagnosed at the age of 27 (Credit: Paige Joanna)

    She says: ‘Coping day-to-day depends on the pain level, as some days I can feel achy and it’s bearable and other days it can really affect my mobility and the pain can be disabling. ‘On a fairly good day, I just try to keep warm, rest when I feel fatigued and stay as active as possible. ‘On a bad day, it can be mentally challenging but I manage it the best I can. I use joint pain relief gels, hot baths, hot water bottles and pain relief, as well as lots of rest. It’s about knowing your body is responding in the right way so that you don’t injure yourself or make the pain worse. ‘It can mean making sacrifices on bad days and cancelling plans but it’s important to put your body first.’

    She adds: ‘In winter, I find my arthritis really flares up and I have learned to invest in good thermals when going out and keeping warm wherever possible. The change in temperature from cold to hot can also make inflammation and pain worse for me so it is challenging most days. ‘It doesn’t stop me on good days, but on bad days it definitely has a huge impact on my activity level. ‘Having it in my knees is the most disabling because I struggle to walk without it being painful, so when that flares I have to have help getting up and down the stairs.’

    Paige says arthritis is a misunderstood condition and that people with invisible disabilities (such as arthritis) often struggle day to day, due to a lack of awareness. She says: ‘Since being diagnosed I have had many reactions where people assume I am too young to have arthritis. I have to explain that anyone at any age can develop it as it’s a form of autoimmune disease.

    ‘It’s getting better with the help of charities like Versus Arthritis but there is still a way to go. I also carry around a “please offer me a seat” disability badge from TfL and I wear it on bad days. I’ve been glared at and even had negative comments made when people see me with it on, waiting for someone to kindly offer their seat. People can assume you are putting it on because it’s invisible.

    ‘I’d love to see people understanding invisible illness and invisible disabilities because it would make our lives a little bit easier to not have to explain our struggles constantly.’ Charities such as Versus Arthritis are working to tackle this stigma around arthritis. They also offer advice for anyone living with the condition, such as how to cope with seasonal flare ups.

    https://metro.co.uk/2019/11/09/from-stigma-to-addressing-invisible-illnesses-young-people-share-what-its-like-living-with-arthritis-11040563/

    Thursday 7 November 2019

    Rheumatoid arthritis: 5 Beverages that can help relieve the pain

    From thehealthsite.com

    Rheumatic pain is at times unbearable and doesn't get better even with pain killers. However, few daily hacks may help in better pain management. Here's a list of 5 beverages that can be beneficial in relieving arthritis pain.

    Rheumatoid arthritis is a severe inflammation of joint and tissues in which even a slight pressing may trigger pain. It’s an uncomfortable and painful condition in which even sleeping or sitting in one position may hurt as the joints and tissues get pressed. Usually, strong medicines are given to relieve the pain, but experts believe that lifestyle changes are important to lead a healthy life with rheumatoid arthritis. Apart from food, there are several drinks that have proven benefits against rheumatic pain. Regular consumption of these may give some relief from pain.

    1  Turmeric milk: If you are not lactose intolerant, milk can be beneficial to relieve your arthritis pain. Dairy does have some anti-inflammatory properties. When mixed with turmeric, which is known for its healing and therapeutic effects, the impact of milk on joint pains is positive. So, unless you are not allergic to dairy, you may like to take a glass of turmeric milk at the bedtime.

    2  Green tea: Green tea has anti-oxidants that helps attacking inflammation in body. It’s known to ‘target pro-inflammation protein’ says a study published in the journal Arthritis and Rheumatology. However, if you are taking blood thinner then you must consult with your doctor before having green tea. Vitamin K present in it may counterattack blood thinner’s effects.

    3  Red Wine: Alcohol may not sound like a nice idea when suffering from rheumatic condition, but this drink prove otherwise. Resveratrol present in red wine has anti-inflammatory properties. Studies show that it may help in cutting risk factors contributing to the development of rheumatoid arthritis. However, if consumed in excess may aggravate the condition; make sure to have it in moderation.

    4  Fruit and vegetable mix smoothie: Experts believe in the goodness of whole fruits and vegetables mixed together to make a smoothie over squeezing the fresh juice. The nutrients and anti-oxidants from both are better consumed in the form of a smoothie. So, if you have more patience and time, you may replace simple fresh juice with a smoothie.

    5  Vitamin C-rich fresh juices: Vitamin C has helps in building better immunity and therefore, orange, pineapple, tomato juices can give relief from pain. These fruits have anti-oxidants to fight free radicals in body. So, if you are a slacker to cut and eat fruits, just juice these for your benefit.

    https://www.thehealthsite.com/photo-gallery/rheumatoid-arthritis-5-beverages-that-can-help-relieve-the-pain-698169/healthy-drinks--698173

    Tuesday 5 November 2019

    Q: Do I need surgery for my ankle arthritis?

    From northerndailyleader.com.au

                       When you have had to give up activities because of your pain, that's when                                                                            it's worth doing something about it
    In order to justify going through an operation and recovery, there has to be a significant amount of improvement in the patient. So someone who's bothered a little bit by their arthritis is probably not going to be that happy after a big operation. They might say 'Well, I'm only a little bit better'.

    But someone who says 'I've had to give up walking, I've had to give up playing bowls, I've had to give up exercising and now I can do those things after my joint replacement' - they've gained a lot, even though it's been quite inconvenient to have the surgery. They're so much better than they were, it was worth doing.

    Up until recently, surgical treatment for arthritis in the foot has meant fusing the joint together. The outcome of that is you often go from what is a stiff and painful joint to a stiff and painless joint. So you lose what movement you have, but you also lose the pain.

    However newer treatments are able to preserve the joint and its movement so that we hopefully get a joint that moves but doesn't hurt. The first one is ankle replacement. By using a CAT scan we create a 3D printed version of the ankle which allows us to analyse exactly where the custom-made instrumentation will fit onto the existing limb.

    The big toe is also susceptible to arthritis. That joint is about the size of a 10 cent piece, and you put all of your body weight through that one little joint as you're pushing off on it. If you do a lot of walking or running or if you do things in the gym like squats or lunges, or you wear high heels, it can obviously be quite painful.
    A new thing that we use in the foot and ankle is a thing called Cartiva, a small implant made from the same material as contact lenses. It's currently used in big toes as well as the smaller toes, and I'm sure they will look at using it in other joints.

    What is arthritis?
    Arthritis is a disease of the joints. There are two types of arthritis: the most common is osteoarthritis (OA) which is due to the wear and tear of the joint surface, and inflammatory arthritis (IA), where the body has a reaction against itself which damages the joints. IA can occur in younger people as opposed to OA which affects more older people.

    The signs of arthritis are pain, swelling and stiffness. All of us are experiencing these symptoms to some degree. Sometimes people who have had damage to the cartilage in their joints can develop OA, or are likely to develop it in the future. Some people have a genetic predisposition, and for others it just happens.

    Treatment for arthritis consists of simple things like pain relief using anti-inflammatories, wearing comfortable and supportive shoes.

    https://www.northerndailyleader.com.au/story/6468465/q-do-i-need-surgery-for-my-ankle-arthritis/

    Saturday 2 November 2019

    When Is Wrist Surgery Needed for Arthritis?

    From health.clevelandclinic.org

    When arthritis becomes severe enough, surgical options can fuse, remove or replace

    If wrist pain and stiffness from arthritis can no longer be managed with conservative treatment, surgery may be an option. Just like for hips and knees, there’s joint replacement for the wrist. But other surgeries are actually more common.

    The wrist is made up of eight small bones (carpal bones) arranged in two rows. “It’s like a pyramid of ball bearings, lined up perfectly,” explains orthopaedic surgeon David Shapiro, MD.
    “If you injure the ball bearings or change their alignment, the rest of the pile will shift, and then they start to rub against each other in ways that cause them to wear down — that’s arthritis.


    Arthritis in the wrist can have different causes:
    • Osteoarthritis is degeneration of the impact-absorbing cartilage at the ends of the bone.
    • Inflammatory arthritis, including rheumatoid arthritis, psoriatic arthritis and others, are systemic diseases that can damage cartilage.
    • Pseudogout is a type of arthritis that can lead to wrist arthritis.
    • Trauma, infection and congenital abnormalities are some other causes.

    Partial procedures

    There are several surgical options to stop arthritic bones from rubbing together.
    “One is to remove the arthritic bones and another is to fuse them together so they don’t move and don’t hurt,” Dr. Shaprio says.
    Which operation is better depends on which bones are involved. “You can remove the whole bottom row and the rest of the stack of bones will stay up,” he says. But if you take out just one bone from the middle, the whole pile of bones will collapse.

    A partial fusion stabilizes the wrist and removes the arthritic joint. Both of these options provide good pain relief, although patients typically lose some portion of their wrist motion.

    Whole-wrist procedures

    Some people have arthritis in most or all of the joints in the wrist. This can occur in advanced osteoarthritis or rheumatoid arthritis. In these cases, the choice is between fusing all of the bones (total fusion) and joint replacement.
    With total fusion, the wrist will no longer bend, but you can still rotate it, turning palm up and palm down since this motion comes from the elbow joint. Fusion sounds debilitating, but it does give great pain relief.

    “Patients almost always find they can do more things more comfortably after surgery than before,” Dr. Shapiro says.
    Joint replacement seems appealing because it retains, and may even improve, range of motion in the wrist. “The problem is durability of the implant,” Dr. Shapiro says. With wrist replacement, bones are removed and an implant made up of metal parts and a plastic spacer is inserted. These implants aren’t as predictably long-lasting as implants for other joints, such as hips and knees. And complications can be particularly challenging to treat.
    Joint replacement generally is reserved for older adults who don’t put too much stress on the wrist. Surgeons may also consider replacement for people who have had one wrist fusion and need surgery on the other side, so they retain movement in one of their wrists.

    What to expect from surgery

    The surgeries usually are done as same-day procedures under regional anaesthesia (which blocks sensation to the arm) and sedation. With fusion and joint replacement, the wrist will be in a cast for three to eight weeks. Most people require physical therapy to work on regaining strength and motion. Complete recovery takes a few months.
    Like all surgeries, there are potential complications, including bleeding and infection. “Fusions do not heal as well in smokers, so I try to get people to stop smoking well before the surgery,” Dr. Shapiro says.
    “Future developments will hopefully lead to ways to longer-lasting and more durable implants to increase the indication for and success of wrist replacement.”
    This article originally appeared in Cleveland Clinic Arthritis Advisor.

    https://health.clevelandclinic.org/when-is-wrist-surgery-needed-for-arthritis/