Does Alcohol Affect Psoriatic Arthritis?

From healthcentral.com

The research—and people’s individual experiences—are mixed. Here’s what you need to know 

When you have psoriatic arthritis (PsA)—an inflammatory condition of the joints linked to the skin disease psoriasis—a healthy lifestyle is a key component for managing your symptoms. That includes regular physical activity, a nutritious diet, and avoiding smoking. Does it also mean you should re-evaluate your alcohol intake? The relationship between alcohol and psoriatic arthritis isn’t completely straightforward, so if you have PsA and you also enjoy unwinding after a busy day with an adult beverage, there are a few things to consider.

Psoriatic Arthritis Symptoms

The symptoms of psoriatic arthritis vary from one person to the next but are mainly felt in the skin and joints. The disease can also affect other areas of the body, like the eyes and gastrointestinal (GI) tract. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), people with psoriatic arthritis may experience:

• Eye inflammation that causes pain, redness, and blurry vision

• Fatigue

• Inflammatory bowel disease, the symptoms of which include abdominal pain, diarrhoea or changes in bowel movements, nausea, and unexplained weight loss

• Joint stiffness, pain, and swelling, which can also affect the spine

• Nail changes

• Sausage-like swelling of a finger or toe

• Scaly, inflamed patches of skin on scalp, elbows, and knees

• Tenderness in areas where tendons and ligaments attach to bones, such as the back of the heel or sole of the foot

Alcohol and Psoriatic Arthritis Risk

The answer to the question of how alcohol intake impacts your chances of developing psoriatic arthritis isn’t cut and dry—and that’s because much of the research is conflicting, says Elena Schiopu, M.D., a professor of medicine in the division of rheumatology at the Medical College of Georgia at Augusta University.

For example, a British study of more than 90,000 people with psoriasis (about 1,400 of whom had also developed psoriatic arthritis) published in the British Journal of Dermatology found that moderate drinking (but not heavy drinking) was associated with an increased risk of PsA among those with psoriasis.

On the other hand, a study of more than 80,000 women (141 of whom developed psoriatic arthritis) published in the Journal of Rheumatology found that moderate drinkers were at a lower risk of PsA compared to non-drinkers, while those who reported excessive alcohol use (more than two drinks per day) had a four-fold greater risk of psoriatic arthritis compared to non-drinkers. That may be due to the fact that high levels of alcohol contribute to inflammation, possibly triggering the disease in some people. Still, other research has not found alcohol to be a risk factor for psoriatic arthritis.

If you have psoriasis (which often precedes a diagnosis of PsA) or you’re already living with psoriatic arthritis, where does that leave you? To start, researchers do know that increased alcohol intake is associated with more severe psoriasis symptoms and can affect treatment of the disease. Drinking also raises heart disease risk (which psoriasis also increases). The issue is so pressing that one article in the American Journal of Clinical Dermatology called on dermatologists to ask all patients about their alcohol use.

Dr. Schiopu suggests that if you currently have more than two drinks per day, it will probably benefit you to cut back. “Having alcohol socially once or twice a week and limiting yourself to one serving may not cause a big issue,” she says. (Of course, if you don’t drink now, there’s no reason to start.) You’ll also want to keep tabs on how alcohol affects your psoriasis flares, and if you already have psoriatic arthritis, your PsA flares as well.

Alcohol and Psoriatic Arthritis Flare-ups

People who have psoriatic arthritis will notice that they have their own unique individual triggers for flares (times of active disease where you experience symptoms). You may notice that alcohol intake is one of yours. For example, Dr. Schiopu says that some patients report that wine in particular aggravates their condition. Others find that one drink on occasion is okay, but going over a certain amount brings on symptoms. “It requires some personal experimentation,” she says.

There are a few reasons why alcohol may trigger flares. The alcohol itself may be proinflammatory. In addition, the sugar in alcoholic drinks can trigger flare-ups of psoriatic arthritis, says Elizabeth Ortiz, M.D., a rheumatologist and clinical advisor at the virtual care platform WellTheory. (Sugar is also proinflammatory, she says—in research, patients with rheumatoid arthritis or psoriasis report that sugar is a common trigger.) Dr. Ortiz recommends making the lowest-sugar choice you can, which means staying away from mixers like sodas and cocktails (which often contain added sugar in syrups or juices) and instead opting for spirits mixed with no-sugar-added sparkling water, low-sugar canned alcoholic beverages, or zero sugar wines.

Dr. Ortiz points out that alcohol can also decrease your inhibitions, affecting the food choices you make—and you could end up eating foods that trigger symptoms for you. If you are drinking, “be mindful of the amount you drink, as well as how that amount affects other behaviours,” she advises.

Alcohol and Psoriatic Arthritis Medications

If you drink alcohol and are taking a medication to treat psoriatic arthritis, ask your prescriber about any potential interactions or risks associated with imbibing, advises Dr. Schiopu. One to keep in mind is methotrexate, an immunosuppressive medication that is a common treatment for psoriasis and psoriatic arthritis. Because of the potential harm to the liver, people should avoid using alcohol while taking methotrexate. “This medication is known as a liver irritant, as is alcohol. If you have one liver irritant, why add to it and press your luck with another?” says Dr. Ortiz.

Lifestyle Choices to Help Manage Psoriatic Arthritis

Identifying your personal triggers (and then avoiding them as much as possible) can go a long way to helping you manage your condition. “Knowing how someone reacts is based on trial-and-error and seeing how they feel after eating certain foods and making adjustments to their lifestyle. Everyone has their own personal threshold of what they can tolerate,” says Dr. Ortiz.

Keeping a journal can help you pinpoint the foods, drinks, or habits that may be linked to worsening symptoms. In addition, there are several lifestyle measures that are recommended across the board to help manage the disease and keep symptoms at bay. According to NIAMS, these are:

• Exercise regularly

• Maintain a healthy weight

• Quit smoking

• Seek out mental health to address the emotional toll of PsA

The Bottom Line on Alcohol and Psoriatic Arthritis

Research is conflicting on how alcohol intake affects your risk of developing psoriatic arthritis, and its impacts on symptoms can vary from one person to the next. Rheumatologists recommend moderating your alcohol intake if you choose to drink. And even more importantly, pay attention to how alcohol intake affects your symptoms and make adjustments as necessary, such as decreasing the amount or frequency that you drink, or changing the type of drinks you consume.

https://www.healthcentral.com/condition/psoriatic-arthritis/psoriatic-arthritis-and-alcohol

Millions of arthritis sufferers warned against eating two foods

From msn.com

Arthritis sufferers in the UK, numbering in the millions, have been warned about two common fruits that could potentially worsen their condition. Arthritis, a condition characterised by pain, swelling, inflammation and mobility issues, currently has no cure, but symptoms can be managed.

Diet can significantly impact the condition, either alleviating or worsening it. The Physicians Committee has identified certain foods as "pain triggers", including apples and tomatoes.

The report stated: "While genetic factors are important, studies show that lifestyle factors, including diet, play a role. If you have rheumatoid arthritis, a diet change could help you, and perhaps even eliminate your pain entirely. In research studies, many people who cut out certain trigger foods find that their pain improves or goes away. When those foods are gone, so is the inflammation. A survey of more than 1,000 arthritis patients revealed that red meat, sugar, fat, salt, caffeine, and nightshade plants most commonly worsen the condition."

Both apples and tomatoes contain solanine, a glycoalkaloid poison found mainly in nightshade family species. A study published in the Arab Journal of Nuclear Sciences and Applications in 2013 explored the link between solanine and arthritis, reports Surrey Live.

The study suggests: "Solanine is a toxic compound produced in nightshades family such as potato, tomato and eggplant when exposed to light. The current study was carried out on 18 female postmenopausal albino rats to investigate the effect of solanine on the symptoms of rheumatoid arthritis. The data of the present study showed that old age and postmenopausal suffering from arthritis and joint swelling must eliminate or avoid the nightshades plants to alleviate the joint pain and also decrease the destruction of the tissues."

However, this claim has been challenged by other health organisations. The Arthritis Society Canada recommended monitoring personal reactions to foods containing solanine, according to the Mirror.

In related news, researchers have recently found that a medication which controls blood sugar levels in type 2 diabetes can also benefit patients with certain autoimmune diseases. The drug, Canagliflozin, affects T-cells – which are typically involved in fighting infections but can mistakenly attack healthy tissue in autoimmune conditions.

Therefore, Canagliflozin's action on these cells could help over 400,000 people in the UK who suffer from rheumatoid arthritis and another 50,000 with lupus.

https://www.msn.com/en-gb/health/other/millions-of-arthritis-sufferers-warned-against-eating-two-foods/ar-AA1tO1V2?ocid=BingNewsVerp 

How brushing your teeth could reduce your risk of developing arthritis

From dailymail.co.uk

Brushing your teeth could reduce the risk of developing rheumatoid arthritis, a study has suggested.

Scientists have pinpointed a bacteria, often found in the mouth, which may trigger the painful joint condition.

A study by the University of Leeds found that people who developed arthritis were more likely to have high levels of this bacteria in their gut in the months leading up to diagnosis.

Experts say the findings could help doctors prevent arthritis from occurring in the first place. This might involve prescribing thorough tooth-brushing or a probiotic – a daily tablet containing 'good' bacteria.

Affecting more than half a million people in the UK, rheumatoid arthritis is a chronic disease that causes swelling, pain and stiffness in the joints because the immune system is mistakenly attacking the body's healthy cells.

While there are a number of effective treatments to manage the symptoms of arthritis, there is no cure.

In the study researchers followed 19 patients who were deemed to have a high-risk of developing the condition.

Only five received a diagnosis during the study, but those who did develop the condition were significantly more likely to have substantial levels of prevotella in their gut – a bacteria which is usually found in the mouth.

Research suggests that many cases of arthritis are due to a 'leaky gut' theory, where harmful bacteria leaves the stomach and enters the bloodstream, setting off the immune system.

Experts will now explore ways to lower the amount of prevotella in these at-risk patients. Solutions include eating a high-fibre diet, which research suggests reduces levels of the bacteria.

'As there is no known cure, at-risk patients often feel a sense of hopelessness, or even avoid getting tested,' says Dr Christopher Rooney, lead researcher on the study at the University of Leeds. 'This new research might give us a major opportunity to act sooner to prevent rheumatoid arthritis.'

https://www.dailymail.co.uk/news/article-14091923/brushing-teeth-reduce-risk-rheumatoid-arthritis.html 

Exploring the Benefits of Sauna Therapy for Rheumatoid Arthritis

From creakyjoints.org

"The sauna has been one of the biggest interventions in my rheumatoid arthritis self-care management plan"

At this year’s American College of Rheumatology (ACR) Convergence, Eileen Davidson shared her inspiring patient perspective on how sauna therapy has become a cornerstone of her self-management strategy for rheumatoid arthritis (RA).  

When Eileen Davidson was diagnosed with rheumatoid arthritis (RA) in 2015, she began a journey to find ways to manage her symptoms and improve her quality of life. Over the years, she’s explored various treatments, therapies, and lifestyle adjustments. One of her most impactful discoveries? The soothing power of the sauna. 

The Sauna’s Role in RA Management

Over the years, Eileen has found that time in the sauna not only eases her RA symptoms but also boosts her overall well-being.  

“The sauna has been one of the biggest interventions in my rheumatoid arthritis self-care management plan,” she explains. This non-pharmacological approach has become especially helpful in managing the muscle pain, stiffness, and chronic fatigue that often accompany RA flares. 

The sauna has also helped motivate Eileen to be more active. After periods of reduced activity due to RA flares, returning to exercise can be a daunting challenge. Regular sauna sessions make this transition smoother by alleviating her pain and improving joint mobility.  

Beyond Symptom Management

For Eileen, the sauna offers benefits beyond physical symptom relief. It has had a positive effect on her mental health, offering a much-needed escape during challenging times and even helping to alleviate symptoms of depression.

Sauna therapy has also played a role in managing the chronic fatigue and poor sleep that are often part of living with RA. Living in Canada, where harsh winters can intensify joint pain and fatigue, the sauna provides a welcome respite from the cold. Eileen also credits it with helping her ward off infections, which is especially important since she is immunocompromised. 

The sauna has provided Eileen with numerous benefits, including: 

• Relieving muscle pain 
• Making regular exercise more manageable 
• Improving sleep quality 
• Managing chronic fatigue 
• Providing mental and emotional benefits 

A Call for Integrative Approaches

Eileen’s experience with the sauna has shown her that effective RA management can include complementary approaches alongside medication. “It’s important for clinicians and patients to think outside of the medication box,” she says. “What can patients do every day that will benefit them? For me, it’s the sauna.” 

Eileen hopes that others will find similar benefits from incorporating sauna therapy into their routines, and she advocates for greater support, including insurance coverage, for non-pharmacological treatments. 

“The sauna is a healthy and relaxing daily activity for those living with rheumatoid arthritis,” adds Eileen, underscoring her belief that integrative care approaches can be life-changing for people with chronic conditions like RA. 

A Holistic Approach to RA Management

Eileen’s poster shares a fresh, patient-centred approach to managing RA: sauna therapy. She highlights how it helps relieve muscle pain, makes exercise easier, improves sleep, and eases chronic fatigue. Beyond the physical benefits, sauna therapy has become a key part of her self-care, offering mental, emotional, and social support. 

At ACR 2024, Eileen hopes her story inspires others with RA to explore creative ways to enhance their quality of life while managing their condition. 

https://creakyjoints.org/acr-2024/sauna-therapy-for-rheumatoidarthritis/ 

Are Creaky Knees a Sign of Arthritis Risk?

From bicycling.com/health-nutrition

A new study looks into whether all that crackling and grinding should be a wake-up call for your joint health 

• A new meta-analysis of research looked at whether there was a link between creaky knees and osteoarthritis (OA) risk.
• Researchers found that although the majority of individuals with OA also have creaky knees, creaky knees doesn’t necessarily mean you will get arthritis.
• Experts suggest ways to lower risk of OA and protect your knees.

Maybe you notice the noises first thing in the morning when your joints are still stiff, or they could come up after you’ve been cycling for a while. It’s that crackling, grinding, and popping in your knees that isn’t painful, but seems excessive. Is there a chance this is an early sign of arthritis developing?

While creaky knees—known as knee crepitus—may be part of osteoarthritis (OA) for some, the good news is that it seems to be harmless for many people, according to a research review in the British Journal of Sports Medicine.

Researchers looked at 103 studies involving more than 36,000 participants and found that creaky knees is seen most in those with OA—81 percent of participants with OA had knee crepitus—but it’s also seen in those without that condition. Prevalence of knee crepitus in the general, non-OA population is about 41 percent, according to the meta-analysis.

“It was previously thought that creaky knees were a sign of injury or damage to the knee joint, but we found that knee crepitus is really common in those with and without a knee injury,” said lead researcher Jamon Couch, Ph.D.(c) at the Sport and Exercise Medicine Research Centre at La Trobe University in Vancouver, Canada. “In fact, over one-third of people who have never had a knee injury in their life can experience this.”

Concern about joint issues is also common when you hear that crackling, popping, or grinding when squatting or going up or down stairs, Jamon told Bicycling. Unfortunately, when that happens, it can lead to reductions in physical activity.

“People with creaky knees often feel there are more serious underlying health issues like arthritis, causing them to be fearful of exercising and using their knees,” he said. “While we did discover a link between knee crepitus and features of osteoarthritis on medical imaging scans, people generally shouldn’t be concerned about knee crepitus unless it’s accompanied by painful movement. If there’s no pain, it’s likely not doing any damage.”

                                                                                                                                                     Trevor Raab

In terms of what causes creaky knees, that’s still unknown even though the topic has been explored for well over a century, according to Couch—research on the topic is seen in medical journal as far back as 1885, he added. One prominent theory is that the sounds arise when cartilage rubs against the joint surface or other soft tissues within the knee. Another posits that crepitus can be prompted by air bubbles that build up in the joint and pop when there’s movement, similar to cracking your knuckles.

Although creaky knees without pain may not indicate an immediate concern, it can be helpful to focus on exercise that improves overall knee health if you have risk factors for OA, Couch said. These risk factors include previous knee injuries, excess weight, a family history of OA, smoking, and being an older adult—arthritis risk increases with age.

Exercises utilized for reducing the effects of OA (whether you have the condition or not) are a good starting point. For that, the National Library of Medicine suggests strength and mobility exercises done two to three times a week for about 45 minutes per session, incorporating moves like step-ups, one-leg balancing, and squats. Endurance sports like cycling are also beneficial for improving lower-body strength without overtaxing the knee joints, the organization added.

Activities like these increase blood flow to the knees and other joints, and allow joint fluid to enter the cartilage in the joint more effectively. The National Library of Medicine noted that this can strengthen the muscles around the joints, increase joint stability, and improve flexibility overall.

You may still have creaky knees even with regular, focused exercise—but you’ll be lowering the risk of all that crackling and grinding turning into an OA alarm bell.

https://www.bicycling.com/health-nutrition/a62884186/creaky-knees-arthritis-risk-study/

Dog Walking Helps Arthritic Joints

From arthritis.org/health-wellness

Daily walks keep best furry buddy happy — and your joints, too 

Any dog owner knows that take-me-for-a-walk look: puppy eyes pleading, head tilting, an “oh, please” woof and tail thumping. You probably think you’re doing Fido a favour when you give in and take him for a stroll. Turns out, he may be doing you the favour. Walking has many benefits for people living with arthritis.

Eager canine companions virtually guarantee that their humans walk daily, even when you’re tempted to stay home because of flares, lousy weather or plain old laziness. Walking a dog doesn’t require extra expense, special clothes or going to a gym, and dogs aren’t interested in breaking the routine by taking a day off or going on vacation. Consistency, such as sticking to daily walks, is key when it comes to gaining the benefits of exercise.

Research has shown that people who have dogs tend to be more physically active than those who don’t. Numerous studies have shown benefits of increased physical activity from dog walking, from potentially reducing anxiety to easing the impacts of COPD to an association with lower rates of cardiovascular disease. One small study found that people who had a dog walked more often and lost as much as 14 pounds in a year. That is particularly good news for people with arthritis, because research also has shown that for every one pound lost reduces pressure on weight-bearing joints by four pounds. 

When it comes to selecting a furry friend, you may want to avoid very large or active breeds unless they are properly trained not to pull, jump or otherwise put your joints at risk. Consider adopting a calm, middle-aged or senior dog from a shelter, where staff have already vetted its temperament. And look for leashes and other devices that help deter your pup from pulling or lunging.

https://www.arthritis.org/health-wellness/healthy-living/physical-activity/walking/walking-a-dog-benefits-joints

Can Vitamin D Help With Psoriatic Arthritis? Here’s What Experts Say

From healthcentral.com 

Research has found people with psoriatic arthritis tend to be low in this essential vitamin—but the jury is out on whether a supplement can help

Psoriatic arthritis, an autoimmune disease fuelled by out-of-control inflammation, can cause symptoms like joint pain, fatigue, and swelling from head to toe, so it's no surprise that people might be looking for ways to get relief. And one option that has gotten some attention is vitamin D, which some consider to be one of the best supplements for psoriatic arthritis.

But in reality, the relationship between psoriatic arthritis and vitamin D is—as with a lot of supplements —a tricky one to figure out, since the science behind it is still unclear. What might be driving the correlation? Vitamin D is one of the most promising vitamins for psoriasis (a related but still separate condition that appears on the skin), so there’s reason to be optimistic. So, do psoriatic arthritis supplements like vitamin D merit a spot in your medicine cabinet? Here’s what the experts say.

The Relationship Between Vitamin D and Psoriatic Arthritis

The connection between vitamin D and psoriatic arthritis is more complicated than it seems. Vitamin D, for reference, benefits your body on several fronts. “It’s important for bone health and has roles in the immune system and in maintaining skin health,” says S. Louis Bridges, Jr., M.D., a rheumatologist and physician-in-chief and chair of the Department of Medicine at the Hospital for Special Surgery in New York City.

Research has found that vitamin D deficiency was especially common among people with PsA—and that the lower their vitamin D levels were, the more disease activity, indicated by a higher DAPSA (Disease Activity in Psoriatic Arthritis) score, they experienced. DAPSA is a measurement of PsA severity that takes into account the joints affected, pain levels, and levels of C-reactive protein, which is an inflammation marker.

But it’s unclear whether low vitamin D levels are the cause or the result of inflammation, according to Dr. Bridges. “When there is inflammation, serum levels of vitamin D decrease,” says Dr. Bridges. “Low levels of vitamin D are associated with a variety of inflammatory states.” In other words, it’s like which came first—low vitamin D, which contributes to the uptick in inflammation and DAPSA, or the inflammation, which stifles the levels of vitamin D? It’s hard to say.

Should You Take Vitamin D to Treat Your Psoriatic Arthritis?

Taking vitamin D could be helpful if you have psoriasis alongside your PsA. “Oral vitamin D supplementation may have some benefits in psoriasis,” says Dr. Bridges, though he notes that most research focuses on the efficacy of topical creams applied to plaques (versus oral supplements). “They work by slowing down the rapid skin cell turnover associated with psoriasis and have immunomodulatory effects.”

As for psoriatic arthritis, vitamin D may help ease symptoms—in theory. But “there are no studies that definitively show this, and much more work is needed,” says Dr. Bridges. “We also need studies to understand the role of vitamin D in the development and treatment of PsA, and the differences in vitamin D metabolism between patients with PsA compared to psoriasis without arthritis.”

What are the Best Sources of Vitamin D?

Sunlight is the primary source of vitamin D. “Vitamin D is made or synthesized in the skin from its precursor, a type of cholesterol,” says Shailendra Singh, M.D., a rheumatologist at White County Medical Center in Searcy, AK. “When you're exposed to the sunlight, that vitamin D precursor is formed in the skin—and once that is formed, that is converted into its active form in the liver and the kidneys.” But if you don’t spend a lot of time outside, then sunlight alone might not be enough to make the amount of vitamin D you need.

If that’s the case, you’ll need to get it from your diet—and, ideally, you should be eating your vitamin D rather than taking it through a supplement, according to Dr. Singh. “There are several foods which are enriched in vitamin D,” he says. “Most of the milk available in the market is enriched with vitamin D, as are yogurt and cheese.” You can also find vitamin D in fatty fish and fish liver oil.

How Much Vitamin D You Need With Psoriatic Arthritis

Besides infants, most people need 15 micrograms (mcg) of vitamin D a day, according to the National Institutes of Health (NIH). (A cup of milk has 2.9 mcg, while three ounces of salmon and trout each have over 14 mcg.) Even if you have psoriatic arthritis, that’s all our experts recommended. “I do not recommend routine vitamin D supplementation to treat psoriatic arthritis,” says Dr. Bridges.

The Risks of Too Much Vitamin D

Because it can increase calcium absorption, taking too much vitamin D can lead to hypercalcemia—literally, excessive calcium—which in turn leads to nausea, vomiting, and kidney stones. And while too much vitamin D alone can lead to kidney failure, it's extremely rare, according to the NIH. Really, it only tends to become a problem if you’re taking a lot of different vitamins, according to Dr. Singh. “Overdosing on vitamin D is very, very difficult,” he says.

And, even when you take it in an over-the-counter supplement, “that vitamin D needs to be activated inside the kidneys and in the liver to become active vitamin D—and our body will only produce as much active vitamin D as it needs,” he says. The rest gets excreted out.

Talk With Your Doctor

If you’re curious about supplementing with vitamin D, talk to your doctor—but manage your expectations accordingly. If your doctor checks your vitamin D levels and they’re low, they might recommend a supplement, says Dr. Singh. And if they’re normal, then supplementing with vitamin D won’t add any extra benefit for your psoriatic arthritis. And remember, it’s not a cure-all, and should at most be part of an overarching treatment plan overseen by your doctor.

https://www.healthcentral.com/condition/psoriatic-arthritis/psoriatic-arthritis-and-vitamin-d

Hand and wrist arthritis: You have great options for relief

From novanthealth.org 

Charleston orthopaedic surgeon discusses treating the most common form of arthritis

Whether we type for a living or deliver heavy boxes all day, our hands and wrists can take a beating.

More than 50 million people in the U.S. have arthritis, a condition that damages the joints. Its most common form, osteoarthritis, is a chronic and degenerative disease that affects sensitive cartilage where bones connect to form a joint (think the wrist and knuckles).

Dr. Eric Angermeier

“It's a disease that does not discriminate much and affects a broad swath of people,” said orthopaedic hand and wrist surgeon Dr. Eric Angermeier, co-founder of the Hand Institute of Charleston - Mount Pleasant. To make an appointment, click here.

Angermeier explains how we come to suffer from arthritis and the treatment options that can bring pain relief.

What is arthritis?

The fundamental common element in all types of arthritis is that the cartilage breaks down. And as that cartilage thins and eventually goes away, what you have are two raw bone ends bumping into each other. That often means a lot of pain.

And, as Angermeier explains, a lot of hand and wrist arthritis is determined by genetics rather than wear and tear. Some people just have joints that wear out faster than others. That said, symptomatic arthritis peaks in our 60s or 70s because people are still active and using their hands a lot and aggravating their arthritis.

And while there is no cure for arthritis, advancing technology is helping surgeons rebuild joints to reduce pain and improve function while also promoting a faster recovery.

Are there certain professions that are more difficult for those affected by arthritis?

It really comes down to genetics in a lot of cases. If you have a direct injury to the cartilage of your joints, that can hasten the wear-and-tear of the cartilage. So, if you're in an occupation like construction, you’re more likely to have injuries to the cartilage that may accumulate over time.

But the flipside of that is you may have been one of these folks who was going to get arthritis anyway. If you’re a heavy manual labourer and happen to have arthritis, you're going to hurt a lot more because you're using your hands for heavier activities.

So it's a chicken-or-the-egg kind of situation. We used to think that heavy manual activities may have caused arthritis, but now we think that people with bad arthritis are probably going to get arthritis anyway, and it's the heavy manual activity that's aggravating it.

There are some outliers. If you’ve run ultra-marathons for many years, you're more likely than the average person to have arthritis and wear out your cartilage over time. But a lot of hand and wrist arthritis is determined by genetics and normal use. This is everyone from folks who enjoy gardening and crocheting all the way up to people working construction.

How can we prevent arthritis?

As we age and our cartilage wears out, the joints tend to get stiffer. One thing you can do to counteract the effect of osteoarthritis is to develop a daily regimen of finger stretching and wrist stretching that will help to maintain your range of motion. Even though the arthritis continues to progress, you'll be more functional.

But as yet, we don't have any known treatments, supplements, stretches, braces or other technologies that slow the progression of arthritis or prevent it. We truly don't have any tools to prevent osteoarthritis. Fortunately, we have many opportunities to treat it or help modify the symptoms of arthritis.

Two of the most common supplements are chondroitin and glucosamine (both found naturally in cartilage). You see both of these advertised a lot for people with arthritis, but there is no quality research that indicates that any supplement, those included, slows or prevents the development of osteoarthritis.

Although chondroitin and glucosamine do not prevent arthritis, there is some limited evidence that they can reduce arthritic pain in some patients and are generally felt to be safe. I just wouldn’t recommend spending a lot on supplements that don’t seem to be helping.

Who is a candidate for hand surgery, and how invasive is it?

You should always pursue non-operative treatment first. Usually, we'll try a steroid injection or two to see if we can get symptoms under control. But when that fails to yield adequate relief of pain and stiffness, the most commonly performed surgery for arthritis in the hand and wrist is a carpometacarpal [CMC] joint arthroplasty. It's essentially a reconstruction of the joint at the base of the thumb.

We've developed a minor outpatient procedure that is done through a single small incision, and we replace the bone-on-bone contact at the arthritic joint with an internal sling made from a tendon. The base of the thumb sits in a hammock-type structure that helps to prevent it from rubbing the arthritic bones.

This can significantly alleviate pain and improve strength and function. It’s one of the most satisfying procedures that we have to offer as hand surgeons because it can restore a tremendous amount of hand function.

The thumb represents about 50% of the overall function of the hand, so if you can get the thumb functioning pain-free and with more strength, that can change the quality of life for the patient.

What are the risks of surgery?

There's a very low risk of complications with this procedure and a very high rate of positive outcomes.

These procedures have become more and more minimally invasive, involving just a single incision at the base of the thumb, which helps speed recovery, causes less pain and lessens the risk of infection.

When should somebody make an appointment with an orthopaedic surgeon?

If there's anything bothering your hand or your wrist, I'd strongly encourage you to see a hand surgeon. I think the threshold should be pretty low to get things checked out. Hand and wrist arthritis is highly treatable and often with good results. And there are many different options available depending on where the arthritis is, the age of the patient and how active they are.

https://www.novanthealth.org/healthy-headlines/hand-and-wrist-arthritis-you-have-great-options-for-relief