How to future-proof your wrists

From bbc.co.uk

Modern life is ruining our wrists. We can all do something about it, but it helps to start early 

It began with a dull ache. Over the course of a summer, it rapidly progressed to an arm-juddering pain, radiating through my left hand every time I struck a tennis ball or even attempted to open a door.

I was 18 at that point, and playing competitive tennis was an important part of my life, but I'd just experienced an injury that would plague me for years. Now, nearly two decades later, it could increase my risk of developing wrist arthritis. Such problems are surprisingly common in mid to later life. 

Our wrists are remarkably adaptable. They have the strength to allow us to lift heavy objects (including the World Record of 2,422 kg (5339 lbs)), the flexibility to enable us to hit rogue balls during racquet sports, and the fine control to make tasks like painting possible.

From typing to holding a coffee cup, functional wrists are essential to normal everyday life. But they are easily damaged, and we all need to start thinking about them earlier in life than you’d expect. Here's how to protect yours, so you can continue taking them for granted for years to come.

(Image credit: Getty Images)

A fragile balance

We may think of the wrist as a single joint, but it is actually a complex, comprising multiple smaller joints. These are formed of eight small bones known as the carpal bones, the two long bones of the forearm, and the bases of the five metacarpal bones within the palm. 

"Every ligament and every bone in the wrist that connects it to your forearm bones are really in a very finely-tuned balance," says Andrew Abadeer, an assistant professor at the University of South Florida. "When that goes awry, that's when wrist arthritis starts to develop."

Injuries, combined with the effects of ageing, can disrupt this fragile equilibrium.

Simply avoiding arthritis is a major reason for maintaining your wrist health. There are many different kinds, but it typically takes one of three forms: rheumatoid arthritis, osteoarthritis, or post-traumatic arthritis. The latter two ailments occur when the cartilage cushioning the small bones within the wrist becomes damaged, or the bones become misaligned. Both are linked to the long-term effects of injuries to the ligaments and bones within the wrist, or lingering inflammation due to overuse through repetitive manual tasks. 

Sara Larsson, a researcher who studies wrist rehabilitation at Lund University, explains that this trauma may be as simple as a repetitive twisting movement or tripping and falling on an outstretched hand. "I see many people who had an injury when they were young, everything appeared to be fine again, and then 20 years later, they develop problems."

Arthritis of the wrist has been estimated to affect as many as one in seven Americans. It is not only highly painful, but makes it harder for people to dress themselves and cut their own food, with the psychological burden being linked to depression.

Abadeer describes the wrist as being a "sentinel joint" which can reflect early signs of declining health within the rest of the body. About half of all patients who develop rheumatoid arthritis first feel the effects the disease in their wrist before it progresses to other joints. Because the brain devotes a large region of the cortex, known as the cortical homunculus, to mapping the hands, wrist and fingers, grip strength can reflect brain structure and cognitive health.

But people who reach their sixties with their wrists in better shape – typically assessed in the form of grip strength – tend to have better health overall. Those people are not only less frail and less vulnerable to falls, bone fractures and osteoporosis – a condition that weakens bones. But they are less likely to lose their independence in older age.  

Setting yourself up

Before we get started, Jaehon Kim, an orthopaedic surgeon at the Ichan School of Medicine at Mount Sinai, New York, recommends considering your diet. Foods high in calcium and other minerals, such as small, bony fish (sardines work well for this) and dairy products can help to mitigate against the development of osteoporosis. In addition, while weight might not seem particularly related to wrist health, shedding excess body fat can improve the overall biomechanics of the wrist joint.

But overall, Larsson says that the best preventative measure is to do a few simple home-based workouts which can help make your wrist more resilient and stave off problems further down the line. For each of the below exercises, she recommends performing three sets of 10 repetitions (this means performing the exercise 10 times, resting, performing it again 10 times, resting, and doing it another 10 times), three or four times per week. 

If you have any pre-existing conditions or injuries, it's important to seek medical advice before starting a new exercise regime. And if you feel pain at any point, stop and seek medical help. 

1. Build your shoulder muscle strength

The main muscles in your shoulders are known as the deltoids. While they may appear unrelated to wrists, Larsson says that strengthening the muscle groups across the whole arm can greatly benefit your wrist as they work together like a chain.

"You don't just use your hand, you use the whole arm," says Larsson. "And if you're weak in your shoulders, then you put more load on the wrist. But if you are strong, then you can protect and unload the wrist."

One easy method of training your shoulder muscles is simply to stand with your arms out to the sides, with your arms either straight or slightly bent. Slowly raise your arms up to the ceiling and then bring them down again slowly. Repeat this ten times.

2. Strengthen your grip

Grip strengthening exercises can improve wrist stability by conditioning groups of forearm muscles known as flexors and extensors, which attach to your fingers across the wrist joint, allowing you to grip objects. Studies have previously shown that this can also help people with existing wrist pain. 

"All your forearm muscles connect into your hand on both sides of your wrist in a pulley system," says Abadeer.

To work these muscles, you ideally want a hand therapy ball or therapeutic putty – a silicone-based material which you can squeeze in your hand – but a tennis ball will do.

Even healed wrist injuries can lead to problems decades later (Credit: Getty Images)

Hold the ball or putty in the palm of your hand and squeeze it as hard as you can for five to 10 seconds. Release the grip and relax your hand for another five seconds and then squeeze again. Repeat ten times in each hand. (Read more from the BBC about how grip strength can predict your chances of living to 100.)

3. Gently load and flex the wrist

According to Kim, another key means of reducing the stress on the wrist joints and tendons is exercises that flex and extend the wrist, using some form of mild weight or resistance as a load.

This can also strengthen bones in the wrist, which could have longer-term health benefits, particularly when it comes to preventing a type of osteoporosis known as disuse osteopenia. "When they're loaded, these bones strengthen and start to remodel, adding more strength to the wall of that bone," says Abadeer.

To do this, start by sitting and resting your forearm on a table with your hand hanging off the edge and holding a small weight, between 3 and 7kg (5 and 15lb). For a flexion exercise, have your palm facing upwards and curl your wrist up toward your body before lowering it back down again. For an extension exercise, have your palm facing downwards while holding the weight, and lift your hand up towards the ceiling before lowering it down again. 

If you don't have weights, Larsson suggests using a resistance band instead. Fix one end of the band under a table leg and hold the other end across your wrist so you're experiencing some resistance while carrying out the exercises.

Repeat both flexion and extension ten times. "I think this can go a long way in terms of helping the joints in your wrist, especially if you're typing and writing a lot," says Kim.

4. Supinate and pronate 

Lastly, there are supination and pronation movements. These can improve the range of motion of your wrist and its overall functionality. Like the flexion and extension exercises, they can be carried out over a table with a small weight or resistance band.

Begin with your hand over the edge of the table with your thumb pointing up. Then slowly turn your wrist so your palm faces down, then return to the starting position, and rotate the other way so your palm faces up. Repeat this ten times.

Abadeer says that such exercises are becoming increasingly important as we now live in what he describes as "a pronated world", where our hands spend many hours of the day in a fixed position, either due to typing on a laptop or a phone. 

As with all our joints, strong, flexible wrists are something that we often take for granted. But as I found myself when my wrist was out of action for many months, it's only when you lose something that you realise its true importance.

* All content within this article is provided for general information only, and should not be treated as a substitute for the medical advice of health care professionals.

https://www.bbc.co.uk/future/article/20260904-how-to-future-proof-your-wrists

Canada: Calgary boy’s arthritis diagnosis highlights a disease many still associate only with old age

From ctvnews.ca

September is Arthritis Awareness Month in Canada, shining a spotlight on a disease that can affect far more than joints — and far more than older adults.

For Calgary’s Riley Ostrowski, the diagnosis came when he was just seven years old, after a frightening and confusing stretch of hospital visits, painful symptoms and months without answers.

He woke early one morning crying and unable to move his neck, prompting his family to take him to hospital.

“I feel like it just stopped all of my physical movement,” said Riley.

“I felt it in my ankles, my shoulders and my wrist and I wasn’t even able to walk up or down the stairs.”

Riley Ostrowski

What followed was a 12-day stay at Alberta Children’s Hospital, along with months of appointments, testing and uncertainty before Riley was eventually diagnosed with systemic juvenile idiopathic arthritis, or systemic JIA.

Riley’s mother, Jennifer Schultz, says that at its worst, the disease affected as many as 14 of her son’s joints.

“He experienced high fevers, rashes, fatigue, and pain and until this happened, we had no clue kids could get arthritis,” she said.

“It took about four months to get the diagnosis, but the fact that we were able to get treated right away was a Godsend because some families have spent more than a year or two years before they got an answer.”

Riley’s mother, Jennifer Schultz, says that at its worst, the disease affected as many as 14 of her son’s joints

Riley was initially treated with anti-inflammatory medication and steroids before moving to biologic therapy.

His family says the medication made a dramatic difference.

“The treatments have been amazing and work very fast,” Schultz said.

Riley initially received treatment intravenously at Alberta Children’s Hospital every few weeks, but has since transitioned to injections at home.

His condition is now largely in remission, and he has returned to many of the activities he enjoys, including playing baseball.

“I sometimes feel like a normal kid. I was freaked out when I first started having to inject these needles, but I feel a lot stronger,” Riley said.

“I love playing baseball, writing comics, and playing video games. So if there are any other kids out there with juvenile arthritis, it’s the love of your family that makes you strong.”

What is juvenile idiopathic arthritis?

Dr. Marinka Twilt, a paediatric rheumatologist at Alberta Children’s Hospital and professor of paediatrics at the University of Calgary, says juvenile idiopathic arthritis is an autoimmune disease in which the immune system mistakenly attacks the body’s own tissues.

The exact cause is not known and is likely influenced by a combination of genetic and environmental factors.

“It’s nothing that a patient or parent has done wrong, and nothing that they could have prevented from it to happen,” Twilt said.

Juvenile arthritis affects an estimated one in 1,000 children.

Twilt says symptoms in children can sometimes be difficult to recognize because younger patients may adapt to pain rather than complain about it.

“They’ll just find another way to still do what they want to do,” she said.

Some children may stop using an affected joint, become unusually tired or lose the ability or willingness to do activities they previously enjoyed. Younger children may suddenly want to be carried more often or stop running and playing.

“If you see that there’s regression in what they could do before, that would be really a sign to go and see a health-care provider,” Twilt said.

Twilt says treatment options for juvenile arthritis have improved significantly, but awareness remains important because earlier diagnosis can help children access effective treatment sooner.

“Awareness is good for the patient that they’re earlier diagnosed, but then when they’re diagnosed, we have to have access to treatment,” she said.

Building support for families

Cassie + Friends, a Canadian charity supporting children with juvenile arthritis and other rheumatic diseases, says roughly 25,000 children across the country are living with those conditions.

“We really want people to understand that kids get arthritis too,” said David Porte, chair and one of the organization’s founders.

Porte helped establish Cassie + Friends after his own daughter, Cassie, was diagnosed with juvenile arthritis at 20 months old.

The organization now provides families with education, financial and emotional support while also connecting children with others facing similar diagnoses.

Cassie + Friends, a Canadian charity supporting children with juvenile arthritis and other rheumatic diseases, says roughly 25,000 children across the country are living with those conditions

Cassie + Friends is holding a Calgary run and walk at Fish Creek Park on Oct. 3, bringing families, doctors and supporters together to raise awareness and funds.

“The medication is great; that’s what treats a disease. But it’s really building this community around it is what lets the families really thrive together,” Porte said.

“We really want people to understand that kids get arthritis too. We really want people to understand what those symptoms are, what they should be looking for if their child has sore joints in the morning, if they’re complaining about pain, that not to overlook it.”

Porte adds that the community events his team runs across Canada are also a chance to build awareness.

One of the challenges is access to treatment.

“The access is not consistent across the country. The access is not consistent for all kids and families, so that is one of the other things that we’re really working on.”

Growing economic burden in Alberta

Arthritis Society Canada is also using Arthritis Awareness Month to highlight the broader impact of the disease.

According to the organization, arthritis carries an estimated $5.1-billion annual economic cost in Alberta through expenses such as medication and hospital care, as well as lost productivity.

Trish Barbato, president and CEO of Arthritis Society Canada, said the report shows another $10 billion is also attributed to social value loss.

“The social impact cost is a new number. It is related to what do people lose because they’re in pain all the time, because they don’t have mobility.”

The cost of pain, reduced mobility, lost independence and the activities people can no longer take part in means arthritis is now the leading cause of disability across Canada.

Barbato adds that the Alberta figures also show the consequences for both individuals and the health-care system.

“It’s a failing of the system. It’s not a failing of individuals who choose to find another path,” Barbato said when discussing the challenges faced by people trying to access arthritis care.

She says improving access to community-based therapy and education could also help people manage the disease and, in some cases, reduce pressure on the health-care system.

“And so when you think about someone who says, ‘I have a bad knee,’ I always joke, ‘You do not have a bad knee. You have end stage arthritis.’”

“If you’re not mobile, if you can’t walk, that is going to impact your job and your ability to be productive.”

The report projects the overall economic and social burden of arthritis in Canada will rise from $142.4 billion annually today to $222.3 billion by 2055, as the number of people living with the disease is expected to grow from more than six million to at least 10 million.

Primary Care Alberta says arthritis can significantly affect a person’s health, independence and quality of life, and that provincial guidance is available to help health-care providers assess and manage the condition.

It says Albertans can also access supports including arthritis education, physiotherapy, self-management workshops and exercise programs.

https://www.ctvnews.ca/calgary/article/calgary-boys-arthritis-diagnosis-highlights-a-disease-many-still-associate-only-with-old-age/ 

One injection could keep osteoarthritis drugs working for weeks

From sciencedaily.com

Scientists have created an injectable gel that can remain inside arthritic joints for weeks, slowly releasing medication while also improving lubrication. The approach could make it easier to deliver disease-modifying drugs directly where they are needed while limiting exposure elsewhere in the body. 

Scientists at the University at Buffalo have developed an injectable hydrogel designed to keep osteoarthritis treatments inside the joint for much longer than conventional injections.

After a single minimally invasive injection, the material changes from a liquid into a smooth, lubricating semisolid depot at body temperature. Once in place, it can remain in the joint for several weeks while gradually releasing drug-loaded nanocarriers.

A new injectable gel could turn one shot into weeks of targeted osteoarthritis treatment while helping lubricate damaged joints. Credit: Shutterstock

A Major Challenge in Osteoarthritis Treatment

Osteoarthritis (OA) is one of the world's leading causes of chronic pain and disability. Common treatments delivered directly into joints, including analgesics, corticosteroids, and viscosupplements, can ease symptoms, but their effects are often short-lived, and they do not consistently slow the progression of the disease.

One of the biggest obstacles is that small molecule drugs and biologics can be cleared quickly from synovial fluid. Researchers also face challenges when trying to deliver hydrophobic drugs at concentrations high enough to be effective without increasing exposure throughout the rest of the body.

The University at Buffalo hydrogel platform was designed to address both problems by keeping therapeutic compounds concentrated in the joint and releasing them gradually over time.

A Drug Depot That Forms Inside the Joint

The injectable formulation begins as a liquid, allowing it to be delivered with a minimally invasive procedure. At body temperature, it rapidly becomes a lubricious semisolid material that acts as a local drug reservoir.

The platform combines a biocompatible polymer matrix with drug-loaded nanocarriers. These nanocarriers are designed to carry high amounts of poorly soluble therapeutic compounds, which are otherwise difficult to deliver in an aqueous environment.

The system also uses materials with prior regulatory acceptance, a feature intended to make eventual clinical translation more practical.

Once inside the joint, therapeutic compounds are released through diffusion and gradual relaxation of the hydrogel matrix. This process provides controlled local exposure over multiple weeks rather than allowing the medication to disappear rapidly from the joint.

Researchers have validated the approach using a SIRT6 activator. The platform can also be adapted to carry other hydrophobic disease-modifying compounds.

Longer Lasting Drug Delivery and Joint Lubrication

One potential advantage is a longer therapeutic window. By retaining medication locally for an extended period, the system could reduce how often patients need invasive joint injections while also lowering the possibility of systemic side effects.

The hydrogel was also designed with disease modification in mind. Rather than focusing only on pain relief, it could deliver compounds that target biological processes involved in osteoarthritis, including chronic inflammation and cellular senescence.

Another feature is its dual role inside the joint. The material functions both as a sustained-release drug delivery system and as a viscosupplement, meaning it could potentially improve joint lubrication while simultaneously delivering treatments aimed at the underlying disease.

The platform can carry poorly soluble drugs at relatively high concentrations and can be adapted for different therapeutic payloads and joint applications.

Potential Uses Beyond Knee Osteoarthritis

The primary intended application is knee osteoarthritis (large addressable market).

The same technology could also have potential uses in post-traumatic OA, intervertebral disc degeneration, rotator cuff degeneration, and the localized delivery of other hydrophobic drug candidates.

https://www.sciencedaily.com/releases/2026/08/260829235947.htm

Thumbs up: New thumb joint replacement surgery relieves arthritis pain

From uchicagomedicine.org

The osteoarthritis pain in Mary Wolf’s left thumb was so sharp and intense, it sometimes woke her up in the middle of the night.

It throbbed when she tried to grip or pinch things, making two of her favourite activities — cooking and knitting — nearly impossible.

Daily tasks were also tough: To close a sandwich bag, she would have to tuck it under her left arm and use her “good” right thumb to help zip it shut.

Steroid shots every four months brought temporary relief over a period of three years, but they became less effective over time.

“The pain was ridiculously impacting my life,” said Wolf, 63, a retired fifth grade teacher.

Last spring, Wolf found new hope.

Jeffrey G. Stepan, MD, MSc, her orthopaedic surgeon at the University of Chicago Medicine, became one of only a few hand surgeons in the United States to train on an innovative new implant surgery that replaces a patient’s arthritic thumb joint with a small, prosthetic version.

When the surgery became available at UChicago Medicine in May 2026, Wolf didn’t hesitate.

“I said, ‘Sign me up,’” she said. “I had to do something drastic to change this.”

How does a thumb osteoarthritis implant work?

Thumb osteoarthritis, which causes joint pain at the base of the thumb, is a common condition that affects millions of Americans. It occurs when the protective cartilage that cushions the end of the bones wears away, causing bones to rub against one another.

It’s most common in people over age 50, and it affects women more often than men, according to the American Society for Surgery for the Hand, a medical specialty society.

Treatment starts with a thumb brace, hand therapy and steroid injections.

If the thumb pain persists, patients may choose to have thumb carpometacarpal joint trapeziectomy — a surgery that involves removing the arthritic joint. Although the surgery is effective and has high satisfaction rates, recovery can be painful and take 6 to 9 months, Stepan said.

Meanwhile, doctors in Europe have been performing a simpler and more efficient version of this surgery, using an implant called TOUCH CMC 1 Prosthesis, since 2018.

“Instead of removing the arthritic joint, they were replacing the joint with this implant,” Stepan explained.

Patients who had this implant were pain-free and regained thumb movement in less than six weeks, Stepan said. But the implant, which uses a ball-and-socket design, wasn’t approved for use in the U.S.

When Stepan heard that the U.S. Food and Drug Administration was going to approve this implant, he flew to France in April 2026 to learn how to do the surgery. He is one of only a handful of surgeons in the U.S. who are trained and approved to perform this surgery.

Thumb osteoporosis joint replacement surgery ‘absolutely life-changing’

Wolf had her surgery at the University of Chicago Medical Center in Hyde Park on May 20, 2026, and she was in and out of the hospital in less than five hours.

She received twilight anaesthesia and a nerve block in her shoulder, so she didn’t have feeling in her left arm for 24 hours. But she experienced no side effects. She wore a splint to immobilize her thumb for two weeks, but she was able to move it in “teeny circles” without pain just two days after the surgery.

“I haven’t had any pain since that first night,” she said. “The surgery was absolutely life-changing.”

Since then, Wolf has resumed her cooking and blanket-knitting project.

Stepan, who performed his third thumb osteoporosis joint implant surgery in June, said the option is available for anyone who has struggled with pain in the base of their thumb and wasn’t helped by standard treatments.

“Patients are quickly getting back their strength and getting back their motion,” he said. “Everyone’s been doing really well.”

 https://www.uchicagomedicine.org/forefront/orthopaedics-articles/new-thumb-joint-replacement-surgery

Next-gen ankle implants to help young arthritis sufferers regain mobility

From sheffield.ac.uk

By Sean Barton

The next generation of ankle replacements that could restore mobility in young people suffering from a debilitating but overlooked condition, are being developed by a global team of researchers.

• University of Sheffield researchers are leading a global effort to develop new ankle replacements for young people with ankle osteoarthritis - known as OA
• OA hits a uniquely young, active demographic - often starting in a person’s 20s or 30s following a severe injury through exercise, sports or accidents
• The disease is difficult to treat and can leave young people with a devastating compromise: undergo an operation that permanently locks the foot solid (fusion) or accept an artificial joint that may fail in a decade
• Sheffield is leading a global team of scientists and engineers to develop the next generation of ankle implants that will restore mobility, remove pain and last a lifetime, in what is the EPSRC’s biggest-ever funding award to healthcare technology research

The next generation of ankle replacements that could restore mobility in young people suffering from a debilitating but overlooked condition, are being developed by a global team of researchers. 

Led by Professor Claire Brockett from University of Sheffield’s Insigneo Institute, the research is set to revolutionise treatment for ankle osteoarthritis - a degenerative joint disease that can leave young people facing decades of agonising, progressive mobility loss during their most active years of life.

Unlike knee or hip osteoarthritis, which often develop naturally with age, ankle OA is overwhelmingly post-traumatic - triggered by severe fractures or sprains. This means the majority of people with ankle OA are diagnosed at a much younger age than those who typically need a joint replacement, after sustaining injuries from exercise, sports or accidents.

Current treatments for ankle OA are limited. They range from early management of the disease through physiotherapy, specialised footwear and steroid injections to surgery when the condition worsens. However, as the ankle is a complex joint with a number of small bones and tendons surrounding it, this makes successful surgical intervention difficult to achieve. 

A lack of investment in current treatments means that even when surgeries are successful, patients are often left with chronic pain or limited movement. Consequently, both patients and surgeons tend to postpone the procedure, viewing surgery only as a last resort. 

Previous studies have found that the daily physical and mental toll of living with advanced ankle OA is so severe that it is statistically comparable to suffering from end-stage kidney failure or congestive heart failure, according to patients in the SF-36 survey that measures health-related quality of life. 

Now, an international team of scientists and engineers led by the University of Sheffield has been awarded £12 million - the biggest-ever grant awarded by the Engineering and Physical Sciences Research Council (EPSRC) for healthcare technology research - to develop next generation ankle implants that will restore mobility, reduce pain and last a lifetime. 

Professor Claire Brockett, Professor of Biomechanics at the University of Sheffield, said: “Ankle osteoarthritis leaves patients facing a painful condition and a difficult ultimatum: an ankle fusion, which eliminates pain but permanently locks the bones together and limits movement, or a traditional replacement that preserves some mobility but is typically reserved for older, lighter, or less active patients, and one in 10 will fail within 10 years.

“Our research is looking to give all patients, but particularly younger and more active people, a better option for treatment, so they can continue being active at such an important stage in their lives. We are looking to develop new implants that will last much longer and restore mobility closer to that of the natural ankle.”

The project, called Engineering Advanced Solutions for End-stage Ankle Osteoarthritis (EASE-Ankle OA), is a five year project to tackle Total Ankle Replacement (TAR). It brings together engineers, scientists and clinicians from the University of Sheffield together with researchers from the universities of Birmingham, Warwick, Leeds, Cardiff, Dartmouth College, USA and KU Leuven, Belgium.

Professor Sue Hartley, Vice-President for Research and Innovation at the University of Sheffield, said: “This is an exciting opportunity to work on a significant health problem that has been overlooked in the past. By bringing together diverse expertise, the research will have a profound impact on people's lives, not just in the UK, but globally.

“As the first large grant funded by EPSRC that focuses on the ankle, this project sets a new benchmark for the field - combining a world-leading systematic approach with a commitment to developing the next generation of research leaders to deliver life changing impacts for Total Ankle Replacements patients.”

https://sheffield.ac.uk/news/next-gen-ankle-implants-help-young-arthritis-sufferers-regain-mobility