What is Arthritis?

Arthritis refers to inflammation around joints. There are many different causes of the inflammation but osteoarthritis due to age and ‘wear and tear’ is the most common.

What are the non-surgical and surgical options available?

With a diagnosis of osteoarthritis, often the symptoms come and go and by controlling exacerbating factors, symptoms can be prevented. Controlling these factors can be achieved using splints, physiotherapy, pain relief, behaviour modification or activity aids (devices that do the job for you). Flair ups can be managed non-surgically with steroid injections and non-steroidal anti-inflammatory medication. Other forms of arthritis are managed with medication normally supervised by rheumatologists. Surgery is aimed at symptomatic control whilst preserving and restoring function to joints.

How long do the results last for?

Resting the joint in a splint usually requires 2-4 weeks for a significant improvement to be noted and the full effect will be evident by six weeks. Steroid injections are usually painful for 1-2 days and then take approximately six weeks to take effect. The results of steroid injection can be permanent although most are temporary or incomplete if symptoms are severe. When the effects are temporary (lasting 6-9 months) or incomplete, the steroid injection can be repeated. If the steroid injection fails, or an immediate solution is required, surgical alternatives, will be explored if appropriate. The results of surgery are permanent.

What are the risks?

There is a small theoretical risk of an allergic reaction to the steroid injection, if a person has not had these injections before. The injection sites occasionally bruise and can swell. Infection is a small risk and like with any injection would be treated with antibiotics. When injecting around the tendons, infection may require an emergency operation, but this is extremely rare. Surgical release leaves a scar on the hand, but these usually heal very well. Like with all other surgery, bleeding is also a theoretical risk. Tender scar tissue occasionally takes a few months to settle down with massage. The aims of any intervention are to relieve pain whilst preserving function. The problem rarely recurs or function deteriorates.

What are the success rates?

This is determined by the severity of the diagnosis.

How much does the surgery cost?

The indicative prices below include the surgical fee, any anaesthetic used and the associated fees from the consultant administering this, in addition to the hospital fee and all tests and follow up. An accurate breakdown and a detailed quote will be given following the initial consultation.

From £250 for a steroid injection under local anaesthetic

What general advice is there?

Following any injections or surgery on the hand, swelling and discomfort is inevitable. Elevation of the affected arm and non-steroidal anti-inflammatory medication helps. Early immobilisation for 48 hours helps recovery but must be followed by appropriately gauged mobilisation. Simple pain relief (paracetamol and/or ibuprofen) taken one hour before hand therapy rehabilitation allows more exercises to be undertaken. Desensitisation with moisturiser and massage helps scars to soften and become less painful.