Ask the doctor: Could I have arthritis in my wrist?

By | July 14, 2020

Q I am a 40-year-old woman and have been having pain in my right wrist on and off for a couple of years. It is exacerbated by working with a mouse, but also is present when I don’t work at a desk for a long period of time. I also get joint pain in my hips, etc, but nothing I would worry about as it disappears when I exercise regularly. Is there a possibility that I have arthritis in my wrist? If so, how do I get that checked out.

A It sounds like you may have a simple repetitive strain injury as you describe the computer mouse as an exacerbating factor for your wrist pain. I wonder if you have tried using ergonomic supports?

Most people who work long hours at a desk are likely to be at risk of repetitive strain injury. However, an ergonomically coordinated computer workstation can help reduce your risk. Ensure there is adequate room for the keyboard and mouse (if you have to keep one). There is a fine balance between being too far away from the keyboard or too cramped. Getting the distance right will mean you will be able to maintain good posture and body alignment, which are key elements to any computer workstation.

Ensure your computer screen is at eye level by adjusting the height of your chair and/or table. This promotes correct posture and helps to keep your wrists and hands in-line with your forearms (i.e. neutral alignment). Improving your hand muscle strength by performing thumb stretches for 10 seconds periodically can also be helpful.

You can attend an occupational therapist, physiotherapist or someone with training in this area for a full assessment and advice.

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You mentioned your wrist pain is not always brought on by working at your desk. Think about what other activities at home that may be exacerbating your pain. You are probably right-handed and use the right wrist more than the left. Do you have a newborn infant or toddler at home who requires a lot of handling?

Other medical conditions to consider are the possibility of gout, rheumatoid arthritis or osteoarthritis. If you have a family history of any of these diseases, you are at higher risk. There is a certain amount of mild joint pain and stiffness that can be expected over 50 years old. These are considered ‘age-related change’ and are often seen on scan. But if the pain is persistent over a number of months and is starting to progress, then it may be osteoarthritis (OA).

The classic symptoms of OA are pain and stiffness. There are many different types of arthritis but OA is the most common form. Joint pain is typically worse after joint use, exercise or towards the end of the day. There may be a limitation in range of motion of the joint.

Typically, OA affects one joint initially whereas rheumatoid arthritis affects multiple joints on both sides of the body in a symmetric pattern. As OA progresses, the joint becomes painful at night, resulting in sleep disturbance and often bone swelling surrounding the joint. An X-ray will help identify moderate to severe joint involvement but an MRI scan is better at identifying early OA changes.

For the majority of patients, there is usually one or more risk factors present that ultimately lead to the development of OA over time. If your pain persists or gets worse, you should attend your GP for a full history, clinical examination and investigations.

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⬤ Dr Jennifer Grant is a GP with Beacon HealthCheck

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