Condition Spotlight: Rheumatoid Arthritis in the Upper Extremity by Amy Eckert, Occupational Therapist Doctoral Candidate, OTS

What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder that affects joints by means of  inflammation, bone erosion, and joint deformity in the hands along with other associated body systems. RA is a chronic inflammatory disorder that attacks tissue in the joints and is not from general wear-and-tear in comparison to Osteoarthritis. 

 

Rheumatoid Arthritis Symptoms

Typically early signs of RA begin in the hand in the smaller joints such as fingers and spreads to other regions such as the wrist, elbow and shoulders. General signs of RA are as follows and vary greatly in severity:

  • Inflamed joints that are warm and tender to touch
  • Joint deformity and malalignment 
  • Joint stiffness with noted increased stiffness with decreased general use (mornings and inactivity)

 

Causes of Rheumatoid Arthritis

There is no known cause of RA however genetics are linked to the likelihood of the autoimmune disorder. Risk factors may include:

  • Sex (women more likely)
  • Age (middle age most common age diagnosed)
  • Genetics
  • Smoking
  • Obesity 

 

Conservative Treatments for Rheumatoid Arthritis

Conservative treatments include staying active, medication such as NSAIDs and RA specific medication proscribed by your physician, wearing splints specific for the affected area, and RICE method (rest, ice, compress, elevate) when RA is inflamed. 

 

Your hand therapist will provide specific exercises depending on your severity and area needing to be addressed. Additionally, adaptations to everyday items and rooms may be suggested by your OT to assist with independence with completion of your day-to-day tasks. 

 

What Does Rheumatoid Arthritis Surgery Look Like?

Cortisol injections may be beneficial should more conservative methods prove unsuccessful prior to surgery. Surgery can include but is not limited to removal of inflamed lining of the joint, tendon repair, joint fusing, and joint replacement.

 

Precautions/Contraindications?

Avoiding risk factors such as smoking is important to decrease your chances of developing RA in your hands. Staying active, observing for any changes to the sensation and/or structure of your hands and fingers, and knowing when to discuss any concerns with you physician can assist in the treatment of RA as early detection may assist with improved functional status. Do not over use the affected extremity and allow time to rest based on the guidelines from your therapist. 

 

References

https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648

 

A little bit about Amy Eckert, our visiting OT student…

Hi! My name is Amy and I am Creighton University Occupational Therapy Student completing my Doctoral Capstone Experience at Colorado Springs Therapy Center for the past 14 weeks. I plan to graduate with my Doctorate in Occupational Therapy in May 2022 and have hopes to specialize in hand therapy with an ultimate goal of becoming a Certified Hand Therapist. I have completed other fieldwork experiences where I provided direct care to clients in a hand therapy setting which further sparked my interest in specializing. I have always been interested in anatomy and passionate about serving others in a healthcare profession so occupational therapy has allowed me to combine both interests! One of my favorite quotes which I feel embodies occupational therapy and hand therapy is, “Man, through the use of his hands as they are energized by mind and will, can influence the state of his own health” -Mary Reilly, OT

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