I have rheumatoid arthritis that is starting to affect my hands. I've seen photos of people with severe hand deformities. Is there anyway to avoid or prevent that from happening to me?
You are right that rheumatoid arthritis can be a very disabling and deforming condition -- but it doesn't have to be! With the coordinated efforts of a team of health care specialists, patients can often address problems early on and delay or prevent them from developing. How can you do this? First, by making good use of the newer medications for rheumatoid arthritis called disease-modifying antirheumatic drugs (DMARDs) as prescribed by your rheumatologist. These drugs have been shown to slow down the destructive processes created by the inflammatory effects of rheumatoid arthritis. Working with a hand therapist (occupational or physical therapist) to maintain joint motion, muscle strength, and function is important. The therapist will show you ways to protect your joints and preserve motion. Everything you do with your hands (whether at home, work, or play) can be modified to accomplish these goals. Having a hand surgeon on your team keeping tabs on your situation can be a help as well. There's no doubt that improved medical treatment has reduced the number (and severity) of hand, finger, and thumb deformities caused by rheumatoid arthritis. But these and other problems still do crop up and may require surgical intervention. Surgery doesn't have to wait until the damage is done. For example, surgery can be done to realign the bones and reduce pain (when present). Correcting alignment and minimizing deformities may help improve motion and function. The surgeon can take action once evidence is seen that the wrist bones are migrating (shifting). Tendon transfers, partial fusion of the wrist, and removing some of the inflamed synovium (joint lining) may prevent shifting of the bones, thus reducing the risk of hand and finger deformities. Let your team know of your interest in being as pro-active as possible in managing this disease. Don't hesitate to bring a problem to their attention. It is better to address issues as they arise rather than trying to "make do" or "get through" until it is too late for the optimal (best) result.