Wrist arthritis
in Rockhampton
Wrist arthritis is wear of the joint surfaces that causes pain, stiffness and a weakening grip. Most is managed without surgery for a long time; when it becomes advanced, there are reliable operations that trade a degree of movement for a comfortable, working wrist. Patients are seen at Mater Private Hospital Rockhampton from across Central Queensland.
What is wrist arthritis
The wrist is not one joint but a cluster of eight small bones that slide against each other, plus the joint between the two forearm bones that lets you turn your palm up and down. Arthritis is the loss of the smooth cartilage lining those surfaces, so bone loads against bone. The result is pain on use, grinding or catching, stiffness, and a grip that weakens and tires — often first noticed with jars, keys, taps and tools.
What matters clinically is which pattern is present. Wrist arthritis that follows an old ligament injury or an un-united scaphoid fracture wears in a predictable sequence, which is what makes joint-preserving surgery possible — the operation is chosen by which parts of the wrist are still healthy. Arthritis on the little-finger side, at the joint between the forearm bones, behaves differently again and is treated separately. The consult confirms the diagnosis on examination and X-ray, establishes the pattern, and sets out a pathway that runs from splinting, hand therapy and injection through to surgery when — and only when — symptoms justify it. The wrist osteoarthritis education page covers the underlying condition in more detail.
The forms it takes
"Wrist arthritis" covers several distinct patterns, each with its own cause and its own best treatment. Establishing which one is present — and which parts of the wrist are still healthy — is what determines the operation, if one is needed.
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SLAC and SNAC wrist
The commonest pattern of wrist arthritis seen in practice, and the one that follows an old injury. The wrist is a cluster of eight small bones that move like interlocking gears; when a scapholunate ligament tear (SLAC) or a scaphoid fracture that never healed (SNAC) lets one gear slip, the whole mechanism grinds and the joint wears in a predictable sequence. Because the pattern is predictable, the operation is chosen by which parts of the wrist are still healthy — commonly a proximal row carpectomy or a partial fusion that removes the worn surfaces while keeping useful movement.
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Primary wrist osteoarthritis
Wear of the cartilage lining the small wrist bones without a single injury to blame — pain and stiffness that build over years, grinding on movement, and a grip that tires. Managed for a long time with activity modification, splinting, hand therapy and injection; when pain dominates daily life despite those measures, the surgical options are arthroscopic debridement in earlier disease, or a salvage procedure that removes or fuses the worn joints.
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Post-traumatic arthritis after a wrist fracture
Arthritis developing years after a distal radius fracture, particularly where the bone healed in a poor position — a malunion, where the bone is solidly healed but in the wrong shape, so the joint surfaces load unevenly. Tends to affect younger patients than primary osteoarthritis. Where the malunion itself is driving the symptoms, a corrective osteotomy that realigns the bone can be considered before any salvage operation.
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Ulnar-sided (DRUJ) arthritis
Arthritis of the distal radioulnar joint — the small joint between the two forearm bones at the little-finger side of the wrist, which is what lets you turn your palm up and down. Pain on rotation rather than on bending the wrist is the giveaway: turning a key, a door handle or a screwdriver. It can follow a fracture, an ulna that sits long relative to the radius, or inflammatory disease, and it is treated separately from arthritis of the main wrist joint.
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Kienböck's disease
Loss of the blood supply to the lunate — the small cube-shaped bone at the centre of the wrist that acts as a shock absorber — which then collapses and leads to arthritis. It presents in younger adults, often with no clear injury, as central wrist pain and progressive stiffness. Treatment depends on the stage: early disease is managed to protect the bone, while a collapsed lunate with established arthritis is treated like any other worn wrist.
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Inflammatory arthritis
Rheumatoid arthritis and related inflammatory conditions attack the joint lining rather than wearing the cartilage mechanically, and often affect several joints of the wrist and hand at once. Medical management of the underlying disease — usually with a rheumatologist — comes first and has changed the outlook considerably. Surgery is directed at the joint destruction that can still follow, and at tendons the disease puts at risk.
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Thumb base arthritis
Arthritis at the base of the thumb is common, often confused with wrist arthritis because the pain sits at the thumb side of the wrist, and it is a different problem with a different operation. The distinguishing feature is pain on pinch and grip — opening jars, turning keys — localised to the joint at the base of the thumb rather than across the wrist.
From splint to surgery
Treatment escalates only as far as the symptoms require, and most patients never reach the end of the ladder:
- Non-operative first. Activity modification, a supportive splint for flare-ups and heavier tasks, hand therapy to maintain movement and grip, simple analgesia, and a corticosteroid injection where a specific joint is the pain source.
- Wrist arthroscopy. In earlier disease, or where the diagnosis is not settled on imaging, keyhole assessment allows the joint surfaces and ligaments to be seen directly and worn tissue debrided.
- Joint-preserving salvage. Where wear is established but confined to part of the wrist, a proximal row carpectomy or a partial fusion removes the worn surfaces while keeping useful movement — the standard approach in SLAC and SNAC wrist.
- Total wrist fusion. Where the whole joint is worn, fusion reliably removes pain at the cost of wrist movement. The fingers, thumb and forearm rotation are unaffected, so most everyday tasks remain possible.
- DRUJ surgery. Arthritis of the joint between the forearm bones — pain on turning the palm rather than bending the wrist — is addressed separately, with surgery directed at that joint.
Which operation suits you depends on the pattern of wear, your work and hobbies, and what you need the wrist to do — the trade-off between movement and pain relief is the substance of the discussion, not an afterthought.
The threshold for referral
Wrist arthritis is usually managed first by the GP and hand therapist. A specialist opinion is worth seeking when:
- Pain disturbs your sleep.
- Everyday tasks — jars, keys, taps, tools — are limited.
- Grip is weakening, or the wrist tires quickly with use.
- An X-ray has confirmed established arthritis of the wrist.
- Splinting, hand therapy, analgesia and injection are no longer giving acceptable relief.
- A previous wrist fracture, or a scaphoid injury that may not have healed, has become painful again.
A GP referral is needed for a Medicare rebate, and seeing a specialist does not commit you to surgery — much of the value is confirming which pattern of arthritis is present and mapping the options. If you are not sure the diagnosis is arthritis at all, the wrist pain guide triages the common causes by where it hurts.
How a wrist consult works
The first consult takes 30–40 minutes. It runs through a structured history (how long, what makes it worse, whether rotation or bending is the painful movement, how it affects grip and daily tasks), a focused examination of the wrist joints and the distal radioulnar joint, and a review of any X-rays you bring. The consult ends with a diagnosis (or a clear plan to confirm it) and an itemised treatment plan — hand therapy, splinting, injection, further imaging, or surgery — written for the GP.
Hand therapy is coordinated on-site through Ruby Doolan's practice (Extend Rehabilitation), which keeps post-consult, post-injection and post-operative therapy in one place. The fees, Medicare rebates and quote process are on the fees page; GPs can find the referral pathway and urgency triage on the referrer page.
Across Central Queensland
Patients are seen for wrist arthritis from Rockhampton and the wider region. Drive time and scheduling notes are on each catchment page:
Patient questions we hear most
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Can wrist arthritis be treated without surgery?
Yes — most wrist arthritis is managed without surgery for a long time, and surgery is never the first step. Activity modification, a supportive splint for flare-ups and heavier tasks, hand therapy to maintain movement and grip, simple analgesia and an occasional corticosteroid injection all help. These measures do not regrow worn cartilage, but they control symptoms and preserve function. Surgery is considered when pain dominates daily life and non-operative measures are no longer giving acceptable relief.
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How is wrist arthritis diagnosed?
A plain X-ray of the wrist is the key test — it shows loss of joint space, bony spurs, and the specific collapse patterns of SLAC and SNAC wrist, which is what makes the diagnosis more than just "arthritis". History and examination establish which part of the wrist is involved, whether rotation (the DRUJ) or bending is the painful movement, and how much function is affected. A CT or MRI is added when the diagnosis is unclear or an operation is being planned.
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What surgery is available for an arthritic wrist?
It depends on which parts of the wrist are worn and which are still healthy. In earlier disease, wrist arthroscopy allows the joint to be assessed directly and worn tissue debrided. Where wear is established but confined to part of the wrist, a proximal row carpectomy or a partial fusion removes the affected surfaces while keeping useful movement. Where the whole joint is worn, a total wrist fusion reliably removes pain at the cost of wrist movement, with the hand and fingers unaffected. Arthritis of the distal radioulnar joint on the little-finger side is treated separately, with surgery directed at that joint.
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Will I lose movement in my wrist?
That depends on the operation, and it is one of the main things the consult works through. Debridement and joint-preserving procedures aim to keep movement. A partial fusion or proximal row carpectomy keeps some movement while removing the worn surfaces. A total wrist fusion deliberately trades wrist movement for a reliably pain-free, strong wrist — the fingers and thumb still work normally, and forearm rotation is unaffected, so most everyday tasks remain possible. Which trade-off suits you depends on your work, your other hand, and what you need the wrist to do.
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Does wrist arthritis always get worse?
Arthritis is generally progressive and worn cartilage does not grow back, but the rate varies widely between people and symptoms fluctuate — many people have stable symptoms for years. SLAC and SNAC wrist follow a more predictable sequence than primary osteoarthritis, which is part of why establishing the pattern matters. The aim is to keep the wrist comfortable and working, and to consider surgery only when symptoms — not the X-ray alone — justify it.
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When should I see a specialist about wrist arthritis?
Reasonable triggers are: pain that disturbs your sleep, pain that limits everyday tasks like opening jars or turning a key, grip that is weakening, stiffness that is progressing, arthritis confirmed on an X-ray that your GP and hand therapist have been managing without enough relief, or a previous wrist fracture or scaphoid injury that has become painful again. A GP referral is needed for a Medicare rebate. Seeing a specialist does not commit you to surgery — much of the value is confirming which pattern of arthritis is present and mapping the options.
Speak to the practice
about your wrist
Most patients are referred by their GP. Bring the referral and any imaging you have already had — the practice handles the rest. Want to put a number on it first? The wrist self-assessment scores your pain and function in a few minutes.
