Midcarpal Arthritis
Recognising the Symptoms and Symptoms
Ali Phillips | Hand & Wrist Specialist
Pain on top of your wrist?
I'm Ali Phillips. If you're feeling a deep ache, stiffness, or a clicking sensation on the top of your wrist, you may have midcarpal arthritis. Let's explore what this means and how we can get you back to feeling your best.
Book a ConsultationWhat is Midcarpal Arthritis?
Your wrist is made of two rows of small bones. The midcarpal joint is the joint between these two rows, right in the middle of your wrist. It's crucial for most of your wrist's bending and twisting movements.
Midcarpal arthritis is a "wear-and-tear" condition where the cartilage in this specific joint wears down. It is most often diagnosed as a result of a previous trauma or an untreated ligament injury that leads to a condition called a SLAC wrist (Scapholunate Advanced Collapse).
What are the symptoms of Midcarpal Arthritis?
Pain on Top of the Wrist
A deep ache or sharp pain, often felt on the top of the wrist, that gets worse with activity.
Stiffness & Limited Motion
Makes gripping objects, turning doorknobs, and other ordinary tasks harder and more painful.
Clicking or Popping
A catching, clicking, or popping sensation due to the roughened joint surfaces rubbing together.
Is This Your Wrist Pain?
If these symptoms sound familiar, getting an accurate diagnosis is the first step towards relief. Let's talk about your options and find a solution that works for you.
Get a Clear DiagnosisHow will I diagnose your wrist pain?
A diagnosis involves our conversation, a physical examination, and an X-ray. A key test for midcarpal arthritis is the 'Dart-Thrower's Motion'. You can try this gently at home, but please stop if it causes pain.
1️⃣
Hold your hand out as if you are about to throw a dart.
2️⃣
Move your wrist down and towards your thumb side.
3️⃣
Then, move it up and towards your little finger side.
Pain during this specific diagonal motion is a strong indicator of midcarpal arthritis, as this movement primarily uses the midcarpal joint. An accurate diagnosis is the most important first step.
How can I help you get better?
We'll create a personalised treatment plan together, starting with the simplest options first.
Splinting & Rest Supporting the wrist with a splint and avoiding activities that trigger pain can help reduce discomfort.
Anti-inflammatories Over-the-counter medications like ibuprofen can help to manage pain and reduce inflammation.
Steroid Injections These can provide good, though often temporary, pain relief by reducing inflammation directly in the joint.
Surgery: Four-Corner Fusion If other treatments fail, my preferred procedure is a Scaphoid Excision and Four-Corner Fusion. This provides excellent pain relief while preserving a good degree of functional wrist movement.
Frequently Asked Questions
This is a surgical procedure where I remove the problematic scaphoid bone and then 'fuse' four of the central wrist bones together into a solid block using a special plate (I use the Trimed Fusion Cup). This stops the painful, arthritic movement while still allowing for a good, functional range of up-and-down wrist motion.
It is a very successful operation for relieving pain. While all surgery has risks, I am proud to say that in my practice, I have a 100% fusion rate for this procedure, meaning the bones have successfully healed together in all my patients so far. The biggest risk is that the bones may not heal together, which occurs in about 1 in 4 cases in the medical literature.
Recovery involves a period of immobilisation in a cast or splint for several weeks to allow the bones to fuse. This is followed by dedicated hand therapy to regain strength and movement. Full recovery can take several months, but the goal is a significant reduction in pain and a return to most daily activities.
Yes, there will be a scar on the back of your wrist. I make every effort to place the incision carefully to minimise its appearance. Over time, the scar will fade and become less noticeable for most people.
Test Your Knowledge!
