Hand surgery or therapy?

By sog01j

1 min read

I am 54 and have had RA for 25 years. I am very active and feel like I've managed with the RA pretty well.

The worst damage seems to be in my hands. I'm an accountant and after 10 years at home with my kids, I am back working part-time. About a year ago, I lost the ability to type with all of my fingers. Typing with my two index fingers is very slow and frustrating. I've been to my Rheumatologist and to 2 hand surgeons. They all seem to think that surgery is the only solution at this point. But when I go to the hand therapist she says exercise and night braces will help. I'd love any first hand advise from others who have been dealing with hand deformations.

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hwb0w4 Member
Hello! I've had RA for 32.5 years(not that I'm counting)and I realize your frustration with the typing and visual aspect. I've been doing body and hand exercises for most of those years to keep my joints mobile and properly aligned with the help of medications. Unfortunately, I'm one of those RA Patients who has failed with the biologic medications. Imuran and Vioxx(discontinued) were the last medications that actually worked for me. Therefore, I have the deformities in my fingers within the last 6 or 7(?) years. As you probably have, I've researched this problem on the net and asked my Rheumy. The results seem to be that, if an RA Patient is in remission then the surgery lasts for some time. If the RA Patient has continued active RA, then the good results will last between 3 - 6 months. I've read that there are silver rings which can be purchased by RA Patients in order to prevent the fingers from becoming deformed. I'm a bit leary about that product. I look forward to others' experiences and/or knowledge concerning this topic. Good luck to us both Suzanne! Happy New Years!
1. sog01j Member
 Thanks so much. I will give hand therapy another try. Thanks for the encouragement!!
nallenchef Member
What is causing your inability to type? Did your doctor tell you? Is it tendon breakage or joint deformities. I accidentally posted an answer for you to the RA Facebook page. You can read more about my surgeries. I have had both wrists reconstructed in the past year. They are much improved. My advice would be to search for an orthopedic hand surgeon who specializes in RA. It took me 4 tries. US News and World Report is a good place to begin. The doc should be 55 or older because the younger surgeons don't see the level of damage I have. I never took biologics over my twenty years with RA. People who do don't have as much or any.
nallenchef Member
I forgot to say that therapy could well help but only a competent orthopedic hand surgeon really can tell you that. If you want a recommendation my surgeon is Peter Jepson at Spectrum Hospitals in Grand Rapids MI. I know how hard and scary this is. It took me six months to find a surgeon who laid our my options clearly and who I trusted.
1. sog01j Member
 Thanks so much for your great feedback. I couldn't find your post on Facebook. Can you copy and paste it here? Thanks for the referral but I need to find a doctor in southern California.
coloradogirl Member
I've had RA for 28 years, and my hands were victims of deformities, causing embarrassment and impeding typing on a keyboard. I'd had corrective surgery on both feet, full knee replacements on both knees, and an elbow joint replacement. But I was still nervous about hand surgery, and put it off as long as possible. I ultimately interviewed 2 doctors, 1 recommended by my Rhuemy, the other by a prominent orthopedic surgeon who did not specialize in hands. The 2nd one actually did my elbow replacement 18 months earlier, and was the surgeon I chose for my hand. The key was the post surgical plan and recovery expectations, plus the comfort level with the physician, his staff & the hospital. It was a long process, but I was able to return to work in 7 weeks, wearing a "working splint," which was really more like a glove with adjustable straps to keep my fingers properly aligned. 6 months after surgery, I was able to discontinue using the splint. I'd had all 4 knuckle joints at the base of my fingers replaced, and some tendon work on my thumb. I am happy to report that, a year later, my fingers are straight & strong! The surgery took a lot out of me, from a short term endurance/fatigue perspective, but the results were worth it!
1. sog01j Member
 Thanks so much for that great feedback. My youngest son is a HS Junior. So I will probably interview doctors and do lots of research but may not do surgery til June of 2017. It might be easier to do once he is done with High School. Did you get any disability income? Is that hard to arrange?