Call Us Today at 855-980-6981

Our specialists are among the few across the globe to perform all aspects of reconstructive procedures.

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Over 50 years of combined expertise in orthopedic and plastic surgery disciplines.

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Published in Journal of Hand Surgery.

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Individualized treatment delivers the best quality of life faster with less time away from work.

Understanding Arthritis & Available Treatment Options

Hand arthritis is a condition that occurs because of inflammation of one or several joints, causing pain and stiffness that can worsen with age. There are different types of arthritis that people experience, each with various causes, including wear and tear on the joint, underlying medical conditions, infections, or trauma.   

Accurately diagnosing and treating a patient with arthritis involves identifying the root cause of their disease and treating not only the joint, but the underlying medical problems as well. The two most common types of arthritis are inflammatory arthritis and Osteoarthritis. 

Inflammatory arthritis, such as rheumatoid arthritis, occurs when the immune system attacks the joints, which starts with the lining of the joints.  The surrounding soft tissues, including the ligaments and joint capsule, become inflamed, causing a cascade that eventually leads to joint destruction and deformity. 

Osteoarthritis is typical wear and tear with age. It is often associated with cartilage breakdown over time, eventually leading to “bone-on-bone grinding”.  In this scenario, the joint surfaces wear down, and the resulting irritation creates an inflammatory response to the surrounding tissues, resulting in painful, swollen joints.

Although classically thought of as a disease that affects only the bones and joints, arthritis is actually a more complex process that also affects the surrounding soft tissues, such as cartilage, ligaments, and nerves. This complex process requires a multidisciplinary approach to treatment with specialists who can target different components to provide you with the best pain relief and functional improvement.

How
We Can
Help

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Joint Denervation Surgery

Joint denervation is a new and unique treatment approach that addresses the “supply” of pain to the brain rather than the joint itself, combating shoulder and elbow pain and arthritis by eliminating the associated neurologic pain pathways with very little recovery time.
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Multidisciplinary Approach

At our practice, we endorse a multidisciplinary approach. Patients who are good candidates for medical management of their inflammatory arthritis are treated through our partnerships with top-tier rheumatologis
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Arthritis Injections

Using X-ray or ultrasound guidance, our physicians are highly trained and experienced in administering an injectable anesthetic and steroid medication with an ultra-fine needle to target arthritis, reduce inflammation, and relieve pain.

Our Mission Is To Improve The Quality Of Our Patients’ Lives

Our cutting-edge procedures have helped transform the lives of thousands of patients. Hear their stories and more about the procedure here:

"Dr. Shah is very informative, professional, and soothes the patient by educating them for their well-being. He treats the patient as necessary, not more not less with skill and intelligence. I am grateful."

- CSH Patient of Dr. Shah

"Dr. Iyer was professional, courteous and made me feel very comfortable. He has a great bedside manner, and I am very pleased with the outcome. I would absolutely recommend him to others."

- Patient of Dr. Iyer

Find Convenient Care with Six Locations Across New Jersey.

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Red Bank
Red Bank
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331 Newman Springs Rd. 
Building 2 - First Floor, STE 200
Red Bank, New Jersey 07701
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Phone: 855-980-6981
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Florham Park
Florham Park
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83 Hanover Road
Suite 260
Florham Park, New Jersey 07932
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Phone: 855-980-6981
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Freehold
Freehold
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3499 Route 9 North, Building 1
Suite 1A
Freehold, New Jersey 07728
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Phone: 855-980-6981
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Hopewell
Hopewell
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1 Capital Way
Suite 390
Pennington, New Jersey 08534
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Phone: 855-980-6981
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Hackensack
Hackensack
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20 Prospect Ave
Suite 903, 9th Floor
Hackensack, New Jersey 07601
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Phone: 551-228-2208
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Is Arthritis Treatment Right for Me?

The three most common locations where arthritis occurs in the hand are at the base of the thumb (where the thumb and wrist come together), at the joint closest to the fingertip, and at the middle joint of a finger. If you experience persistent joint pain or other symptoms of arthritis, our treatment may offer relief. Schedule a consultation if you experience chronic: 

  • Stiffness
  • Swelling 
  • Redness around the joint
  • Physical joint deformities 
  • Decreased range of motion
  • Difficulty opening jars
  • Difficulty opening twist-off bottle caps
  • Pain with prolonged writing or typing
Have questions, or need more information? Get in touch with us today.
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Our Surgeons

Andrew Elkwood
Physician

Andrew Elkwood

MD, MBA, FACS
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Peter Andrawes
Physician

Peter Andrawes

MD
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Nicole Ferro
Physician

Nicole Ferro

DO
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Edward Hahn
Physician

Edward Hahn

MD
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Hari Iyer
Physician

Hari Iyer

MD, FAAOS
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Ajul Shah
Physician

Ajul Shah

MD, FACS
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David Tsai
Physician

David Tsai

MD
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Mark Yazid
Physician

Mark Yazid

MD
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About
The Center for
Hand & Upper Extremity Surgery

The Center for Hand & Upper Extremity Surgery at The Institute for Advanced Reconstruction offers comprehensive, highly specialized treatments for hand and upper extremity injuries. 

Our dedicated team of providers is composed of surgeons with subspecialty expertise in hand and upper extremity surgery and microsurgery, as well as a physical medicine and rehabilitation physician specializing in pain management.

We are dedicated to providing advanced treatments for arthritis affecting the upper extremities, such as 1st carpometacarpal, basilar joint (base of the thumb), finger arthritis (including DIP and PIP joints), and wrist arthritis.

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Frequently
Asked
Questions

What is arthritis?

Our joints are the intersection where two bones meet and articulate, which then allows this joint to move. All joints throughout the body are lined with a slick substance known as cartilage, which allows for the smooth movement of one bone relative to another. Arthritis is a generic term that indicates the degeneration of this cartilage which leads to “bone on bone” motion, which causes significant pain and deformity. 

Is treatment the same for finger, wrist, shoulder, and elbow arthritis?
No, finger, wrist, shoulder, and elbow arthritis are not treated the same. The treatment for each type of arthritis depends on the location and severity of the condition, as well as the patient's overall health and medical history.
 
What may indicate finger arthritis?
Pain is the most common presenting symptom for patients who are developing or have developed arthritis of the fingers. There is pain located at the joints themselves that initially occurs sporadically, and as the joints degenerate further, the pain becomes more consistent and more difficult to live with. Eventually, the joint mechanics will deteriorate and then other joints in the finger can become affected.
How is finger arthritis diagnosed?

The diagnosis of finger arthritis is made by reviewing your medical history, a physical examination, and X-rays. Additional tests, such as a CT scan, may be required to get high-level detail of the arthritis to determine the type of treatment that is necessary.

What may indicate wrist arthritis?

Wrist arthritis can be indicated by symptoms such as:

  • Pain and stiffness in the wrist, especially during movements or activities
  • Swelling in the wrist
  • Decreased range of motion or flexibility in the wrist
  • A crunching sensation or sound (crepitus) when moving the wrist
  • Bony growths (osteophytes) on the wrist
  • Weakness in the wrist or difficulty with grip strength.
How is wrist arthritis diagnosed?

Wrist arthritis is typically diagnosed through a combination of tests, including a complete medical history, physical examination, and imaging, such as X-rays, MRI, or CT scans to help your physician visualize the bones and joints in your wrist and detect any signs of arthritis. 

What may indicate shoulder arthritis?

Those with shoulder arthritis often experience aching or pain in the shoulder, especially with movement. They may also experience:

  • Stiffness
  • Decreased range of motion
  • Less flexibility
  • Difficulty lifting or reaching overhead
  • Grinding or creaking sensation in the shoulder
  • Swelling and inflammation
How is shoulder arthritis diagnosed?
To confirm a diagnosis of shoulder arthritis, your doctor may perform a physical examination, review your medical history, and order imaging tests such as X-rays, MRI, or CT scans. In some cases, other tests may be necessary to rule out other conditions that cause similar symptoms.
How do I know if I have elbow arthritis?

Patients with elbow arthritis often experience pain or aching in the elbow, especially with movement. They may also experience:

  • Stiffness
  • Reduced range of motion
  • Less flexibility at the elbow
  • Difficulty gripping or lifting objects
  • Swelling and inflammation
How is elbow arthritis diagnosed?
To confirm a diagnosis of elbow arthritis, your doctor may perform a physical examination, review your medical history, and order imaging tests such as X-rays, MRI, or CT scans. In some cases, other tests may be necessary to rule out other conditions that cause similar symptoms.
How is arthritis treated?
The goal in treating your arthritis is to improve your pain while preserving and obtaining as much motion as possible. At The Center for Hand & Upper Extremity Surgery, we use an algorithmic approach to treat this common problem, allowing our patients to determine which course of action is best for them. Generally speaking, the treatment will be guided by a few main factors:1. How “bad” the arthritis is – how painful it is, how deformed the joint is, how many other joints are affected.
2. The “you” factors – your age, hobbies, functional demands, activities, your health, and what you do for work.
Will I need therapy following arthritis treatment?
Your need for therapy will be specifically determined by your surgeon as well as your specific situation and treatment plan. Therapy is often a component of non-surgical as well as surgical treatment plans, but there are times when it is not necessary.
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