Regenerative Orthopedics · Miami, FL

Small Joint Arthritis in Miami

Arthritis in the hand, wrist, elbow, foot or ankle can make everyday movement painful. Dr. David Karli evaluates the joint and discusses whether treatment can help you feel and move better.

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Overview

Which Joints Can Arthritis Affect?

Hand and Wrist Arthritis

Arthritis at the base of the thumb or in the finger joints can make pinching and gripping painful. Wrist arthritis can limit motion and strength, making everyday tasks like typing and opening jars difficult.

Some anatomical names are a mouthful. Here’s what they mean:

CMC (carpometacarpal) joint: at the base of the thumb, near the wrist. Arthritis here often hurts when you pinch or turn a key.
IP (interphalangeal) joints: the finger joints. PIP is the middle joint; DIP is the joint closest to the fingertip. Arthritis here can cause stiffness or pain when you bend your fingers or grip something.
TFCC (triangular fibrocartilage complex): on the little-finger side of the wrist. Pain in this area may be more noticeable when you twist your wrist or put weight through your hand.

Elbow Arthritis

Elbow arthritis can make lifting, turning your forearm or fully straightening your arm painful. You may also notice stiffness or catching. Dr. Karli looks at which part of the elbow is affected and whether it matches where you feel pain.

Some anatomical names are a mouthful. Here’s what they mean:

Ulnohumeral joint: the elbow’s hinge, which lets you bend and straighten your arm.
Radiocapitellar joint: the joint on the outer side of the elbow, which may hurt when you rotate your forearm.

Foot and Ankle Arthritis

Arthritis in the big toe, midfoot or ankle can make standing and walking uncomfortable. The big toe may hurt when you push off; midfoot arthritis can ache across the top of the foot; and arthritis in the joint just above the heel may make uneven ground difficult. Similar to the hand and wrist, the foot and ankle are composed of many small joints working together.

Through a detailed workup, imaging and evaluation, we check whether an arthritic joint is involved versus alternative sources like ligaments or tendons around the joints. It’s not uncommon that it’s a combination as well.

Some anatomical names are a mouthful. Here’s what they mean:

First MTP (metatarsophalangeal) joint: at the base of the big toe. Arthritis that makes this joint stiff is often called hallux rigidus.
TMT (tarsometatarsal) joints: across the middle of the foot. Arthritis here can cause pain on top of the foot, especially when standing or walking.
Tibiotalar joint: the main ankle joint, where the shin meets the foot.
Subtalar joint: just below the ankle, where the ankle bone meets the heel bone. Arthritis here can make walking on uneven ground painful.

The Therapy

What Are My Treatment Options?

A brace, hand therapy, changes to footwear or activity, and other standard treatments may help, depending on the joint. If physical therapy and other conservative care have brought little or no relief, cellular therapies can play a very important role in getting you back to feeling better.

When appropriate, Dr. Karli may discuss PRP or a cell-based option such as Bone Marrow Cell Concentrate (BMC), Umbilical Cord-Derived Cells or MUSE Cell Therapy. The choice depends on the joint, how advanced the arthritis is, what you’ve already tried and your goals. No single injection is right for every hand, wrist, elbow, foot or ankle.

If joint damage or deformity is severe, surgery may offer a better chance of relief. Dr. Karli will tell you when he thinks a regenerative option is unlikely to help.

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Overview

Can Treatment Help?

Yes. Treating an arthritic joint can bring pain relief and make everyday movement easier, whether that means gripping, moving your elbow or walking. What you can expect depends on the joint and how advanced the arthritis is. Dr. Karli will tell you what he thinks is realistic for you.

Common Questions

Frequently Asked Questions

How does Dr. Karli find which joint is causing the pain?

This is an important question as the hand, wrist, foot and ankle are composed of many small joints working together to function properly. He reviews your symptoms, examines the area and uses imaging (X-ray, ultrasound and MRI) when needed. The goal is to identify the arthritic joint causing trouble before choosing treatment.

What if my arthritis is advanced?

Dr. Karli will look at the joint damage and your goals, then tell you whether an injection is worth considering or a surgical evaluation offers a better chance of relief. Because the joints in the hand, wrist, foot and ankle are much smaller than the knee or shoulder, he also considers how much volume and cell dose each joint can receive—and whether that gives treatment a reasonable chance of meaningful, sustained relief. He evaluates this case by case.

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