Living With Chronic Wrist Arthritis: A Case Study

Introduction

An acute illness, such as the flu, goes away quickly after taking precautions and medication, and the person returns to normal daily life. However, a person suffering from a chronic illness faces a different scenario: the illness stays with him for life, disrupting his daily activities and impacting the lives of those around him. This paper observes a person living with a chronic illness — specifically, arthritis — and reports on his condition, the effects of the illness on his daily routine, the social and cultural determinants of his disease, and recommendations drawn from evidence-based peer-reviewed literature.

Patient Overview, Chronic Condition, and Pathophysiology

The person under observation is a 42-year-old White, non-Hispanic male living in New York City. He has resided in the same family home for most of his life, meaning his environmental factors have remained largely constant since childhood. He has been living with chronic arthritis in his right wrist for the past five years.

He recalled that one day, five years ago, he woke up with his right wrist locked and experienced severe pain and an inability to move his hand. As a basketball player and right-handed person, he initially assumed the pain was due to excessive playing. After visiting a doctor and undergoing tests and a physical examination, he was diagnosed with chronic arthritis of the right wrist. His doctor noted that men are most likely to develop this condition in middle age, which was consistent with his case.

The wrist is a major joint that enables movement of the hand in nearly all daily activities — lifting objects both light and heavy, and facilitating movement of the entire arm. When the right wrist is affected by chronic arthritis, the impact is especially significant for a right-handed person, as primary tasks such as eating, drinking, and personal hygiene all depend on that hand.

When first meeting the patient, one immediately notices his slightly tilted right hand held in a locked position. He did not offer his right hand when greeting and instead extended his left. He spoke in a calm, composed tone and responded to questions without self-pity or shame. He appeared as a self-determined individual prepared to face his challenges and find workable solutions. His composed demeanor suggests he will adapt well to self-management practices, as strong will is one of the most important traits for overcoming chronic health challenges.

The pathophysiology of his condition includes pain in the wrist area, swelling in more severe episodes, and an inability to move the arm freely due to pain. Swelling is sometimes caused by effusion — the accumulation of fluid in the affected joint (Akhondi & Panginikkod, 2020). The patient noted that symptoms are most pronounced in the morning after waking, likely because the hand rests in a fixed position during sleep, allowing fluid to accumulate in the affected joint and cause severe pain. This is also when redness and swelling are most visible, and the joint is effectively disabled from movement. Range of motion is restricted, and the patient experiences extreme weakness in the joint. Other symptoms — including fever, fatigue, and restlessness due to pain — occur a few times per month in more severe episodes. He has found that gentle hand exercises and slow, continuous movement of the affected joint throughout the day help relieve pain as time progresses.

Individual Risk Factors

The individual risk factors contributing to the patient's condition include family history and age (Mayo Clinic, 2019). His mother had a history of arthritis, making it likely that he developed the illness in part through familial predisposition. Age is also a crucial factor, as aging produces changes in cells and muscular structure that directly affect arthritis (Anderson & Loeser, 2011). Weakened mobility impacts joint tissues in terms of catabolic and anabolic ranges, contributing to an imbalance in joint movement. Joint laxity changes with age in ways that negatively affect musculoskeletal risk for joint deformation and bone aging. People over the age of 20 face increasingly higher risks of severity, especially in chronic conditions (Leung, Rainsford & Kean, 2013). Since the patient is still in middle age, his condition may worsen with further aging. However, because he remained active in sports and daily physical activity, he has avoided obesity, which could otherwise compound the severity of his arthritis.

Genetic factors also represent a possible contributing risk. Research has indicated that hand arthritis is more likely to develop in individuals with associations on the q arm of chromosome 11 (Kalichman et al., 2003). Changes in joint alignment and development due to genetic variation can disrupt joint structure and cause severe pain and arthritis in the hand joints.

Gender also plays an important role in arthritis risk. Research shows that females are more prone to developing chronic arthritis with advancing age than men (Ferguson et al., 2019). However, in the patient's case, the risk remains relevant in terms of bone deformation, pain intensity, and disability. Studies have further shown that joint pain is more prevalent among athletes (Jonasson et al., 2011), suggesting that his basketball activity may have contributed to triggering right-hand arthritis, particularly when combined with the family history inherited from his mother.