Understanding Hand Arthritis
Arthritis in the hand—especially at the base of the thumb (the carpometacarpal or CMC joint)—is a common condition that can cause pain, swelling, decreased grip strength, and difficulty with everyday tasks like turning keys, opening jars, or writing. This form of osteoarthritis typically develops gradually due to wear and tear, and can significantly affect hand function and quality of life.
Dr. Iyengar offers both conservative and surgical treatments for hand arthritis, with a focus on preserving motion, reducing pain, and maintaining independence. The most commonly affected joints include the CMC joint at the base of the thumb, as well as the finger joints and wrist.
When should I consider treatment?
If you experience persistent hand pain, joint swelling, stiffness, or weakness—especially when pinching, gripping, or using your thumb—an evaluation may be appropriate. When conservative treatments are no longer effective, or if arthritis begins to interfere with your daily activities, surgical options can provide lasting relief.
Early diagnosis and treatment can help preserve joint motion and slow the progression of joint damage.
What are my treatment options?
Non-Surgical Options
For early or mild arthritis, Dr. Iyengar may recommend activity modification, splinting, anti-inflammatory medications, or corticosteroid injections to reduce pain and inflammation. Custom thumb braces can also offload the affected joint and help maintain function.
CMC Arthroplasty (Thumb Joint Reconstruction)
For patients with advanced CMC arthritis who have failed non-surgical care, CMC arthroplasty is a highly effective procedure. This surgery involves removing the arthritic portion of the trapezium bone at the base of the thumb and reconstructing the joint using a tendon graft or implant. The goal is to eliminate pain while preserving thumb strength and mobility.
Dr. Iyengar tailors the procedure to each patient’s needs—offering both traditional ligament reconstruction and tendon interposition (LRTI) and newer implant-based techniques depending on joint stability, bone quality, and activity level.
Other Surgical Options
For arthritis in other joints of the hand, surgical options may include joint debridement, fusion (arthrodesis), or replacement, depending on the location and severity of degeneration. Each approach is selected to balance pain relief with the preservation of function.
Why choose Dr. Iyengar for arthritis surgery?
As a fellowship-trained hand and upper extremity surgeon, Dr. Iyengar has advanced expertise in both joint-preserving and reconstructive procedures. He brings a thoughtful, individualized approach to arthritis care—offering the latest surgical techniques alongside comprehensive non-operative management to help patients return to the activities they love.
What does recovery look like?
Recovery after CMC arthroplasty typically involves a short period of immobilization in a splint or cast, followed by a structured hand therapy program to restore range of motion and strength. Most patients experience significant pain relief and improved hand function within a few months. Recovery timelines may vary depending on the surgical technique and severity of arthritis.
While arthritis is a progressive condition, early treatment and the right surgical approach can offer long-term relief and meaningful improvement in hand function.
Check out how our patients looked before and after.
Check out galleryWhat our patients have to say.
Krista S.
I can’t imagine a better experience for a very scary surgery. Dr. Iyengar has a good bedside manner and truly cares about his patients.
Stew B.
Everyone is friendly and professional Doc is amazing. I am grateful for the services they provide.
Aimee S.
There isn't a bad thing I can say about Dr. Iyengar or my experience. I found Dr. Iyengar after I had been to a friend's consultation up in Bellevue. I heard her quote and options, and knew I wanted to be closer to home for my procedure. I got in for my consultation the same week as I had inquired about my procedure. Dr. Iyengar won me over with the fact that we both grew up in Puyallup, we share a love for Olive Garden breadsticks, he is friendly, knowledgeable, has an incredible bedside manner, taking time to answer questions and get to know your needs, professional, and funny. From consultation to 3 weeks post op, and everything in between has been an experience that I would recommend to family and friends, and have recommend to anyone that asks. If you're going back and forth, do yourself a favor and stop looking. Dr. Iyengar is your guy!! My BFF and I are proof that this guy is THE. BEST.
Carrie N.
Dr. Iyengar and his team here are amazing! They made me feel immediately welcome and calm-which is not always easy if you are facing a medical procedure. Post-op follow up has also been spot on!
Lawrence W.
I was having trouble getting a grip on some hand tools, and at a restaurant that used round table ware rather than flat and edged utensils I notice I couldn't seem to hold them from rolling. My primary physician referred me to Dr. Iyengar. Probably one of the better 20 mile appointments I've had.Dupuytren's contracture, is the culprit the good doctor diagnosed and showed how it prevents my hand from lying flat on a table top because the little, and ring finger were closing on the palm. I mentioned that the middle finger of that hand also locked often with some pain associated with the nuisance. "We can take care of these two procedures today if you'd like" he offered and it made sense if he was willing, I'd travelled 20 miles for the diagnosis, getting the cure at the same time was more than just good sense.
In less than an hour, a pain free hour, the troublesome contracting cord had been freed up and a needle shot of a drug, perhaps cortisone, though I've forgotten, and I was on my way to the physical therapist to learn what I could do following up on the minimal surgery.
From the time I entered the office until I left was a pleasant and friendly exchange of information and personal stories. I didn't wait long, so short I could not get through reading the diplomas and advanced training and education certificates hanging on the walls that Dr. Iyengar has garnered from his studies and surgical skills.
The good doctor keeps a friendly atmosphere for staff and patients, for me 20 miles no longer seemed inconvenient. I'll see him for the followup and look forward to that. You'll be in good hands with Dr. Iyengar and staff.
Steve M.
Iyengar Plastic Surgery recently did reconstruction for my mother's facial cancer that had been removed. At first we were skeptical, this was a difficult reconstructive surgery. Iyengar Plastic Surgery reassured the family it was a process, but they were sure things would go well.They stayed in contact, kept the family informed, were professional and gave 100% to the care of my mother. As she continues to heal the doctors keep us up to date on her healing progress. Thank you Iyengar for everything!
Goldbook G.
Absolutely the BEST doctor I have ever had. I was thoroughly happy with my results. Very caring and empathetic. Went above and beyond to help me. Far exceeded my expectations.
Pooja K.
When I was young, a friend of mine pulled on my earring and it tore my piercing hole. Earrings didn’t fit very well, and I really didn’t like the sight of it. Dr. Iyengar expertly repaired my ear, and in just a few weeks, it looked good as new! Dr. Iyengar was kind, patient, and made sure I was comfortable throughout the entire procedure. He’s a great listener and definitely knows what he is doing. If I ever have plastic surgery needs in the future, Dr. Iyengar is at the top of my list!!! I wear earrings with pride, now :)
Scarlet G.
Dr Iyengar and his staff are so wonderful. Very nice very respectful very helpful especially working through L&I problems. I totally recommendI totally recommend anybody that has any hand problems to go to Dr Iyengar and his staff
Lisa R.
I have lived my entire adult life self conscious of my neck sagging and double chin. Dr. Iyengar took such good care and gave me a tight neck and for once in my life I have a jawline! I had a neck and lower face lift with lipo in my chin.
Kara D.
I have had a wonderful experience with Dr. Iyengar and his team. I appreciate his transparency achieving realistic results that are natural and what is safe for my body. Dr. Iyengar is very attentive ensuring my recovery is going well and is very responsive to questions or concerns that I have had. I love my results, it is everything that I asked for and I feel more confident than ever. I am grateful and appreciative of Dr. Iyengar and his team.
Beth S.
Dr. Iyengar is an incredible doc, he truly listened to my story and provided a plan to address all of my medical needs. After surgery, he has been providing excellent care of me and is the most accessible surgeon I have ever encountered. Having a complex medical history, I was nervous about having this surgery, but Dr. Iyengar and his whole staff have been amazing and I highly recommend them!
Lisa S.
I had a procedure to ease back and neck pain. Dr.Rajiv Iyengar. Was so amazing. His staff was thoughtful. They helped coordinate insurance. Made sure I was well informed and the surgery and results have been beyond my expectations. I suggest you shop around and then STOP when you interview Dr Iyengar. The procedure went without a hitch. He had full control of all the Medical professionals and was very thorough through the day. He is helpful and old fashioned in his bedside manner. Very pleased with results and will recommend to anyone.
Liza C.
From my very first consultation, I was blown away by the level of care and professionalism at this practice. Every single team member, from the front desk to the medical coordinators and assistants, was friendly, attentive, and truly made me feel at ease. The customer service is top-notch!
Dr. Iyengar is exceptional. His experience, skill, and depth of knowledge shine through in every interaction. His bedside manner is warm and reassuring, and he takes the time to truly listen to your goals without ever being pushy. He’s incredibly responsive and makes you feel confident and cared for from day one. Honestly, his fresh perspective combined with his expertise is a major positive!
The aftercare has also been outstanding! Thorough, diligent, and consistently supportive. I’ve felt cared for every step of the way.
My entire experience has been nothing short of excellent. I’d highly recommend this practice to anyone looking for a team that’s professional, compassionate, and truly invested in your care. They set the bar high!
Michael W
Dr Iyengar did a repair on an old eyelid surgery. Him and his staff were a pleasure to work with and I could not be happier with the results!
Laurie A.
Dr. Raj Iyengar is awesome!!! I had 3 areas of botox today (glabella, crow's feet, and forehead). I had absolutely no pain and zero bruising. He was very informative throughout the procedure, and very kind. A great experience
Christina R.
I am 6 days post brow lift, blephraplasty, nanofat transfer, and neck lipo with Renuvion, and I already see a significant difference. I am SO excited already, and I’m still healing. Dr Iyengar has an incredible bed side manner, remembers little details about his patients, and has an impeccable résumé. I made the right choice trusting him with my face!
Ron L.
I’m glad to have this doctor and his staff on my side. When I heard the words skin cancer I went through a WIDE verity of feelings. I got worse case scenario and it scared me. After some reassurance I felt much better. I’m amazed at the complexity of the surgery and how well everything went. Just 6 weeks after surgery I’m feeling much better about the future look that everyone will see when they see my smiling face. Thanks Dr. Iyengar. I’ll share photos with anyone interested.
Jenny M.
I’m incredibly grateful that I was referred to Dr. Iyengar for my breast reconstruction surgery. From the very first consultation, he has been an absolute blessing throughout the entire process. His kindness, super friendliness (a rare trait), helpfulness, caring nature, and outstanding service are truly remarkable. Additionally, his extensive knowledge and confident responses to my questions, along with his ability to treat me with personable care, make him an exceptional surgeon.
Quality care in all realms of plastic and reconstructive surgery.
We see our patients as individuals, not just cases on the schedule. Dr. Iyengar makes every effort to get to know his patients personally and thoroughly understand their goals. This personalized approach ensures that every patient receives the highest quality care and achieves the results of their dreams! Dr. Iyengar executes every procedure with precision, integrity and utmost care.
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