If you have a 'destroyed PIP joint' and it sounds like you rely heavily on working with your hands, there are still a couple of options to consider and I recommend that you contact your physician. Firstly, when you say 'destroyed', I assume that you mean that you have end-stage arthritis
, and hence essentially no joint space. In that case, while PT can help with some motion, no joint space means no movement even with the best PT regimens. One other non-operative option would be a cortisone injection into the PIP joint. If you don't have any joint space left, however, I wouldn't expect this to be very helpful, but it certainly doesn't hurt either. The only other options then are surgical, of which there are essentially 2 in your case: PIP joint fusion or PIP arthroplasty. PIP fusion is exactly as it sounds, which means that your joint would be surgically fused there. The advantage of this is that there is no more motion there to elicit pain; the disadvantage obviously is that you have no more motion at that joint. On the other hand, PIP arthroplasty involves cutting out the arthritis of your PIP joint, and replacing that joint with an artificial, silicone hinge. The advantage of that is that you can still move that joint, but the disadvantage is that any time you put a foreign object in your body, the risk for infection or some other complication is higher. If these conditions should ever really apply to you or someone you know, please contact your physician or call 911 in cases of emergency.