If I Need Hand Surgery For Arthritis What Are My Options
Ligament reconstruction and tendon interposition is one of the most popular and effective surgical treatments for basal thumb arthritis because it eliminates pain and restores full thumb motion.
During an LRTI procedure, the hand surgeon removes the arthritic joint surfaces and replaces them with a cushion made of a small piece of tendon thats taken from your forearm through a tiny incision. This tendon helps keep the bones in your CMC joint separated so they dont rub together when you move your thumb.
Another treatment method for basal thumb arthritis is a minimally invasive CMC joint replacement, which replaces the damaged CMC joint with an artificial joint made of plastic or metal parts. An LRTI is considered a better solution than a CMC joint replacement because it uses tissue from your own body. Also, metal and plastic parts can wear out or fail, increasing the likelihood for another surgery.
Joint fusion is another treatment option for basal thumb arthritis. Although its effective at treating pain, its performed only in rare circumstances because it completely prevents your joint from moving.
Causes And Risk Factors
Osteoarthritis is responsible for most arthritis cases in the thumb. This means that the issue stems from gradual cartilage degeneration.
Thumb arthritis usually occurs as part of the regular aging process, and it is more common in adults . People who have had fractures or other injuries to the thumb joint are also more likely to develop thumb arthritis.
Other factors that may increase the risk of thumb arthritis include:
examines the joint and assess:
- the current level of pain
- which movements make the pain worse
- whether there has been a prior injury
They may also perform simple tests, such as holding the joint while the person moves their thumb to test the range of motion. During this, the doctor may listen or feel for grinding sounds or sensations. These can indicate that the bones are rubbing together.
The doctor may also assess whether the joint is warmer than the surrounding tissue, tender, or enlarged.
If the doctor suspects arthritis, they may order an X-ray for a closer examination and to check for any calcium deposits, bone spurs, or areas of erosion. Also, an X-ray can show deterioration or loss of space between the bones.
If a person has pain at or around the base of a thumb, a doctor may also check for symptoms of carpal tunnel syndrome.
Take The Weight Off Your Thumbs
Shimko also suggests these practical ways to take some of the burden off your hands:
- Use an electric or battery-operated can opener.
- Avoid repetitive activities such as using scissors or sewing.
- Build up the handles on your kitchen utensils and gardening tools so you dont have to grip them as tightly. A popular way to do this is with foam tubing.
- Use a speaker phone when you can for talking on the phone.
- Use a bag or backpack, rather than carrying things in your arms, when you can.
- Squeeze excess water from a washcloth or clothing by wrapping it around a faucet and squeezing gently, rather than wringing it out.
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How Is Basal Thumb Arthritis Treated
If your doctor diagnoses you with early-stage basal thumb arthritis, he or she may recommend conservative treatment that includes:
- Over-the-counter anti-inflammatory medications such as ibuprofen
- Splinting, which restricts movement and allows the joint to heal
- Activity modification, such as avoiding certain repetitive movements or refraining from pinching small objects
If the pain doesnt improve with conservative treatment or worsens over time, your doctor may recommend a steroid injection into the joint. Steroid injections cant be repeated indefinitely, but may provide pain relief for several months. If steroid injections are no longer effective, your doctor may recommend basal thumb surgery.
How Is Basal Thumb Arthritis Diagnosed
Your doctor will ask what you are able to do and what makes your pain worse. A physical examination will be carried out with close attention to your basal thumb joint. There are no specific blood tests for basal thumb arthritis, but tests may be made to exclude other forms of arthritis such as rheumatoid arthritis and septic arthritis.X-rays are not needed to diagnose basal thumb arthritis but can be helpful in some instances. X-ray findings are not a good guide to how severe symptoms may become and x-ray findings do not match the amount of pain or impairment you experience. X-rays are usually only helpful if it has been decided that you need surgery, to help the surgeon plan what surgery they should do.
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Hand Osteoarthritis Causes And Risk Factors
Osteoarthritis was once thought to happen because of wear and tear on your joints. Doctors now know thereâs more to the story.
On the ends of your bones, theres a layer of smooth material called cartilage. It helps cushion your joints and allows them to slide easily. But over time, the cartilage gets worn down. The bones rub against each other, causing the symptoms of OA. The wear and tear can also cause other tissues in the joint to make inflammatory cells, which damage it more.
Certain things can make you more likely to have hand OA:
- Age. The older you are, the higher your odds.
- Sex. Compared with men, women are twice as likely to get it.
- Ethnicity. Rates are lower in African Americans.
- Weight. Thinner people are less likely to get it than those who have obesity.
- Injuries. This includes broken and dislocated bones.
- Changes in your genes. Your parents might have passed down a higher chance of OA.
- Joint problems. This includes infections, loose ligaments, overuse, and joints that arenât aligned the way they should be.
What causes flare-ups?
Osteoarthritis Of The Hip
Osteoarthritis in your hips often causes difficulty moving your hip joints. For example, you may find it difficult to put your shoes and socks on or to get in and out of a car.
Youll also usually have pain in the groin or outside the hip. This is often worse when you move the hip joints, although it can also affect you when youre resting or sleeping.
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How To Treat Thumb Arthritis
Thumb arthritis can cause you to feel pain and weakness when you try to pinch things and also when you try to grasp objects. It can be painful opening jars, turning doorknobs or keys, and sometimes writing. This condition is genetic. Just like gray hair, it comes on with age however, women tend to have thumb arthritis more often than men. With some families, it can show up at a younger age.
Like other types of arthritis, this condition is due to the thinning of cartilage, which covers our joints. Without this cartilage, the joints cannot allow the bones to move as smoothly as they normally would, which causes pain.
Because thumb arthritis is typically part of the aging process, treatment can sometimes be unnecessary. To ease the pain, the follow treatments are sometimes used:
What Causes Thumb Arthritis
Joints are connections between two or more bones. A normal joint is made of two smooth, cartilage-covered bone surfaces that fit well together and glide when the body moves. But if the smooth surface wears outoften, just from the wear and tear that comes with agethen the bone surfaces no longer fit together and arthritis can develop.
There are many different types of arthritis, but the kind that most often affects the thumb is osteoarthritis, the most common form of arthritis. With osteoarthritis, the cartilage inside your joints starts to break down, causing changes in the bone that typically start slowly and worsen over time.
An injury to the thumb raises the likelihood that you will develop thumb arthritis. Other conditions, including lupus and rheumatoid arthritis, might also cause deterioration of the basal joint.
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Could Your Thumb Pain Be Basal Joint Arthritis Heres How To Tell And What To Do About It
Just as wear and tear can occur in the joints in the knees and hips, cartilage in the hands can wear down over time. Over time, the cartilage at the base of the thumb could break down and become inflamed, starting to show signs of a condition called basal joint arthritis: arthritis of the thumb. The condition is painful and can make everyday activities harder. Recognizing and treating basal joint arthritis is the first step to helping ease the pain.
How Is Osteoarthritis Of The Hand Diagnosed
A thorough history and physical examination are essential to the diagnosis of osteoarthritis of the hand. As mentioned above, pain, stiffness, and deformities of the joint may be elicited in the physical exam. It is important to differentiate between osteoarthritis and other issues that cause pain, such as carpal tunnel syndrome, before starting treatment. Blood tests will also be used to rule out other forms of arthritis in the hands such as rheumatoid arthritis, gout, and septic arthritis. Rarely, needle aspiration of the fluid of in the joint may be performed to rule out other causes of arthritis.
Imaging studies will be performed to examine the joint itself. Plain X rays can show bone spurs, loss of cartilage, and damage to the bones. Often, the severity of a patients symptoms and the findings on the X ray may not correlate. MRI can then be used to assess early changes of osteoarthritis that may not show up on a traditional X ray.
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What Are The Symptoms Of Thumb Arthritis
Pain in the thumb is the most common symptom of thumb arthritis. You might feel pain when you are pinching or gripping objects, Dr. Luo says. You may also notice a little bump at the base of your thumb, he adds, explaining that this would be a bone spur, or a projection that develops along joints as a result of inflammation, including osteoarthritis.
Other symptoms may include the following:
- Swelling and tenderness at the base of the thumb
- An ache after prolonged use of the thumb
- Loss of strength when gripping or pinching with your thumb
How Can Dr Knight Help You With Basal Thumb Arthritis
Basal thumb arthritis can be extremely painful, and Dr. Knights primary concern is to relieve you of this pain, as well as the accompanying inflammation, so that you can return to your life and work and continue to go about your daily routine with little or no change in behavior.
We looking forward to helping you live a more pain free life. Dr. Knight is one of the top hand doctors in Dallas. Contact us online, give us a call at or visit Dr. John Knight at our Southlake hand and wrist center or Dallas office location.
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Who Gets Arthritis In Their Hands
You are more likely to get arthritis in your hands if:
- Youre older. Osteoarthritis is commonly seen after age 50. Rheumatoid arthritis typically first appears between the age of 35 and 50.
- Youre a woman.
- Youre overweight.
- Youve had previous injuries to your hand. If youve dislocated or broken any joints in your hands or fingers, you are more likely to develop arthritis.
- You’ve inherited genes that cause the development of arthritis.
What Stands Out About Yale Medicines Approach To Thumb Arthritis
The physicians in Yale Medicines Hand & Upper Extremity Surgery Program specialize in evaluating and treating injuries and musculoskeletal disorders that affect your daily movements. We offer the latest technological advances and we are active in research that can lead to better treatments.
At Yale Medicine, we offer the complete range of care to patients, with occupational therapists on site at multiple locations and a new state-of-the-art outpatient surgery center at Yale New Haven Hospitals St. Raphael Campus, Dr. Luo says.
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What Are The Symptoms Of Basal Thumb Arthritis
Because your CMC joint enables your thumb to swivel, pivot, grip and pinch, basal thumb arthritis causes pain when making just about any thumb motion. Tasks such as opening a jar or turning a key can be especially painful. Common symptoms of basal thumb arthritis include:
- Pain or loss of strength when gripping or pinching
- Swelling or tenderness around the joint
- Limited range of motion in the thumb
- Aching or discomfort after prolonged use
Exercise For Your Thumbs
Your doctor or physical therapist may recommend hand exercises. You can do these exercises to improve your range of motion and your arthritis symptoms.
Simple exercises can include a thumb stretch, in which you attempt to touch the tip of your thumb to just under your pinky finger.
Another stretch, called IP, uses flexion. It requires you to hold your thumb stable with your other hand and attempt to bend just the upper part of the thumb. An additional exercise is to simply touch the tips of each of your fingers to the tip of your thumb.
You should only do these exercises after consulting with your doctor or physical therapist. Be sure to get instructions to make sure youre doing the movements correctly.
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How To Manage Symptoms To Slow Or Halt Ra Joint Damage And Diseaseprogression
Getting on medication right away is the No. 1 thing people can do to improve RA symptoms and stop the disease from progressing. Your doctor should start you on methotrexate, according to guidelines published in July 2021 by the American College of Rheumatology .
If this treatment alone doesnt yield the desired results, biologics should be added, the ACR advises.
There is a window of opportunity at the beginning of the disease when you have the best chance of treating with drugs to stop RA from causing damage and the earlier a person starts aggressive drug therapy, the better, says Dr. Greer.
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Treatments For Hand Oa
- Non-Drug Treatments: Reducing strain on joints with a splint or brace, adapting hand movements, doing hand exercises or using hot or cold therapy can help to ease pain.
- Drug Treatments: Medicines to ease OA symptoms are available as pills, syrups, creams or lotions, or they are injected into a joint. They include pain relievers like acetaminophen, counterirritants like capsaicin or menthol and non-steroidal anti-inflammatory drugs and corticosteroids.
- Surgical Treatments: If medications or self-care activities fails to give relief, surgery may be an option. An orthopaedic surgeon can remove the damaged cartilage and fuse bones together or replace the damaged joint with a plastic, ceramic or metal implant.
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Has Any Research Been Done
There are several kinds of research that are continuing currently. One of the researches includes treatment of thumb arthritis using viscosupplementation . The use of viscosupplementation has been compared to the use of corticosteroids and the administrations of a placebo.
How Long Does It Take To Recover From Hand Surgery
Recovery time depends on many factors, including the severity of your condition, type of surgery you had, the skill of your surgeon and your compliance with therapy. Most people can return to their activities about three months after joint reconstruction surgery. Your team of caregivers can give you the best estimate of your particular recovery time.
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Surgical Options For Thumb Arthritis
Surgery can be a helpful treatment for patients with severe thumb arthritis. The usual surgical treatment is to remove the arthritic bone, relieving the pain and inflammation of the worn-out joint. There are different surgical procedures to accomplish this goal, including a trapeziectomy. In some situations, your surgeon may choose to replace the removed bone with a tendon graft, with an artificial implant, or with nothing at all. Alternatively, your healthcare provider may consider fusing the joint, to eliminate all motion at the base of the thumb.
The good news about surgery is that, in appropriately selected patients, surgical treatment of thumb arthritis is very successful. Patient satisfaction with surgical treatment is about 9095%, meaning most patients feel very good after surgical intervention. There are potential complications of surgery, including infection, nerve injury, and persistent pain. Talk to your healthcare provider if you want to know more about the surgical treatment of thumb arthritis.
What Is Thumb Arthritis
Thumb arthritis is the breakdown of cartilage in the saddle joint of your thumb. Arthritis irritates your joints.
Osteoarthritis, also known as âwear-and-tearâ arthritis, is degenerative arthritis.
Degenerative arthritis means that your cartilage wears down as you age. This type of arthritis in your thumb is the second most common type of arthritis in your hand and the most common kind of thumb arthritis. Other conditions like Lupus or Rheumatoid arthritis can also cause your joints to break down.
If your saddle joint doesnât let your thumb pivot, swivel, or grip things anymore, you might be developing arthritis. Previous injuries or fractures to your thumb can also cause arthritis to develop.
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What Are The Causes Of Basal Thumb Arthritis
The basal joint is a very mobile joint, which allows the wide range of movement we need for hand use such as grip, pinch, and fine manipulation. This high mobility leaves the joint with poor stability, which increases the risk of damage to the tissues around the joint.
You are more at risk if:
- you are more than 40 years old
- your work involves repetitive movement or loading of your thumb
- you have had a previous injury or fracture to your basal thumb
- you have other family members with thumb base osteoarthritis.