Questions and Answers

D.G. from Scottsdale, AZ writes.. When I try to turn a key, or use a scissors I have a sharp, stabbing pain in the right thumb. I am at the point where I cannot use my right hand because the thumb pain is so severe. Is there anything I can do to stop this?

D.G. did not indicate his/her age however I suspect what could be occurring are the symptoms of osteoarthritis in the thumb joint. Degenerative arthritis frequently occurs in the middle-aged population. It can affect the hands, thumbs, spine and knees. The symptoms of arthritis can be exacerbated by abnormal stresses on these small joints. The shearing forces on the thumb base cause an inflammatory reaction with associated destruction of the articular cartilage leading to pain, weakness and disability. Degenerative joint disease of the thumb is usually confirmed with a “grinding” sound at the thumb base and XRAY evaluation. These painful symptoms can also occur in the younger population depending upon the nature of their occupation, recreational, and household activities that can strain the thumbs. For example, the dentist or dental hygienist who uses his/her hands to hold instruments on a daily basis could experience thumb base pain.

Degenerative arthritis is an “erosive” condition and cannot be “exercised” away. I recommend that first D.G. needs to stop the inflammatory process, which leads to cartilage destruction by resting the thumb joint. This can be accomplished by placing the thumb in a rigid splint that allows the thumb joint to rest. Anti-inflammatory agents may be incorporated as recommended by your Physician to help slow down the process. A Certified Hand Therapist can assist you in learning to use the thumb in a less destructive way to eliminate biomechanical forces on the joint. Sometimes adaptive devices such as a key holder, pen grip, jar opener etc. are very effective for incorporation into activities of daily living. Once the inflammatory symptoms decrease in the thumb, a Certified Hand Therapist can assist in instructing in strengthening exercises of supportive musculature around the thumb joint and range of motion exercises to prevent motion loss and maintain nutrition to the existing cartilage. Unfortunately, if the thumb joint arthritis is advanced these conservative measures do not always prove helpful. A consultation with an Orthopedic Physician may be indicated and a surgical option may be needed.

 

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