Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 15 July 2023 Specialist Referral Clinic, Vancouver, BC

  Carpal Tunnel Syndrome (CTS) is a condition that may worsen over time if left untreated. As people age, the flexor tendons in the wrist can naturally increase in size, putting more pressure on the median nerve in the carpal tunnel. Non-surgical treatments can help slow down the progression of symptoms, but they may not completely stop it. Using a brace or splint at night to keep the wrist in a neutral position can reduce pressure on the nerve. Wearing a splint during the daytime can also be beneficial to avoid extreme wrist positions. Modifying job or recreational activities that may contribute to CTS can also help slow down the condition. Anti-inflammatory medications and cortisone injections may offer temporary relief from pain and inflammation associated with CTS, but they rarely lead to a permanent resolution of symptoms. If symptoms of CTS occur on a daily basis and non-surgical treatments have failed, surgery may be recommended. Ideally, surgery should be performed before constant numbness occurs in the hands, as this may indicate permanent nerve damage. The surgical procedure for CTS is called a Carpal Tunnel Release. It involves cutting the transverse retinacular ligament to release the pressure within the carpal tunnel. The procedure is typically performed under local anesthesia and takes less than 15 minutes. Most patients do not require narcotic pain medication after surgery, and the wound is usually closed with sutures. Recovery from surgery involves avoiding soaking the wound and engaging in light washing for the first 10 to 14 days. Patients are encouraged to move their fingers actively to reduce swelling and prevent stiffness. Most patients can resume light activities within 3 weeks and heavier activities within 6 weeks. The surgical site may remain tender for several months, and deep massage is recommended after 2 weeks to accelerate scar softening. Grip and pinch strength usually return within 3 to 6 months after surgery, and intermittent symptoms of numbness typically resolve rapidly. However, if constant numbness was present before surgery, it may not completely resolve over time. Infection at the surgical site is a possible complication, but it can be treated with oral antibiotics if detected early. Any concerns should be discussed with the surgeon or a healthcare provider promptly.

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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    Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 31 December 2023

    If you believe you have carpal tunnel syndrome, it is advisable to consult with your family doctor for confirmation of the diagnosis and to discuss treatment options. They may perform a physical examination and evaluate your symptoms to determine if further tests, such as a nerve conduction study, are necessary. Treatment for carpal tunnel syndrome often begins conservatively. In the early stages of the condition, wearing a wrist brace at night can help keep your wrist in a neutral position and alleviate symptoms. Your doctor may also recommend avoiding activities that exacerbate symptoms, such as excessive wrist flexion or extension, during the day. To reduce inflammation and alleviate symptoms, your doctor may prescribe anti-inflammatory medications. In some cases, cortisone injections into the carpal tunnel can provide temporary relief. It's important to note that while these measures can help manage symptoms, carpal tunnel syndrome is typically a progressive condition. If symptoms persist or worsen over time, and they begin to impact your daily life, it may be appropriate to consult with a surgeon who specializes in carpal tunnel syndrome. Surgical intervention aims to release the tight ligament that compresses the median nerve within the carpal tunnel. This can be done through a small incision over the ligament or using an endoscopic approach where the ligament is cut from inside the tunnel. Both surgical techniques generally yield similar outcomes in terms of symptom relief. However, the decision to undergo surgery should be made in consultation with your doctor based on the severity of your symptoms, your response to conservative treatments, and other individual factors. It's important to remember that carpal tunnel syndrome can have varying courses, and not all cases will require surgery. Many allied health professionals, such as physical therapists and occupational therapists, can assist in managing symptoms and potentially delay the need for surgery. However, if you experience daily symptoms and find that your quality of life is significantly affected, it is advisable to seek medical attention from a specialist.

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  Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 13 July 2023 Specialist Referral Clinic, Vancouver, BC

  Dupuytren's Disease is a condition characterized by the progressive thickening and tightening of the connective tissue in the palm of the hand, resulting in the formation of nodules and cords that can cause flexion deformities of the fingers. While many people with Dupuytren's Disease may not require treatment, in cases where the contracture becomes significant and interferes with hand function, intervention may be necessary. There are three main categories of intervention for Dupuytren's Disease: Palmar Fasciectomy: This is a traditional surgical procedure that involves the excision of the abnormal tissue in the palm. It is usually successful in achieving greater extension of the affected digits. The skin is closed with sutures, which are typically removed within two weeks. Splinting may be required post-surgery for more significant contractures, particularly involving the proximal interphalangeal (PIP) joints. Percutaneous Aponeurotomy: This is a less invasive surgical technique where multiple small incisions are made along the course of the abnormal fascia. The tissue is sequentially released to restore finger extension. While this procedure allows for a faster recovery, it has a higher recurrence rate compared to palmar fasciectomy. Collagenase Injections: This treatment involves injecting a solution called collagenase into the abnormal tissue. The collagenase dissolves the cords within the hand, and then a manipulation of the digits is performed 24 to 72 hours later to tear the pre-dissolved cords. It is important to note that collagenase is currently not available in Canada, although it was previously available before July 2020. Each form of treatment has its advantages and disadvantages, and it is recommended that patients discuss these options with their surgeon to determine the most appropriate course of action for their specific situation.

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  Joy 14 May 2015

  The case study mentions the patient's symptoms occurred after opening multiple jars. Does this infer that arthritis can be caused by repeated movements?

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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    K. Michael 31 July 2015

    My aunt has arthritis and finds that any repetitive motion increases her pain. Especially griping motions.

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    Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 03 June 2015

    I think that Arthritis can definitely be aggravated by repeated actions that stress the joints.

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  Dr. John Watterson MD, FRCPC Rheumatologist, Victoria, BC 23 April 2015 Artus Health Centre

  Osteoarthritis is a degenerative joint disease that can affect any area of the body. Osteoarthritis of the hands is specifically involving certain areas, including the end joints and the middle joints of the hands, and the joint at the base of the thumb.

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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    Chantal Sayers Vancouver, BC 18 December 2015

    I am a guitar player and I find that the joints in my left hand can get tender and sore. I don't know if this is due to overuse, or whether this is the starting of osteoarthritis. What signs should I look for to understand the difference? Thank you

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    K. Michael 11 August 2015

    Is it common for osteoarthritis to show up in one finger ? Or does it usual affect the entire hand at once ?

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  Dr. Crysta Serne BSc(Kin), DC Chiropractor, Vancouver, BC 20 March 2015 Vitality Clinic, Downtown, Vancouver, BC

  To answer your question Chantal- there are several different types of arthritis (osteoarthritis, rheumatoid arthritis, psoriatic arthritis, etc.) The most common form of arthritis is osteoarthritis and it has 2 ways of developing. Primary osteoarthritis occurs in the body over time and will typically affect more than one joint. Secondary osteoarthritis occurs after a trauma of some sort- a fall, surgery, etc and is usually confined to the joint involved in the trauma. The best course of action is to seek out a general practitioner who can then refer you to have x-rays taken. An x-ray is one of the easiest ways of identifying the type of arthritis you may have. Once the diagnosis in made, you can seek out the appropriate type of treatment. Pain is not something you have to live with! As a chiropractor, I see patients on a daily basis with all types of arthritis. Aside from adjustments, a large part of my job is to provide lifestyle choices to increase quality of life.

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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    K. Michael 15 July 2015

    Are there really options to eliminate all pain from arthritis ? I have an aunt with severe rheumatoid arthritis and she lives with pain on a daily basis. She is just grateful for days where the pain doesn't interfere with her everyday life and remains just "background noise"

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  ShirleyG 09 March 2015

  Can being double jointed in your thumb lead to thumb arthritis ?

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  K. Michael 08 March 2015

  I think that joint pain can be a normal part of aging but sensitivity to cold can be a sign of arthritis

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  Chantal Sayers Vancouver, BC 26 February 2015

  I'm just wondering if it is typical to have arthritis only in the thumb? If you have arthritis in the thumb would this be an indicator that you are likely to have it elsewhere in the body? I have experienced sore finger joints, usually when it is cold out, but typically feel joint pain elsewhere as well ie: in ankles, feet, hips

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  ShirleyG 12 February 2015

  Can thumb arthritis be related to carpal tunnel syndrome ? My Uncle had carpal tunnel surgery last year and has been experiencing numbness in his thumb the last few months. The doctor suspects this may be the onset of arthritis in the thumb. Are there specific tests that should be run ?

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  ShirleyG 12 February 2015

  Are there specific exercises that can be done to help prevent thumb arthritis ?

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  Bernadette van der Boom-Bebb 06 December 2014

  It's good to learn about ways to reduce stress on your thumb. I like the track-ball suggestions below. Does anyone have any other good ideas?

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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    Yuan Lew, MSc MBA 11 December 2014

    Lowering the mouse/mouse pad can help with thumb pain due to computer use.

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    K. Michael 06 December 2014

    @Bernadette after my car accident I was told to train myself to use my left hand more (the un-injured one). I know mouse with my left hand instead of my right. It has greatly improved my ability to work without pain

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  stravers82 03 December 2014

  I have had collagen injections for my hip arthritis, I'm wondering if maybe this could be an option for the thumb also?

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  K. Michael 28 November 2014

  I didn't realize you could have arthritis in only one finger. Is it only the thumb ?

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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    Yuan Lew, MSc MBA 10 December 2014

    @Kimberley, if it gets worse, definitely get it looked at. My mom has osteoarthritis but her right middle finger is worse. She followed up with an x-ray and a specialist and it was actually a bone spur. Her option is to tolerate the stiff joint or surgery. The spur may return with surgery, so she opted to tolerate for now.

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    K. Michael 03 December 2014

    @Yuan Lew - I have had increasing amounts of pain in the ring finger of my left hand for a few years. It is especially painful when exposed to cold.

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    Yuan Lew, MSc MBA 01 December 2014

    I was told my other fingers are showing initial signs of osteoarthritis, so no, I don't think it's just the tumb.

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  Yuan Lew, MSc MBA 26 November 2014

  A very useful video describing thumb arthritis, what it is and the causes of it.

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 26 November 2014

  I have pain in both my thumbs from I believe too much computer. I think I hold my thumb at an angle away from my fingers when I use the mouse. I also think I tense my hand and thumb when I use the mouse. Anyone else going through this. I have tried a brace and that works well but I lost the brace.

  Reply to: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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    K. Michael 10 December 2014

    @Michelle Kaarto why do you not always use your non dominant hand to mouse ?

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    Michelle Kaarto, BScK, CSEP CEP 08 December 2014

    I switch my mouse to the non-dominant hand every month. It only takes a day for me to adapt to using my left hand with the mouse, and then it's smooth sailing. It also gives my right hand a much-needed break as I feel similar tension and strain in my hand/wrist that @Jackson is reporting.

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    K. Michael 29 November 2014

    @Yuan Lew - we have a trackball mouse that requires less movement of the wrist of thumb. Also you can train yourself to use your less dominant hand to mouse with

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    Yuan Lew, MSc MBA 29 November 2014

    I have seen certain products on the market to replace the computer mouse to address thumb arthritis or hand pain. Perhaps research alternatives to a mouse?