THUMB PAIN?? Basilar Joint Arthritis
Basilar joint arthritis is arthritis of the thumb, or the (carpometacarpal joint) thumb joint. The thumb joint receives a tremendous amount of stress especially with pinching and every day motions. The thumb joint generally due to repeated strain and wear and tear, wears out and has many arthritic problems with the most common being:
Rheumatoid arthritis (autoimmune disease), traumatic arthritis (by injury), and osteoarthritis (degenerative disease).
Upon evaluation, your surgeon will perform several test including; manipulation of the joint, physical examinations, x-rays, MRI, and bone scans in order to determine if one has basal joint arthritis and what can be done to fix the problem.
The amount of pain and discomfort geneerally dictates the course of treatment and how aggressive the plan is towards surgery.
Basilar Joint Arthritis Symptoms;
The first and most common symptom of thumb arthritis is pain. Pain occurs at the base of your thumb when gripping, grasping, pinching an object between your thumb and forefinger, or applying force — such as when turning a key, pulling a zipper or opening a jar. Eventually, you may even experience pain when not using your thumb.
Signs and symptoms may include:
- Pain at the base of your thumb
- Swelling, stiffness and tenderness at the base of your thumb
- Decreased strength when pinching or grasping objects
- Decreased range of motion
- Enlarged, bony or out-of-joint appearance of the joint at the base of your thumb
The pain, stiffness and decreased movement may be minimal or significant, depending on the severity of the condition and how you use your hands in work and recreation
Like all arthritis there is no exact cause; but there can be several reasons including;
· Repetitive use
· Muscle weakness
The cartilage that cushions the joints slowly wears down causing the bones to rub together; the joint friction causes damage which then causes pain.
Treatment focuses on helping to:
- Reduce pain
- Maintain or improve joint movement
- Minimize disability
Recommendation for a combination of treatments, including self-care measures, activity modification, splints, medications and physical therapy. In early stages, nonsurgical treatments are usually effective. In severe cases, surgery may be necessary.
We may recommend the use of a splint to support your joint and limit the movement of your thumb and wrist. Splints help decrease pain, encourage proper positioning and give your joint some much-needed rest. Depending on your needs, you may wear a splint just at night or throughout the day and night.
Several types of splints are available. Some are prefabricated, and you can find them in medical supply stores or drugstores. Others can be custom-made to fit your hand. They may be soft and cloth-like or made of plastic. Your doctor or an occupational or physical therapist with special training in treating hand disorders (hand therapist) can help you decide which kind of splint is right for you.
We may recommend that you take acetaminophen (Tylenol, others) on a regular basis to relieve your joint pain. Acetaminophen may have fewer side effects than do other pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the inflammation and relieve the pain in your thumb and wrists. NSAIDs include such over-the-counter (OTC) medications as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others). Prescription-strength NSAIDs include ketoprofen, diclofenac (Cataflam, Voltaren) and nabumetone (Relafen).
NSAIDs have risks of side effects that increase when used at high doses for long-term treatment. Side effects may include ringing in your ears, gastric ulcers, cardiovascular problems, gastrointestinal bleeding, and liver and kidney damage.
If a combination of analgesics and splint use isn’t effective, we may recommend injecting a long-acting corticosteroid into your basal joint. Corticosteroid injections can offer some pain relief and reduce inflammation. Corticosteroid injections are only a temporary solution. Thumb arthritis is a progressive, degenerative disease, which means it will worsen over time — with injections or without.
When surgery is necessary
If you don’t respond to other treatments or if your ability to use your thumb is significantly compromised, we may recommend a surgical procedure.
Each of the surgical procedures for basical joint arthritis can be done on an outpatient basis. After surgery, you can expect to wear a cast or splint over your thumb and wrist for up to six weeks. Once the cast is removed, you may work with a physical therapist to help regain hand strength and movement. Although recovery is slow, you should be able to resume your normal activities within six months of surgery.
If you are experiencing thumb pain or discomfort cal (310) 275-6600 and make an appt to see Dr. Danielpour and Dr. Layke