Get a Grip: Arthritis of the thumb and 3 things you can do to tell it to take a hike! by Christina Nowak

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Get a Grip: Arthritis of the thumb and 3 things you can do to tell it to take a hike! by Christina Nowak

Did you know:

  • Over 1/3rd of women have arthritis of the thumb after menopause?
  • Arthritis in the thumb is the second most common spot for arthritis
  • Arthritis is one of the leading causes of pain and disability in Canada and THE leading cause of disability in women.
  • So much of the research has been done on knee arthritis that there is surprisingly less about what to do about the thumb

We use our hands for so many things we do everyday from taking care of ourselves, driving a car, to showing emotion when we are telling a really great story (you know those people who do it more than others!). When we are struck by arthritis in one of the most commonly used joints in our body, it sucks! Arthritis in the hand, especially the thumb, can prevent us from doing a lot of our day to day activities … and we rely on our hands a lot! Over 25% of all of our activities use our thumbs and our thumb is necessary for 40% of the things we do with our hands.

Pain in the bottom portion of the thumb that comes on gradually and gets worse over time are the hallmark signs of (osteo)arthritis. Other causes of thumb pain can be rheumatoid arthritis (not covered in this article), gout or infections. In general, these other sources of thumb pain tend to come on more suddenly. An X-ray can be ordered by your doctor to see if arthritis is the culprit for your thumb pain and a rehab professional or doctor should be consulted before making a diagnosis.

[For my clinicians: passive range of motion under axial load is a sensitive way to test for thumb OA. Finkelstein’s will also commonly be positive ]

Arthritis, as of this moment (science is doing some amazing things!), can’t be reversed. However, we can help with the PAIN and LOSS OF MOVEMENT that happen as a result of arthritis. Right now, there is very limited

Here are 3 things you can do to tell your arthritis to take a hike:

  1. Use a hot wet cloth or wax bath.

One of the quickest ways to help with pain relief is to apply heat to the thumb. I like using a wax bath if you have one or a wet hot cloth. The heat helps to get rid of the pain but unfortunately it is often short lived. This is definitely a temporary solution but helps especially if you know you’ve overdone it one day. Pain killers can help too but personally I avoid meds if I can.

Word of caution: Watch the temperature and don’t apply too much pressure into the hand – it can cause burns.

2. Stretch out your fingers and thumbs

Gentle stretching and movements of the finger and thumb can help relieve some of the stiffness that often leads to discomfort in arthritis. Stretching the thumb forward and back (don’t crank too hard on your fingers that will just make the pain worse) for 60 seconds just into slight discomfort but not pain can help to relieve some of that feeling of stiffness. This is helpful especially in the morning and using heat first can make stretching more effective.

3. Try a splint

Arthritis recommendations show that the research jury is still out on the use of a thumb splint to help with the pain and disability related to thumb arthritis. That being said, try it out. I wouldn’t go and get a custom expensive splint done if you don’t know it’s going to work. I would go to a local medical supplies store and try out a thumb splint. You can get one for fairly cheap and then see if it works. My word of caution though is that sometimes the splint can increase a person’s confidence and therefore they do TOO much with their hands that they aren’t used to, the pain gets worse and then they say that a splint doesn’t work.

These are three ways to get started on managing the pain and disability from arthritis. Many people that I work with express frustration because the pain in the hands prevent them from doing things around the house or perhaps more heart-breaking, have stopped them from doing hobbies they love to do like playing the guitar or knitting/art.

Arthritis unfortunately is often something that is managed and not fixed. The Arthritis Society does a wonderful job providing online self-management resources for anyone who is struggling with the pain of arthritis. As well, if working with a rehabilitation professional and doing your exercises diligently hasn’t helped with the arthritis or at least made it manageable, surgery is another option. There are a few options for surgery that range from movement of the ligaments to a total joint replacement and one option hasn’t been shown to outshine the other. If you feel like this is you, talking to your doctor and getting a referral to a surgeon may be your next step.

In the mean time, a physiotherapist can help you learn tips and tricks (on top of the ones that I gave you today) that can help you manage the pain of your arthritis. You aren’t alone. Talking to others about ways that have and haven’t worked for them is a good way to learn how you can help yourself improve.

References:

  1. Bakri, K., & Moran, S. L. (2015). Thumb carpometacarpal arthritis. Plastic and Reconstructive Surgery, 135(2), 508-520. doi:10.1097/PRS.0000000000000916 [doi]
  2. Berger, A. J., & Meals, R. A. (2015). Management of osteoarthrosis of the thumb joints. The Journal of Hand Surgery, 40(4), 843-850. doi:10.1016/j.jhsa.2014.11.026 [doi]
  3. Bernstein, R. A. (2015). Arthritis of the thumb and digits: Current concepts. Instructional Course Lectures, 64, 281-294.
  4. Spaans, A. J., van Minnen, L. P., Kon, M., Schuurman, A. H., Schreuders, A. R., & Vermeulen, G. M. (2015). Conservative treatment of thumb base osteoarthritis: A systematic review. The Journal of Hand Surgery, 40(1), 16-21.e1-6. doi:10.1016/j.jhsa.2014.08.047 [doi]
  5. The Arthritis Society. Facts & Figures. https://arthritis.ca. Accessed July 10, 2016.

By Christina Nowak

 

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