This blog post was written and contributed by Carthage Area Hospital Hand Therapist, Carl Petitto, OT/L, CHT
One of the most common places in the entire body where severe osteoarthritis occurs is at the base of the thumb. When you look at all of the movements of the thumb, you can see that it moves in many directions. An opposable thumb (opposes to or touches all the fingers of the hand) gives us the ability to manipulate objects in our environment much more effectively as contrasted to nearly any other living being on our planet. Our thumbs are very mobile. The price we pay for this freedom of movement is more wear and tear. Let’s break down the word “osteoarthritis.” “Osteo” means bone, “arthro” means joint, and “itis” means inflammation. This is inflammation of the joint. It is a mechanical wearing of the joint surface. As the joint surface (cartilage) wears away, pain and inflammation become more prominent. In an attempt to stop this movement which is causing pain, the body will try to fuse these two surfaces together. This is when we start to see bone spurs developing. Often, the edges of the bone surface will begin to get jagged and very sore to the touch.
We are born with thumbs for a reason – we absolutely need them, so what can be done about this painful condition?
- Reduce pain and inflammation with cold mid-day and at the end of every day. Cold running water for 10-20 seconds is quick and easy. Studies have shown that this is as effective, and often more effective, than an ice pack applied for 10 minutes!
- Maximize blood flow to bring more oxygen and nutrients to the joint with a heating pad on LOW, each morning. Morning ONLY – using heat during the day while you are using your hands will increase inflammation. After you have been resting while sleeping, it is safe to use heat in the morning. In the morning, you probably notice that your thumbs are stiff. Low heat will get them moving and make them healthier.
- Soft neoprene thumb stabilization splints to be used during aggravation-inducing tasks only. Splints should NOT be worn continuously. You can obtain the proper splint from your hand therapist.
- Specific movements 2-3x/day as instructed by your hand therapist – the correct dosage and type of range of motion is safe for the joint and will stimulate the body to preserve remaining cartilage!
- Self-traction. Traction is when you separate the joint. This causes light internal suction that pulls nutrient rich fluids into the joint space, preserving cartilage and reducing inflammation and pain. Your hand therapist will teach you this
How many therapy visits are usually needed? The answer is only two or three. Your hand therapist will teach you how to properly self-manage this condition to keep pain and inflammation minimized and the use of your hands maximized.
Is there surgery to help this? It is time for surgery if your symptoms are overwhelming and you decide to have surgery. The very effective technique is a joint replacement at the base of the thumb. I refer patients to board certified hand surgeons who routinely perform these. New techniques that are being used are very successful and the hand therapy following surgery is very effective. Conservative treatment (treatment without surgery) should be the first option.
For more information or to seek treatment, please contact Carthage Therapy Services at 315-493-1340.
Complimentary screenings are available. If you are having pain, stiffness, numbness, or tingling anywhere within your hand to shoulder, contact Carthage Area Hospital Therapy Services today at 315-493-1340.
About Carl Petitto, OT/L, CHT
Carl is an occupational therapist who has undergone additional training as a board certified hand therapist, specializing in rehabilitating patients with orthopedic conditions affecting the hand to shoulder. Carl also fabricates custom splints as an additional tool to help people to get well in minimal time. He has been treating the upper extremity since 2000.