>>>Rick Papandrea, MD: One of the most common conditions that a hand surgeon will see in the office is arthritis of the base of the thumb and we call it basilar joint arthritis or a CMC joint arthritis and that’s right here where the thumb joins the wrist that knuckle can wear out. So knuckle that has a lot of motion to it and a lot of stress on it and it can wear out with time and with use.
That condition is probably a little more common in women, but I see it in laborers, men as well as women. It can be from heavy use on the job or heavy use doing things you enjoy like crafting or knitting. It can be something that occurs quickly or is something that occurs over a long period of time. As far as treatment options for it, really it goes from the simple little to the more complex. Things like anti-inflammatory medications, Motrin or Aleve can be utilized, Tylenol, over-the-counter medications, rubs, creams, this sometimes help. When things like that do not help or in addition to those things bracing can sometimes help and the one common about a brace whether its from your doctor or from a pharmacy, is to make sure it includes the thumb itself, if it includes just the wrist and is cut out over the thumb that actually usually makes the arthritis hurt more.
Seeing your doctor usually makes sense when simple things like I have just mentioned do not work and sometimes your doctor can prescribe medications that are similar but may be more strong or he or she can inject Cortisone or an anti-inflammatory medication right into the joint and that can be pretty beneficial too. I have personally seen injections last over a year, although most of the time it lasts about three months. When bracing does not work, when medications do not work, when injections do not work, then surgery is something that seriously consider and the surgery to rebuild that joint works very well.
It is a type of joint replacement, but it does not utilize any artificial parts and it works very well after rehabilitation time of about three months or so. Patients do well and their grip increases and their pain goes away. Some patients are unfortunate enough where their arthritis is bad enough that their thumb starts to get deformed and the arthritis here causes the thumb bone to get stuck down and when that happens, this knuckle will start to bend backwards and when a patient starts to see that bending back or a zigzag deformity, that is time they really see a physician with a little more urgency. It is not an emergency, but it is not something that you should leave alone for a long time because it makes reconstruction harder.
So overall there are a lot of things that somebody can do for CMC or basilar joint arthritis. Some of them are simple like over-the-counter medications or a brace. Some of them are a little more complicated like an injection. Now when those things stop working, reconstruction or rebuilding the joint works very well and the only time to get may be a little bit of urgency to see your physician is when the thumb goes into that collapsed or zigzag position..
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