Thursday, 1 September 2022

How To Relieve Arthritis Pain in Your Thumb

From health.clevelandclinic.org

From heating pads and ice to exercises and splints, find the relief that works for you 

When arthritis takes hold in your thumb, actions you may have taken for granted can become more challenging. Opening jars, turning doorknobs or carrying a dinner plate can become monumental — and sometimes painful — feats.

Osteoarthritis of the hand is the second most common type of arthritis in the United States, second only to arthritis in the knee.

Osteoarthritis is commonly seen in the thumb joint where your thumb meets your wrist — also known as your carpometacarpal (CMC) or basal joint. Your CMC joint is responsible for things you commonly use your hand for without even realizing it — the swivelling, pivoting and pinching when you grip items in your hand.

There are a lot of myths about arthritis, so we talked with orthopaedic surgeon David Shapiro, MD, and occupational therapist Patty Shimko, OTR/L, about the signs of arthritis in the thumb and how you can find relief.

Signs you may have arthritis in your thumb 

The symptoms of thumb arthritis can limit your hand function and make everyday tasks difficult. 

“When osteoarthritis causes the cartilage to wear away, the shock- and impact-absorbing function of the cartilage is lost,” Dr. Shapiro says. “The bones can rub against each other, causing stiffness and pain.” 

If you’re living with arthritis in your thumb, you may have:

  • Swelling, stiffness, tenderness or pain in your bottom-most thumb joint, at the base of your thumb or in the palm of your hand near your thumb.
  • Pain with activities that involve gripping or pinching, like opening a jar or buttoning a shirt.
  • Aching or discomfort after prolonged use of your hand.
  • An enlarged thumb joint. 
  • A bony bump on your bottom thumb joint that limits your motion.

Who’s most likely to get thumb arthritis? 

Osteoarthritis is commonly seen in people over the age of 50. Rheumatoid arthritis typically first appears between the ages of 35 and 50. 

Anyone can develop arthritis in the hand, but it affects women and people assigned female at birth (AFAB) five times more frequently than men and people assigned male at birth (AMAB), Dr. Shapiro says.  

“Women and people AFAB seem to have more joint laxity (looser joints), which leads to malalignment of the joint, cartilage wear, arthritis and pain,” Dr. Shapiro notes. 

If you’ve had fractures to your hand or thumb or a history of other injuries in the area, you may also be at a higher risk for developing arthritis. Contrary to popular folklore, cracking your knuckles — while cringe-worthy — doesn’t put you at risk for arthritis.

How to tell if you have arthritis in your thumb  

If you suspect arthritis may be the cause of your thumb pain, talk with a healthcare provider. X-rays can show if you have a loss of bone cartilage and the formation of bone spurs that indicate arthritis. Your healthcare provider may also do a blood test to determine if the cause is rheumatoid arthritis.  

At-home treatment for thumb arthritis pain 

There are a few treatments you can try at home to relieve pain in your thumb from arthritis. Dr. Shapiro suggests: 

  • Using a heating pad for five to 15 minutes a few times a day. Some people prefer ice to relieve their pain. Try them both to see what works for you. 
  • Taking acetaminophen (Tylenol®) and/or a nonsteroidal anti-inflammatory medication (such as Advil®). Dr. Shapiro says using both in combination is sometimes very effective and allows you to use less of each individual medication. 
  • Taking paraffin baths (a use of warm wax to relieve joint and tissue pain). 
  • Applying topical arthritis creams. 

Splints can also provide some pain relief, Dr. Shapiro says. Try a soft splint, similar to a biking glove with a strap that stabilises your thumb. Hard plastic splints, either custom-made or off the shelf, might also help increase your function and relieve some pain. 

Take the weight off your thumbs 

Shimko also suggests these practical ways to take some of the burden off your hands: 

  • Use an electric or battery-operated can opener. 
  • Avoid repetitive activities such as using scissors or sewing. 
  • “Build up” the handles on your kitchen utensils and gardening tools so you don’t have to grip them as tightly. A popular way to do this is with foam tubing. 
  • Use a speaker phone when you can for talking on the phone.   
  • Use a bag or backpack, rather than carrying things in your arms, when you can. 
  • Squeeze excess water from a washcloth or clothing by wrapping it around a faucet and squeezing gently, rather than wringing it out. 

Exercises for thumb arthritis relief 

Exercising your thumb and hands can bring some relief from arthritis pain and help you maintain motion and strength in your hands. Shimko offers these four exercises that can help relieve pain from thumb arthritis:

  1. Use your fingers of one hand to softly massage the fleshy part below your thumb on your other hand. 
  2. Gently bend the bottommost knuckle of your thumb so it moves toward your palm and then away from your palm.  
  3. Without using your other hand, gently move your thumb as far away from your other fingers as you can, trying to form the letter “L” with your index finger and your thumb. 
  4. Tap each of your fingers to your thumb, one at a time.

What about supplements like glucosamine or chondroitin? 

The U.S. Food and Drug Administration (FDA) doesn’t review or approve supplements. Supplements aren’required to undergo the same rigorous clinical trial methods that medications must pass. But some clinical trials show glucosamine or chondroitin can improve pain for some people, but there isn’t any proof that these supplements slow the progression of osteoarthritis. Talk with a healthcare provider before using supplements. They may interfere with medications you currently take. 

However, some foods like green tea, fish rich in omega-3 fatty acids, nuts and whole grains could help relieve your pain. 

Additional help for thumb arthritis 

If home treatments aren’t doing the trick, it may be time to talk with a doctor about your arthritis pain. Your doctor may recommend some additional medical interventions.

Steroid injections 

Steroid (cortisone) injections may help. While individual physicians will manage this differently, one or two injections are usually worth a try and may provide lasting relief, Dr. Shapiro says. 

Surgery 

If nonsurgical treatment is no longer effective and your pain is overwhelming, surgery might be an option. 

Ligament reconstruction and tendon interposition (LRTI) surgery is the gold standard for surgical treatment of basal joint arthritis, Dr. Shapiro says.

LRTI involves the removal of your trapezium (a bone in your wrist located just below your thumb). A “spare” tendon from your forearm is then used to stabilize your thumb. The procedure is performed on an outpatient basis. People usually wear a splint or cast for up to six weeks, typically followed by a course of occupational therapy. 

“LRTI provides 95% pain relief and about 70% to 80% return of grip strength,” Dr. Shapiro states. “While complete recovery can take a while, most patients end up much more functional, and much happier after the operation than before.”

Arthritis can be a real pain in the … thumb. While common, arthritis pain in your thumb can make everyday tasks more difficult. Talk to your healthcare provider about ways to make your daily tasks easier and your options for relief.  


https://health.clevelandclinic.org/losing-your-grip-how-to-treat-your-thumb-arthritis/

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