Understanding yur thumb stearthritis Intrductin The CMC jint is ne f the mst imprtant jints f the thumb and hand due t its wide range f mtin. Over time, the CMC jint is subject t large and repeated frces during use which may lead t degenerative (stearthritis) changes. Individuals can develp unstable pinch patterns that alter the natural muscle and ligament structures designed t stabilize the thumb jint. With the educatin and exercise tips fund in this handut, yu can learn t retrain yur thumb t use a mre stable pinch pattern. Predispsing factrs t thumb CMC jint stearthritis include Anatmic anmalies f the jint Acute trauma t the sft tissue structures (i.e. ligaments) Fracture t the base f the thumb Hrmnally linked excessive laxity f ligaments (i.e. females during peri r pst menpause) Nn-surgical appraches t symptm management include pain-relieving mdalities, rthsis supprt (splinting), targeted exercises, and jint prtectin techniques. Symptm Management Pain-relieving mdalities Superficial heat and cld mdalities such as ht packs, paraffin baths, warm water baths, cld packs, ice baths, and ice massage. The gals f these thermal mdalities are t reduce pain, decrease inflammatin, imprve functin, and increase r maintain mtin. Nnsteridal anti-inflammatry drugs -NSAIDs (shuld be discussed with yur physician) These medicatins are rutinely used t reduce pain and inflammatin, and they can be ral r tpical. A cmmnly prescribed tpical NSAID is Vltaren gel.
Crticsterid injectins (shuld be discussed with yur physician) Usually prvide shrt-term pain relief. Sterid injectin at the thumb jint is less cmmn than in larger jints such as the knee r shulder. Studies have shwn that lng-term use f multiple crticsterid injectins can cause articular cartilage lss and weakening f the capsule. Splinting Splinting is the mainstay f cnservative management f an unstable and painful thumb. It helps t rest and supprt the thumb jint and reduces stress during use. There are several types f splints available fr treating an unstable and painful thumb. Yur therapist will discuss with yu the benefits f each and make suggestins based n yur specific symptms. Exercises NOTE: Yur therapist will discuss with yu which exercises are apprpriate fr yu, and when yu shuld begin the stabilizatin exercises. During perids f a markedly unstable r inflamed jint, rest and supprt thrugh psitining are required and exercises may be cntraindicated. As a general rule, exercises are mre apprpriate when the jint is nt inflamed and relatively painless. The thumb CMC jint is stabilized by ligaments and muscles that help t keep it n the trapezium (wrist bne). Knwledge f a few key muscles will aid in prtecting yur thumb. Sme muscles wrk against the thumb jint by becming t tight and mving the thumb away frm the trapezium. The first drsal intersseus is a strng finger muscle that cmes frm the side f the thumb bne and helps t keep the base f yur thumb n the trapezium. Helping t maintain the strength f this muscle, and learning t use it prperly when yu pinch will help t prtect yur thumb jint and keep it stable. The adductr pllicis is a cmmn muscle t tighten up arund the thumb and pull it twards yur palm. Helping t relax this muscle with pressure pint exercises will help t prtect yur thumb and prevent defrmity.
Jint Prtectin Techniques Jint prtectin can be defined as the act f decreasing the stress/lad n a jint and its surrunding tissues while perfrming daily activities. Sme activities that are likely t exceed the frce f yur thumb jint are cutting with scissrs, pening a bttle r jar, and turning a key in a lck. Activity mdificatin Altering lng-term behavirs can be difficult. It is imprtant t understand that these alteratins are essential t the success f prtecting yur jints frm stress that leads t pain, inflammatin, and pssible defrmities. Basic principles f jint prtectin include: Rest- allw frequent breaks t avid veruse f yur thumb. Exercise t maintain jint mtin- finding balance between rest and exercise will be very imprtant and will be different fr each persn. Respect pain- if yu ntice that yu have dne t much f a certain activity, with increased pain that lasts mre than tw hurs, pay attentin and next time d a little less. Distribute weight evenly- use bth hands when lifting instead f ne when pssible. Always lift an bject frm the bttm with bth arms and palms, and nt frm the tp with yur fingers and thumbs. Avid staying in/hlding ne psitin fr lng perids f time- take rest breaks when perfrming activities and use utensils/equipment with larger handles. Use larger and strnger jints- carry a heavy purse n yur shulder r elbw versus using yur fingers.
Assistive Devices Many assistive devices used fr jint prtectin are designed t reduce the pinch and grip frces assciated with varying activities. In general, utensils and equipment with larger handles are mre supprtive fr smaller jints fund in the hand and thumb. These devices may include jar peners, spring laded scissrs, drknb turners, mdified kitchen utensils, mdified key hlders, and pen grips r larger pens. NO/WRONG YES/RIGHT