Degenerative Arthritis in the Thumb: Causes and Treatments

Finger osteoarthritis

Hello, doctor.
I would like to ask about an issue with my right thumb.
In the past, my thumb was frequently hit by a ball, and I thought it would heal on its own.
However, many years have passed, and now I have a persistent problem where I cannot hold onto objects for long (especially if they have some weight).
My hand doesn't feel fatigued, but the area around my thumb becomes sore easily.
Although it has been a long time since the injury, I went to a small clinic last night to get an X-ray.
The doctor examined my spine and my thumb, and he mentioned that the joint of my right thumb, specifically the second joint from the nail side, has a narrowed gap and is slightly angled inward, indicating "mild to moderate" degenerative joint changes.
However, I can still move my finger freely.
I asked the doctor if there are any treatment options, and he said that the only thing that can be done is to prevent further injury.
Are there any other treatment options available, doctor?

Xiang, 20~29 year old female. Ask Date: 2016/07/29

Dr. Shi Guozheng reply Orthopedics

Degenerative arthritis of the finger joints is primarily managed through symptomatic treatment, meaning that treatment is only necessary when pain is present.
Typically, medications are used, and it is important to avoid excessive use to prevent rapid deterioration.
Additionally, soaking the joints in warm water can help to soften them.

Reply Date: 2016/07/29

More Info

Degenerative arthritis, particularly in the thumb, is a common condition that can significantly impact daily activities, especially when it comes to gripping or holding objects. This condition, also known as osteoarthritis, occurs when the cartilage that cushions the joints wears down over time, leading to pain, stiffness, and reduced range of motion. In your case, the history of trauma to the thumb, such as being hit by a ball, could have contributed to the development of this condition.

Causes of Degenerative Arthritis in the Thumb
1. Previous Injury: As you mentioned, your thumb was previously injured. Trauma can lead to joint instability or damage to the cartilage, which may predispose the joint to degenerative changes over time.

2. Age: Aging is a significant risk factor for osteoarthritis. As we age, the cartilage naturally wears down, and the body's ability to repair itself diminishes.

3. Repetitive Use: Activities that involve repetitive motion of the thumb, such as gripping or pinching, can exacerbate wear and tear on the joint.

4. Genetics: A family history of arthritis can increase the likelihood of developing the condition.

5. Obesity: Excess weight can put additional stress on weight-bearing joints, including the thumb.

Symptoms
The symptoms you described, such as difficulty holding objects for extended periods and localized soreness in the thumb area, are typical of degenerative arthritis. Other common symptoms include:
- Pain during movement or after prolonged use.

- Stiffness, especially in the morning or after periods of inactivity.

- Swelling or tenderness around the joint.

- A decreased range of motion.

Treatment Options
While your doctor indicated that the primary goal is to prevent further damage, there are several treatment options available that may help alleviate symptoms and improve function:
1. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can design a program that includes exercises to strengthen the muscles around the thumb and improve flexibility. They may also employ modalities such as ultrasound or electrical stimulation to reduce pain.

2. Splinting: Using a thumb splint can help stabilize the joint, especially during activities that require gripping. This can reduce pain and prevent further injury.

3. Medications: Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. In some cases, your doctor may prescribe stronger medications or topical treatments.

4. Injections: Corticosteroid injections can provide temporary relief from inflammation and pain. Hyaluronic acid injections may also be considered, as they can help lubricate the joint.

5. Lifestyle Modifications: Weight management and avoiding activities that exacerbate symptoms can help. Ergonomic adjustments in daily tasks can also reduce strain on the thumb.

6. Surgery: In cases where conservative treatments fail to provide relief, surgical options may be considered. Procedures can range from arthroscopy to remove damaged tissue to more invasive surgeries like joint fusion or joint replacement.

Conclusion
While degenerative arthritis in the thumb is a chronic condition, there are various treatment strategies available to manage symptoms and maintain function. It is essential to work closely with your healthcare provider to develop a personalized treatment plan that addresses your specific needs and lifestyle. Regular follow-ups can help monitor the condition and adjust the treatment as necessary. Additionally, staying informed about your condition and exploring new therapies can empower you to manage your symptoms effectively.

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