Thumb Ligament Pain: When to Consider Surgery? - Orthopedics

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Understanding thumb ligament pain, particularly when it has persisted for over two years, can be quite complex. Your situation, characterized by pain during activities such as lifting heavy objects or washing dishes, along with a history of consultations with multiple orthopedic specialists, suggests that you may be dealing with a significant underlying issue.
Firstly, it’s important to clarify that thumb ligament pain can arise from various conditions, including ligament laxity, tendonitis, or even arthritis. The fact that one orthopedic surgeon diagnosed you with ligament laxity and suggested the need for an artificial ligament indicates that they believe the structural integrity of your thumb's ligaments is compromised. This is a serious consideration, especially if conservative treatments have failed.

When conservative treatments such as physical therapy, wax therapy, electrical stimulation, acupuncture, and infrared therapy do not yield results, it often indicates that the underlying issue may be more severe than initially thought. In your case, the persistent pain and the audible clicking or popping sounds in the joint could suggest that there is more than just inflammation at play. These symptoms could be indicative of a condition known as De Quervain's tenosynovitis, which affects the tendons on the thumb side of the wrist, or possibly a form of ligament injury that has not healed properly.

Regarding the need for surgery, it is essential to weigh the benefits and risks. Surgical intervention is typically considered when:
1. Conservative Treatments Fail: As you have experienced, if multiple non-surgical treatments have not alleviated your symptoms, surgery may be warranted.

2. Functional Impairment: If the pain significantly limits your daily activities or quality of life, surgery might be the best option to restore function.

3. Structural Issues: If imaging studies (like MRI) reveal significant structural damage or if there is a clear diagnosis of a condition that requires surgical correction, then surgery may be necessary.

In your case, the suggestion of an artificial ligament replacement is significant. This type of surgery is typically reserved for cases where there is substantial ligament damage that cannot be repaired through traditional means. Traditional surgery might involve repairing or tightening the existing ligaments rather than replacing them entirely.
As for potential complications or long-term effects, any surgical procedure carries risks, including infection, nerve damage, stiffness, and the possibility of requiring further surgery in the future. However, many patients find that the benefits of alleviating chronic pain and restoring function outweigh these risks.

Lastly, regarding your question about whether this could be "mother's thumb" (De Quervain's tenosynovitis), it is possible, especially if you experience pain on the thumb side of your wrist. This condition is characterized by pain and swelling at the base of the thumb and can be exacerbated by repetitive hand movements.

In conclusion, given your prolonged symptoms and the ineffectiveness of conservative treatments, it may be time to consider surgical options seriously. Consulting with a hand specialist who can provide a thorough evaluation, including imaging studies, would be beneficial. They can help determine the most appropriate surgical intervention based on the specific nature of your ligament issues. Always ensure that you discuss all your concerns, including the type of surgery, recovery time, and potential outcomes, with your surgeon to make an informed decision.