Thumb Joint Inflammation: Post-Surgery Pain and Nerve Issues

Thumb joint inflammation?

Hello, Doctor.
I have been experiencing pain near the wrist in both of my thumbs for a long time.
After an X-ray, I was diagnosed with arthritis and required surgery for joint stabilization.
My right hand is more painful, so I underwent the surgery first, where a titanium pin and a screw were placed in the joint, and 1cc of bone graft material was injected.
The wound has healed now, but I'm experiencing a tingling pain that extends to the tendon in my thumb and wrist.
It feels like it’s being pulled, and I cannot make a fist with my thumb in the palm position.
The pain is even worse than before the surgery! Could this be due to nerve damage? Thank you for your response!

Ahao, 40~49 year old female. Ask Date: 2021/12/10

Dr. Shi Guozheng reply Orthopedics

It is normal to experience slight numbness after small nerve injuries on the skin, and this may improve over time.
After surgery, joint stiffness can occur, which can be alleviated through rehabilitation.
If there are any concerns, you can return for a follow-up appointment with your attending physician for clarification.

Reply Date: 2021/12/10

More Info

It sounds like you are experiencing significant discomfort following your thumb joint surgery, and I understand how distressing this can be. Based on your description, it seems that you are dealing with a combination of post-surgical pain, potential nerve involvement, and possibly inflammation in the surrounding tissues.

After surgery, especially in the case of joint fixation, it is not uncommon to experience pain and discomfort. This can be due to several factors:
1. Surgical Trauma: The surgical procedure itself can cause trauma to the surrounding tissues, including muscles, tendons, and nerves. Even if the incision site has healed, the deeper tissues may still be inflamed or irritated.

2. Nerve Irritation or Damage: Given that you mentioned experiencing a "pulling" sensation and numbness, it is possible that the surgery may have inadvertently affected nearby nerves. The thumb and wrist are innervated by the median and ulnar nerves, and any swelling or scar tissue formation can lead to nerve compression or irritation, resulting in symptoms like tingling, numbness, or pain.

3. Scar Tissue Formation: After any surgery, scar tissue can develop. This scar tissue can sometimes adhere to nerves or other structures, leading to discomfort and restricted movement. This could explain the difficulty you are having with fully flexing your thumb.

4. Inflammation: Post-operative inflammation can lead to increased sensitivity and pain in the area. This inflammation can be exacerbated by overuse or improper positioning of the hand during recovery.

5. Rehabilitation and Recovery: It is essential to follow a rehabilitation program after surgery to regain strength and mobility. If you have not started physical therapy, it may be beneficial to consult with a physical therapist who specializes in hand therapy. They can provide exercises to improve range of motion and strength while also addressing pain management techniques.

Recommendations:
1. Follow-Up with Your Surgeon: It is crucial to discuss your symptoms with the surgeon who performed the procedure. They can assess whether the pain is a normal part of the healing process or if there are underlying issues that need to be addressed.

2. Physical Therapy: Engaging in physical therapy can help improve your range of motion and decrease pain. A therapist can provide targeted exercises and modalities to help alleviate your symptoms.

3. Pain Management: If your pain is severe, your doctor may recommend medications such as NSAIDs (non-steroidal anti-inflammatory drugs) or other pain relief options. In some cases, nerve blocks or corticosteroid injections may be considered to reduce inflammation and pain.

4. Monitor Symptoms: Keep track of your symptoms, including when they occur and any activities that exacerbate the pain. This information can be helpful for your healthcare provider in determining the best course of action.

5. Avoid Strain: Be cautious with activities that require gripping or pinching, as these can exacerbate pain and discomfort in the early stages of recovery.

6. Consider Nerve Evaluation: If symptoms persist or worsen, a referral to a neurologist may be warranted to evaluate for any nerve damage or compression that may require further intervention.

In conclusion, while post-surgical pain and discomfort can be a normal part of the healing process, it is essential to communicate openly with your healthcare team about your symptoms. They can provide you with the best strategies for managing your pain and improving your recovery. Remember, healing takes time, and with the right support, you can work towards regaining full function of your thumb.

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