Effective Treatments for Thumb and Wrist Pain in Seniors

Hand pain

Hello, Dr.
Hsieh.
I would like to ask about my grandmother, who is 72 years old.
She experiences pain and weakness in her left thumb and wrist, particularly in the web space, during movement, making it difficult for her to hold a bowl.
She had an injury in her youth and has a history of severe gastric ulcers, for which she takes medication that causes stomach pain, so she is hesitant to take painkillers.
She has undergone treatment in the rehabilitation department, including ultrasound and electrical stimulation, which have provided some improvement, but her symptoms frequently recur.
Are there any other methods that could help her recover more quickly? How long might it take?

kevin, 30~39 year old female. Ask Date: 2001/07/06

Dr. Xie Tianjie reply Orthopedics

Lesions caused by old injuries to the hand and wrist joints may include disorders of the joints and ligaments.
A detailed X-ray examination at an orthopedic outpatient clinic is necessary.
For patients who are not suitable for analgesics, the use of splints and rehabilitation therapy can help alleviate pain.

Reply Date: 2001/07/06

More Info

When it comes to treating thumb and wrist pain in seniors, particularly for someone like your grandmother who is 72 years old and has a history of injuries and gastrointestinal issues, a multifaceted approach is often the most effective. Given her symptoms of pain and weakness in the thumb and wrist, as well as her past injury, it is essential to consider both conservative and possibly interventional treatments while being mindful of her overall health, especially her history of severe gastric ulcers.

Understanding the Condition
The pain and weakness in your grandmother's thumb and wrist could be due to several factors, including osteoarthritis, tendonitis, or even carpal tunnel syndrome, especially if she has a history of repetitive strain or injury. The fact that she has previously experienced a significant injury could also contribute to chronic pain or weakness in the area.

Initial Conservative Treatments
1. Physical Therapy: Since she has already undergone some rehabilitation, continuing with physical therapy can be beneficial. A physical therapist can provide tailored exercises to strengthen the muscles around the wrist and thumb, improve flexibility, and reduce pain. Modalities such as ultrasound therapy and electrical stimulation can also help alleviate pain and promote healing.

2. Activity Modification: It’s crucial to modify activities that exacerbate her symptoms. For instance, using adaptive devices or tools that require less grip strength can help her manage daily tasks without pain.

3. Heat and Cold Therapy: Applying heat can help relax and loosen tissues and stimulate blood flow to the area, while cold therapy can reduce inflammation and numb sharp pain. Alternating between the two can provide relief.

4. Splinting: A wrist or thumb splint can immobilize the area, providing support and reducing strain during activities. This can be particularly helpful during flare-ups of pain.

Pharmacological Options
Given her history of gastric ulcers, it is essential to be cautious with medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be harsh on the stomach lining. Instead, consider discussing the following options with her healthcare provider:
1. Acetaminophen: This can be a safer alternative for pain relief, as it is less likely to irritate the stomach compared to NSAIDs.

2. Topical Analgesics: Creams or patches containing capsaicin or lidocaine can provide localized pain relief without systemic effects on the stomach.

3. Corticosteroid Injections: If her pain is severe and persistent, a corticosteroid injection into the affected area may provide significant relief. This should be discussed with her doctor, considering her overall health.

Alternative Therapies
1. Acupuncture: Some studies suggest that acupuncture can help alleviate chronic pain and may be worth exploring as a complementary treatment.

2. Massage Therapy: Gentle massage around the wrist and thumb can help reduce tension and improve circulation, potentially alleviating pain.

3. Dietary Changes: Incorporating anti-inflammatory foods into her diet, such as omega-3 fatty acids (found in fish), fruits, vegetables, and whole grains, may help reduce overall inflammation in the body.

Duration and Expectations
The duration of treatment and recovery can vary significantly based on the underlying cause of her pain, her overall health, and her adherence to the treatment plan. Generally, with consistent therapy and lifestyle modifications, many patients experience improvement within a few weeks to months. However, chronic conditions may require ongoing management.

Conclusion
In summary, treating thumb and wrist pain in seniors, especially in someone with your grandmother's medical history, requires a careful and comprehensive approach. It’s essential to work closely with her healthcare providers to tailor a treatment plan that considers her unique needs and limitations. Regular follow-ups can help adjust the treatment plan as needed to ensure the best possible outcomes.

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