Certified Hand Therapist Michelle McMurray, MOT, OTR/L, CHT discusses thumb arthritis, also known as basal joint arthritis.
Basal joint arthritis, or thumb arthritis, is the most common site of arthritis in the hand. This may also be referred to as the CMC (carpometacarpal) joint. Pain typically occurs at the base of the thumb where the hand meets the wrist. People typically report pain and weakness with grasping or pinching activities. Most people do not realize how important this particular joint is to the function of the hand until it hurts. The amount of force transmitted through the CMC joint holding a 1-pound object at the tip is amplified to over 13 pounds at the CMC joint. Basic activities of daily living can require between 6 and 8 pounds of pinch at the tip of the thumb, which would be amplified more than 10 times that at the base of the thumb! Over time, this can cause break-down of the joint with loss of cartilage (the smooth part of the joint) and inflammation. This is sometimes a painful process.
When this occurs in the body, what options do we have to feel better? Most people do not choose surgery as their first option, and it is often not recommended as the first option. Initial options may include injections, splinting, medications and/or rest. Additionally, there are modifications that can be made to our daily activities which may also help to decrease the pain.
Here are a few examples of some easy and inexpensive ways to protect your hands to decrease the stress and inflammation at your thumb:
Courtesy of Michelle Fontaine, MD, Orange Regional Medical Center
MIDDLETOWN – Cold weather is behind us and our hands have emerged from their mittens into a world with hazards.
During the summer, the emergency room typically sees an increase in traumatic hand and finger injuries. And, it’s not surprising that the surge comes as yard work begins, since lawnmowers are a common cause of hand injuries.
To ensure you cut your lawn and nothing else, taking a few simple precautions can help. Always wear gloves as a first line of defense when operating a mower or other trimming tools. Keep your hands away from blades and the chute at all times. If your mower is clogged, use extreme caution when cleaning it out. Never touch mower blades with your hands, even if the engine is off. Once an obstruction is cleared, the blades may unexpectedly turn and cause serious bodily damage.
Grilling is another culprit. We see slicing injuries not just from basic food prep – which is a year-round issue – but from people using knives improperly. For example, we see people separate frozen burger patties or slice buns in their hands rather than on a table top.
Did you know that the American Society for Surgery of the Hand provides online information on 20 different hand and upper extremity conditions in Spanish? Here are some of our most popular conditions in Spanish:
- Artritis de la base del pulgar (thumb arthritis): La artritis en la base del pulgar es una predisposición genética: al igual que las canas y el afinamiento del pelo, aparece con la edad y surge más temprano en algunas familias. A diferencia del afinamiento del cabello, las mujeres tienden a padecer artritis del pulgar antes que los hombres.
- Dedo en gatillo (trigger finger): La tendosinovitis estenosante, comúnmente conocida como “dedo en gatillo” o “pulgar en gatillo”, afecta los tendones y poleas de la mano que flexionan los dedos.
- Quistes sinoviales (ganglion cysts): Los quistes sinoviales (o “gangliones”) son bultos muy comunes en la mano y la muñeca que aparecen junto a articulaciones o tendones. Los lugares más comunes son la parte de arriba de la muñeca, el lado de la palma de la muñeca, la base de los dedos del lado de la palma y la parte superior de la articulación que está más cerca de la punta de los dedos.
- Síndrome del túnel carpiano (carpal tunnel syndrome): El síndrome del túnel carpiano (STC) es una afección que surge debido al aumento de la presión sobre el nervio medo en la muñeca. En efecto, es un nervio pellizcado en la muñeca.
- Epicondilitis lateral (tennis elbow): La epicondilitis lateral, en general conocida como codo de tenista, es una afección dolorosa de los tendones que se unen al hueso en la parte externa (lateral) del codo.
For additional topics in Spanish, visit www.HandCare.org.
I have been told to see a hand therapist, but am unsure what that means. Who provides “hand therapy”?
A hand therapist is an occupational therapist (OT) or physical therapist (PT) who has specific training and expertise in treating hand and arm conditions. Typically, this person has spent many additional years gaining expertise with hand and arm injuries and treatment. When an OT or PT has reached this higher level of experience, they often become a Certified Hand Therapist (CHT).
So I can see anyone that is a PT, OT or CHT to take care of my problem?
You will want to ensure that the therapist you see, whether it is an OT or a PT, is qualified to treat your condition. If they are a CHT, it means they have had extra training and passed a rigorous exam to demonstrate their skill. If they are an OT or a PT, they may still treat hand and arm conditions, but you should ask questions to ensure they have spent extra time after their formal education learning about the hand and arm. To find a hand therapist near you, click here.
Baseball season is in full swing for the pros. Unfortunately, for many youth baseball players, summer leagues are just one of the year-round seasons they play. A Tommy John injury (injury of the ulnar collateral ligament at the elbow) was unheard of in youth leagues in the mid-90s. By 2010, the adolescent rate was nearly 40 percent. As a baseball enthusiast, I find this trend disturbing. I asked Dr. Bobby Chhabra, Chair of the Orthopedic Department at the University of Virginia, his perception of this epidemic.
“Every year I see more and more adolescent elbow injuries from pitching and throwing. These injuries vary across a spectrum from little leaguer’s elbow, to muscle strains, to UCL injuries (Tommy John), and cartilage injuries. I would agree that the adolescent rate is increasing and the trend shows that this group may soon reach half of all surgeries performed to repair a Tommy John injury.
The reasons for this are likely multi-factorial but include the increasing number of kids who play one sport and pitch year round from a young age, have poor mechanics, have fatigue leading to poor mechanics and injury, and have overuse with minimal rest.
A carpometacarpal boss, also known as a CMC boss or “bossing,” is a lump that appears on the back of the hand. It is typically in line with the pointer or middle finger. The exact cause of it is unknown, although sometimes they can arise from a traumatic injury or repetitive wrist motion that can happen during things like golf.
Here are some signs that you have a CMC boss:
- You notice a lump on the back of your hand
- It appeared between the ages of 20 and 40
- You feel pain when moving the wrist up or down
- You feel a snapping sensation when moving the wrist