The thumb is involved in 25 percent of daily activities. However, if the thumb causes pain or if there is an actual loss of function, this can result in enormous suffering. Rhizarthrosis is usually responsible for thumb pain.
What is rhizarthrosis?
The thumb saddle joint connects the first metacarpal bone to the carpal bone so that it connects to the base of the thumb. If there is rhizarthrosis, arthrosis of the saddle joint of the thumb, pain occurs as a result, which – depending on the course of the disease – can become increasingly severe. For leber’s optic atrophy guide, please visit deluxesurveillance.com.
One reason why rhizarthrosis occurs can be the mechanical overload of the thumb. Sometimes ligament instability can also trigger rhizarthrosis. The pain is caused by worn joint cartilage. As a result, the thumb swells; there is inflammation in the tissue.
The typical bone changes (formation of edge jags) and a narrowing of the joint also follow. In the advanced stage of the disease, the cartilage covering is worn away in such a way that the bones rub against each other.
Symptoms, Ailments & Signs
Those affected initially complain of pain when gripping the tip between the index finger and thumb; sometimes there is also pressure pain on the extensor side. Even twisting movements can cause pain. Since the movements are part of everyday activities, those affected notice relatively quickly that the thumb is “offended”.
Screw caps can no longer be opened without pain; even carrying beverage bottles can sometimes cause pain. Those affected describe the feeling of an “unstable thumb”; the patients describe again and again that the thumb would feel “shaky”. At the beginning, the complaints only appear in the context of a direct activity; Subsequently, there is also pain at rest or at night.
Diagnosis & course of disease
The doctor makes the diagnosis based on clinical examinations and an x-ray of the thumb. From this, the doctor can recognize a malposition of the joint, whereby he can sometimes also identify the typical changes that are possible in the course of arthrosis. However, before diagnosing rhizarthrosis, he must be able to rule out other diseases – such as infections, gout or other rheumatic diseases.
Patients usually respond to conservative treatment. However, rhizarthrosis is a classic wear and tear disease, so that the symptoms can worsen over the years. In the final stage, the joint usually stiffens so that the thumb can hardly be moved.
If there is rhizarthrosis, this initially leads to increasing instability of the thumb joint, combined with pain and a loss of strength in the hand. This increases the risk of accidents and falls. In general, physical performance also decreases and those affected can no longer cope with tasks at work and in everyday life as before.
Occasionally, osteoarthritis leads to incorrect posture, which in the long run leads to joint wear and permanent malpositions. Rarely, after surgery for rhizarthrosis, there are serious movement disorders in the entire hand, often accompanied by swelling, pain and decalcification of the hand bones. In addition, bleeding, wound healing disorders and inflammation can occur in the area of the intervention.
Deep infections, while rare, may require reoperation and cause permanent dysfunction. If a larger skin nerve is injured, there is often a feeling of numbness that can last for months. In severe cases, there is a permanent loss of skin feel. Apart from these complications, the prescribed medication can also cause symptoms and long-term effects. Kidney and liver damage as well as chronic gastrointestinal diseases are possible.
When should you go to the doctor?
A loss of strength in the hand, increasing problems with turning movements and stabbing pain in the thumb joint are symptoms that can indicate rhizarthrosis. Medical advice is needed if the symptoms gradually get worse and cannot be alleviated by rest and cooling. At the latest when palpable osteophytes are noticed in the thumb or instability of the thumb joint occurs, this must be clarified by a doctor. Patients who already suffer from osteoarthritis should inform the responsible doctor. Risk groups also include people who subject their hands to excessive loads, such as climbers and bodybuilders.
Rhizarthrosis is treated by a specialist in arthritic diseases. Other points of contact are the orthopedist or the general practitioner. The treatment is carried out by various specialists and physiotherapists. If the pain persists, an alternative medicine practitioner can prescribe an appropriate natural remedy. If the symptoms persist despite all measures, the doctor must be informed. Further treatment in a specialist clinic may be necessary in order to at least cure the symptoms of the condition.
Treatment & Therapy
At the beginning, the physicians opt for conservative treatment. This means that the patient should avoid overloading; that means he has to rest his thumb. A thumb bandage is then applied. Conservative basic therapy also includes ice applications and the intake of various anti-inflammatory drugs (diclofenac or ibuprofen).
Sometimes electrotherapy can also lead to an improvement in the symptoms. If there are no improvements, further therapies – such as intra-articular injections with hyaluronic acid, acupuncture or mixed corticoid injections – can alleviate the symptoms. However, if conservative treatments fail, any medical professional will recommend surgery.
Before the doctor decides on the operation, he must discuss several options with the patient. On the one hand there is the stiffening operation (arthrodesis). The advantage of the operation is that the joint can be subjected to greater stress, but the disadvantage must not be ignored – the thumb can only be moved to a limited extent after the operation.
Furthermore, there must be no signs of wear on the adjacent joints, as these can be aggravated by the operation. For this reason, arthrodesis is only recommended for young patients. Another possibility is the endoprosthesis made of silicone, plastic or metal.
These are models that are also used for knee or hip operations. However, due to the lack of positive long-term results, the surgical method has not yet been 100 percent accepted. The standard, however, is resection arthroplasty. The doctor makes an approximately four-centimetre-long incision so that he can remove the carpal bones that have changed due to the disease.
As a result, he ensures that space is gained so that the bone can no longer rub against the bone. A tendon plasty is performed to improve stability. This is a kind of “bioprosthesis” which has so far provided excellent results. However, patients need to be aware that they will have reduced thumb strength – post-procedure – which – in many cases – is not a real problem.
Resection arthroplasty is usually performed on an outpatient basis. After the operation, a plaster splint is put on (for about two weeks); after that, the patient must wear a thumb bandage (for four weeks). However, the remaining fingers can be moved without any problems, even after the procedure.
Rhizarthrosis can only be prevented to a limited extent. Researchers have come to the conclusion that acidic and sugary foods, nicotine, alcohol, meat, white flour and table salt can promote rhizarthrosis. For this reason, it is advisable when people who consume too many acidic or sugary foods make a change in diet. If the doctor has already diagnosed rhizarthrosis, the right diet can alleviate the symptoms; Furthermore, the course of the disease is favored positively.
Follow-up care is necessary if rhizarthrosis is treated surgically. In most cases, the patient wears a thumb splint for a period of about six weeks. If, on the other hand, a prosthesis is used, the splint is worn for around three to four weeks.
If the surgical wound heals well, the skin sutures on the thumb saddle joint can be removed again after 10 to 14 days. There is no need to worry about major pain. In most cases, the patient only feels the thread being pulled when it is lifted with the tweezers.
As an alternative to a thumb splint, a plaster cast can also be applied. Although this is not a must, it has a positive effect on the healing of the wound. The pain is also limited by the immobilization of the thumb. The dressing is usually changed two to three times in the week after the operation. If the wound heals optimally, one or two dressing changes are sufficient.
If swelling and pain occur after the surgical procedure, painkillers can also be used. After the operation, some patients suffer from sensory disturbances on the extensor side of the thumb, such as tingling or numbness. Once the scar has matured, however, these reduced feelings will disappear on their own after a few weeks or months.
You can do that yourself
Patients who have rhizarthrosis can prevent the disease from progressing by consistently wearing splints and regularly cooling the affected body region. Large loads on the hand should be avoided. After extreme exertion, hand gymnastics and targeted warming of the wrist help.
At the same time, the diet should be changed. In order to avoid hyperacidity, appropriate foods, such as coffee, alcohol, table salt and spicy foods should be avoided. Sufficient fluid intake is also important. Dietary supplements with collagen hydrosylate, omega-3 fatty acids and glucosamine support cartilage tissue and synovial fluid.
Rhizarthrosis should be examined by a doctor, as there may be a serious underlying cause. In severe cases, an operation is necessary, after which the patient has to rest. Persistent symptoms indicate a serious underlying condition, which must first be diagnosed and treated.
Rhizarthrosis can also be treated preventively by specifically avoiding strain on the hand and especially on the wrist. This can be achieved, for example, with a medical pad or with regular massages. If a pronounced arthrosis has already developed as a result of the rhizarthrosis, a specialist must be consulted.