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Internist
Internist, Doctor
Category: Medical
Satisfied Customers: 790
Experience:  MD,MBBS, ECFMG Certified, 06 years experience in medicine & surgery
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The distal joint of my left thumb is painful and locks up.

Resolved Question:

The distal joint of my left thumb is painful and locks up. When I snap it back into place (yes, it snaps back into place!), it really hurts! I've been taping the joint to stablize it and reduce the pain. I am left handed and I have osteoarthritis in both hands, but this joint is different. I can't take NSAIDs because of a recent G.I. bleed and a long history of G.I. problems.
Submitted: 4 years ago.
Category: Medical
Expert:  Internist replied 4 years ago.

Welcome to Just Answer

I am sorry to hear about your problem.

 

1-Since when you have got this problem?

2-The problem is only in thumb?

3-Is there some stiffness as well?

 

Thanks

Customer: replied 4 years ago.
This problem has been going on for several months. It is getting progressively worse. If I use my left hand alot, such as writing, it is very painful for hours later. I can move my thumb while I'm sleeping and the pain awakens me. The osteoarthritis affects my index fingers and my middle fingers on both hands, but the left hand is worse. I also have pain at the base of my thumbs at times. My grips and manual dexterity are affected.
Expert:  Internist replied 4 years ago.

Thanks for the detailed info

Some of the possibilities are discussed below.

 

1-The exact cause of thumb arthritis, as with osteoarthritis in general is not known,most of the time this is due to aging,overweight patients,muscle weakness can cause these symptoms.

Treatment is focused on two things

a-Splints which decrease pain, encourage proper positioning and give your joint some much-needed rest. Depending on your needs, you may wear a splint overnight or throughout the day.

b-Medications like NSAIDs for the pain(In case there would have been no contraindication as in your case)

 

2-The other possibility which comes to my mind is De Quervain's tenosynovitis,in which the sheath of the tendons on the thumb side of your wrist becomes inflamed or swollen, restricting the tendons' movement.

Treatment if started early should result in improvement in 4-6 weeks and includes as follows.

Immobilization same as splint method i described above.

Minimize repeated thumb movements whenever possible,

Heat or ice therapy is better AVOIDED.

 

Now in your cases like yours there is likelihood that you will get benefit from local corticosteroid injection,it will subside the tendinitis and bursitis around the involved joint and will help you alot.

 

 

I hope the info helps.

Customer: replied 4 years ago.
As I mentioned earlier, I had a gastric bleed due to erosion at the gastric cardia last month. NSAIDs are out of the question and Tylenol offers minimal relief. The taping of the joint seems to help the most, but the thought of having to tape that joint forever is agravating. I've looked at splints on the inernet, but they are more for stablizing at the base of the thumb, not the distal joint. I am considering going to an orthopedist that specializes in hands soon.
Expert:  Internist replied 4 years ago.

Thanks for the input.

 

Yes that is in fact what i mentioned,as you are running out of the basic conservative measures like NSAIDs and Splints,what next in the management comes is the use of local Corticosteroid injections and you need to get consultation with your rheumatologist for considering this option as the next plan.

 

I hope that helps.

If you have any questions feel free to ask

If the info helps,Kindly click ACCEPT,Thanks.

Internist, Doctor
Category: Medical
Satisfied Customers: 790
Experience: MD,MBBS, ECFMG Certified, 06 years experience in medicine & surgery
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