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"My thumb hurts every day. What am I suppose to do?"

ZocdocAnswersMy thumb hurts every day. What am I suppose to do?


I went to a hand doctor, he took an x-ray of my left hand. At the base of the thumb he pointed out that I have a bone spur on the trapezium, plus I the thumb isn't sitting in the socket. He told me to go home and take Alive every day, than another visit, physical ther. for thumb exercise, another visit, cortisone shot, another visit, than after more visits, than he'll do surgery. I am pissed, my thumb hurts every day because of use. What am I suppose to do?


I am sorry about the pain and debilitation that your thumb is causing you. I recommend that you see your hand surgeon. Based on your description, it sounds like you may have carpometacarpal (CMC) arthritis, also known as basal joint arthritis. All that means is that you have arthritis at the base of your thumb where your thumb metacarpal bone articulates with the trapezium wrist bone. In fact, your arthritis sounds far along enough that the bone spurs have essentially caused your joint to be dislocated. The initial treatment is essentially what your hand surgeon has already been doing, which is to try to treat the symptoms, in hopes that this will put off any need for surgery for as long as possible. For some patients, anti-inflammatory medications (Aleve, ibuprofen, etc), therapy, bracing, and activity modifications are enough to alleviate their symptoms. For many others, however, their pain, like yours may best be addressed with surgical intervention. Since there is no cure for arthritis aside from surgically resurfacing the affected joint, surgery involves exactly that: removing the arthritis of that joint, and filling that previously-arthritic joint with something. These types of surgery include replacing that thumb joint with metal implants or plastic polymer joints. The time tested procedure is to remove the arthritis, and fill that space with a rolled up ball of one of your accessory wrist flexor tendons (called the palmaris longus). Again, the goal of these treatments is pain control, and to expect that your thumb would be as good and strong as before arthritis would be very unrealistic. In fact, you will almost certainly lose some of the normal grip strength that your thumb provides. If your pain is really as bad as you say, you should see your hand surgeon, and communicate this. You may be a very appropriate candidate for surgery at this point.

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