When I recently saw my doctor, she told me that the thumb pain I’ve been experiencing is probably due to arthritis, but she didn’t give me any advice. At work, I use a computer with a mouse all day. Is there anything I can do to prevent the arthritis from getting worse?A
Yes, there are some steps you can take, but let’s start with what your doctor told you. As you probably know, there are different types of arthritis. Your doctor most likely thinks that the pain you’re having is due to osteoarthritis. It is extremely common for this condition to develop at the base of the thumb—where the thumb and wrist join together.
Osteoarthritis develops when there’s a wearing away of the cartilage that buffers and protects the area where two bones come together. It is similar to wearing the rubber off a tire after many miles of use. This “wear and tear” arthritis can result from the aging process, overuse or injury. Currently, there is no way to prevent cartilage damage from worsening, other than to not use the joint that’s involved. Obviously, not using your hand is certainly an impractical—if not impossible—task.
There are, however, some simple ways to relieve your thumb arthritis pain. Using a splint to rest the thumb for a few hours a day can be very helpful. It is usually possible to use a mouse and keyboard even when wearing such a splint. To ensure that you get a splint that is customized for the shape of your hand, it’s smart to see a certified hand therapist, an occupational therapist or physical therapist who specializes in treating the hand and upper extremity. Insurance often pays at least part of the cost of splint fabrication. To find a hand therapist in your area, check the online directory found on the website for the American Society of Hand Therapists.
Sometimes heat or cold (like an ice pack) can help ease the pain. Hand exercises can also help relieve any pain and stiffness in your thumb. However, they should be pursued carefully, because too much exercise can worsen the pain from arthritis.
Anti-inflammatory medication, such ibuprofen (Motrin), can significantly help ease arthritis pain. If the pain persists, a steroid injection into the thumb joint space may be even more effective. An injection can often give relief for six to 12 months, and as long as it is not administered too frequently (more than twice per year), is a very safe treatment. Topical medications are also available, such as anti-inflammatory creams, but they typically are less effective than oral medications or injections.
Although there are different devices that can be used in place of a computer mouse (like a trackball) or instead of the keyboard (like voice-recognition software), computer use itself is actually not the main cause of arthritis symptoms. People use their hands constantly for activities of daily living outside of the workplace, so computer use is neither a particularly bad activity for your hands nor is it done for a long enough duration to be a major cause or aggravation of arthritis pain.
If none of the above treatments are effective or last long enough, joint replacement is an option. Surgery for the most common type of thumb arthritis has been around for decades. It is performed in an outpatient setting, usually under twilight-type anesthesia, and allows most patients to resume normal use of their hand without pain. Post-operative immobilization in a splint or brace is often required for about four weeks, after which time many patients can use their affected hand with minimal limitations.