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Johns Hopkins Health - Do You Have a Bum Thumb?
Issue No. 25
Do You Have a Bum Thumb?
Date: July 8, 2014
Where the thumb joins the wrist—the thumb basal joint—is the hand’s most mobile joint. With that mobility, unfortunately, comes a susceptibility to osteoarthritis.
“There’s no particular cause, other than general wear and tear from using the hands, which we do every day,” says W. P. Andrew Lee, M.D., a hand surgeon and director of the Department of Plastic and Reconstructive Surgery at Johns Hopkins. Thumb arthritis is common in people in their 60s and beyond, and sometimes it develops even earlier.
Symptoms include discomfort progressing to pain, especially in manual activities such as opening a jar lid or turning a doorknob. Because of the pain, people tend to limit thumb mobility.
Lee begins treatment conservatively, with a thumb brace that supports the thumb and reduces pain, or a cortisone injection to decrease inflammation. The next step would be surgery to remove the degenerated bone where the joint is and reconstruct the joint with a wrist tendon. (“The procedure should be done by a hand surgery specialist,” Lee says.) Therapy follows this outpatient procedure, and significant, pain-free activity can resume in about three months.
Watch a Q&A on the diagnosis, management and treatment of thumb arthritis with W. P. Andrew Lee, M.D., a hand surgeon and director of the Department of Plastic and Reconstructive Surgery at Johns Hopkins. Visit bit.ly/thumbarthritis.