Hello,

I am a 28 year old male who was recently diagnosed with arthritis in my left thumb. A little history on the problem. I woke up sometime last May to a slight pain in my thumb. I played the whole "It will get better" game until sometime in September where I visited my general practitioner. He diagnosed tendonitis and sent me packing with some naproxen. Needless to say I got little to no relief, but continued fighting the pain until November. At this point I was having days where my thumb constantly ached and some days where it felt ok, but use had all but ceased. I visited my GP again and this time he sent me home with soem Relefan (sp?) and told me to splint my wrist. Again, little to no relief. I made an appointment 2 weeks ago with a hand specialist where he took xrays and diagnosed the arthritis. There was a decent bone spur on the xray as well. He gave me a corticosteriod shot into the joint, a better splint and said there was a 50-100% chance I would need surgery.


Here is where I stand now. The pain has been substantially reduced, but is definitely still present and the little movement the thumb does produces heavy grinding. I'm a land surveyor by trade and work has been really, really slow in our office and I am fearing layoff sometime this summer. To me, wearing a splint and having some relief from pain, yet zero functionality in my thumb still is not how I want to be. With the pontential layoff and subsequent loss of insurance I am debating on just doing the surgery now. A somewhat loss of motion coupled with the ability to actually use my left hand seems much more appealing than pain and a splint while not being able to use my hand.

I guess I am asking for thoughts and opinions as to wether you think the surgery would be the proper decision. Thanks!
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First Helper LMTATEB
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replied February 22nd, 2011
Hello and thank you for posting your medical question on E health Forum.

Based on the history and diagnosis of presence of a spur in the thumb joint, surgery would be the best way ahead, as this will reduce all the symptoms as well as increase the functionality of your thumb.

Surgery in your case, will work better than conservative methods.

I hope this helps.



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replied January 20th, 2012
surgery vs splint and injections
I have had the surgery on my left hand (Dec 2009) I am scheduled for the same surgery on my right hand next month.
That alone should answer your question and calm your fears.
I will admit that the recovery is long I was out of work for 3 months. However I have regained my left thumb and it is pain free. I am sure it is weaker than it was when it functioned 100% (before first symptom). However, it is much better than it ever was with the pain and weakness before surgery. I cannot think of anything that I cannot do now with the left hand. I can open jars and type....just about everything.
I do hope this helps you.
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replied March 8th, 2011
Basal Joint surgery recovery question
I had basal joint surgery with tendon replacement 5 weeks ago. Much of the thumb pain has eased though it's still stiff but getting better all the time.
My question has to do with a sore wrist and forearm pain.

Are these pains part of the healing process? My hand surgeon is great but getting answers out of him is sometimes challenging.

Steve
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replied March 9th, 2011
Especially eHealthy
stephano,
Sounds like you had an LRTI (ligament reconstruction with tendon interposition) arthroplasty. In this procedure the trapezium is removed, and the beak ligament is reconstructed with, either part or all of, the flexor carpi radialis (FCR) tendon. It is not uncommon to have both of your symptoms, as the wrist joint itself was violated when taking out the trapezium and the FCR tendon is removed from the forearm. It is a common post-op plan to have the thumb and wrist in a cast for six weeks (sometimes a pin is also placed to protect the reconstruction during the first 6 weeks). If a real good, solid reconstruction is obtained during surgery, sometimes a splint can be used instead. Once the reconstruction has healed (usually about 6 weeks), occupational therapy is started to regain ROM and strength. Most people get back to regular activities by 12 weeks, but in some cases it can take as long as 12 to 18 months before the final result is known.
At 5 weeks, you are still in the actively healing period. Sounds as though you are doing well, overall. Mother nature tends to work at her own rate, so a tincture of time may still be needed.
Good luck.
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replied March 9th, 2011
Many thanks for the reply - and yes that is the surgery I had - each day it seems a bit better - ironically, my hand surgeon who is 'board certified" and excellent had me out of the cast at 10 days and had me wearing a rigid splint for the next couple of weeks but said it is advisable to wiggle the fingers as much as I am able.

I did that as per his instructions Also, he said no OT is necessary which was fine with me. I spoke to him today telling him of my wrist ache. He said that's pretty much a separate issue as the thumb surgery didn't invade the wrist. He said give it more time which I am - I have taken only Tylenol since the third day of surgery so I guess I/m just anxious.

Thanks again for your reply.

Stephano
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