Why Does My Hand Hurt?

Have you ever felt pain when you performed everyday activities such as turning keys or opening car doors? Ever wonder why simple activities such as holding eating utensils or a glass of water too painful to perform? Or have you felt tenderness in the thumb muscle or over the joint and an aching feeling at the base of the thumb following heavy use or with weather changes? One common cause of such pains is osteoarthiritis (OA) of the base of the thumb. This is called the Carpometacarpal (CMC) joint, which is the joint between the base of the thumb and the wrist. OA destroys the cartilage surrounding the join, causing it to become inflamed, resulting in pain and restricting movement of the thumb. The actual degenerative process of CMC osteoarthritis is not completely understood. While is it primarily a “wear and tear” process, there are other factors that play a role in the degenerative arthritis. These include previous trauma or injury, repetitive stress over long periods of time or just the aging process. Muscle imbalance in the thumb may also be a contributing factor to CMC osteoarthritis. An imbalance can lead to poor control over the joint causing it to move at a slightly incorrect angle or rotation. If the joint is not stabilized properly it can rub or glide the wrong way causing the surround tissue to become inflamed which stimulates the degenerative process. An exercise program designed by a certified hand therapist may be helpful in restoring muscle balance of the CMC joint. An osteoarthritis progresses and more joint cartilage is lost, less stress of the thumb is necessary to produce pain. People will often avoid using the thumb for those activities that produce pain and over time this disuse can lead to weakness, muscle loss and tendency to drop things. The pain can be so unbearable that it interferes with one’s quality of life at times. Fortunately, therapy has been an effective treatment for the relief of symptoms of CMC joint pain. Therapy may include ultrasound to reduce inflammation and pain. Patient education about joint protection techniques helps one to resume favorite sports and hobbies. For the acute joint, splints in addition to anti-inflammatory medications may be helpful. Splinting the thumb in a comfortable position can be helpful to put it at rest and alleviate the pain associated with CMC osteoarthritis. Certified hand therapists are trained to assess your hand and determine the most appropriate splint for your particular problem. Although there are several style of commercial designed splints available, they often don’t fit “quite right” and the cost is not usually covered through Extended Health Care Benefits (EHC). A custom splint, fabricated by your certified hand therapist is designed to fit your particular hand, and is reimbursable through EHC. Any additional cost may also be used as an income tax deduction. When these conservative methods of treatment are not longer beneficial to the patient, surgery may be necessary. The most important goal of surgery is to eliminate the pain at the base of the joint of thumb. Surgery may be performed in several ways according to the personal preference of the surgeon. In some instances, surgery is necessary to improve the position of the thumb, range of motion and to improve strength for pinching and grasping. Following surgery, patients are often referred to hand therapy for rehabilitation. Exercises designed to stretch and strengthen structures stabilizing the thumb is considered to be the best approach to treating post surgical pain, swelling, and movement limitations. As these restrictions gradually resolve within three to six months most patients experience complete or near complete pain relief along with recover of range of motion. For more information about osteoarthritis, please contact our one of our clinics, you will find out locations at www.handtherapycentres.com. We will be happy to arrange a clinic tour or to provide you with more information about our services.