Rhizarthrosis: arthrosis of the thumb and its treatment

Pain that occurs at the base of the thumb may indicate the development of rhizatrosis. Most often, this pathology occurs in the metacarpal joint, where mobility may be limited and swelling of the external tissues may occur. Arthrosis of the thumb is not a common disease and is often hidden behind various neurogenic pathologies. Primary diagnosis is difficult and the diagnosis may be made too late. Therefore, if pain periodically occurs at the base of the thumb, you should urgently consult a doctor and ask for an x-ray of the supposedly diseased joint. Remember that early diagnosis gives a high chance of successful recovery and maintaining working capacity into old age.

How to understand that you have arthrosis of the thumb

In terms of symptoms, this type of arthrosis also resembles arthrosis of the shoulder or ankle. But it covers small joints in the area of ​​the big toe.

• The person experiences pain and discomfort.
• The amplitude of finger movement is reduced.
• The joint crackles more often.
• Its deformation is visually visible (in later stages).

The problem is that at an early stage, a person often does not pay attention to the symptoms and writes off the pain as fatigue. Sometimes the pain really goes away, but sometimes the stiffness remains, and the discomfort becomes more and more common. Most patients seek help when the pain has become unbearable and the simplest household tasks require Herculean efforts.

The earlier rhizarthrosis is detected, the higher the chances of maintaining full functionality of the hand.

rhizarthrosis

Home > For patients > Rhysarthrosis Rhizarthrosis (Ρίζα – rhiza – root) is arthrosis of the first carpometacarpal (trapezio-metacarpal) joint. Thanks to its saddle shape, it has a high degree of mobility, which is important for normal hand function. This is also a factor contributing to the development of arthrosis. In addition, long-term monotonous work (typists, spinners), excess weight, hormonal changes, consequences of injuries, gout and other conditions can lead first to instability, subluxation of the first metacarpal bone, and then to deforming arthrosis of the carpometacarpal joint. In this case, abduction and extension of the first ray are impaired, pain at rest and during exercise: turning the key in the lock, lifting a filled water bottle, using scissors, a knife, etc.). Women suffer from this disease more often than men (2:1).

Depending on the stage of arthrosis (from 1 to 4), conservative or surgical treatment may be chosen. With the initial manifestations of rhizarthrosis, taking NSAIDs, corticosteroid injections, injections of hyaluronic acid, physical therapy, splinting, and training in new dynamic stereotypes (JPP) can reduce pain and improve the quality of life (in the absence of contraindications).

For severe arthrosis (stages 3-4), surgical treatment is usually used. The most common treatment method aimed at eliminating pain is removal of the trapezius bone (trapezectomy) or a combination of this operation with various types of tendon support autoplasty. One of the alternative minimally invasive treatment methods is trapeziectomy with the installation of a mini TightRope , which ensures stability and at the same time mobility of the first ray.

In general, arthrosis of the first carpometacarpal joint (rhizarthrosis) is a long-term chronic disease that requires a comprehensive and individual approach. Early diagnosis and timely treatment make it possible to prolong the “service” of the joint.

Clinical example. Before surgery. Arthrosis I PVD on the left, stage III. Complaints of pain at rest and with light exertion, a decrease in hand strength by 50%, deformation of the first finger and limited mobility, severe dysfunction of the hand. X-ray 2.5 months after surgery: removal of the deformed trapezium bone. Functional result: no pain at rest, minor pain during exercise, increased range of motion of the first ray and strength of the hand.

14 months after surgery: no complaints, minor pain only after exercise, strength 100%, range of motion 90% compared to a healthy hand. The structure is stable.

How is rhizarthrosis treated?

As with other joints, treatment for osteoarthritis of the thumb depends on the stage at which the disease is detected. It is very important to make a correct diagnosis, because similar symptoms occur with gout, arthritis and other pathologies.

At an early stage, it is enough to take medications to improve metabolism and strengthen cartilage. Physiotherapy also helps well, especially if you go to a sanatorium-resort treatment for general health improvement.

If the symptoms intensify, a comprehensive regimen is prescribed:

• painkillers;
• short-course non-steroidal anti-inflammatory drugs;
• chondroprotectors – to activate the production of new cartilage cells;
• manual therapy sessions (proper adjustment of a deformed joint reduces pain);
• massage to increase the tone of cartilage tissue and improve joint mobility.

Manual therapy and massage are good in the initial stages of rhizarthrosis

To keep your hands healthy, perform simple gymnastics, for example, from the following exercises:

Symptoms of arthrosis of the fingers and hands

The clinical picture is local in nature. Three stages of the disease can be distinguished:

1.
Initial
. Joint stiffness occurs. Physical activity causes muscle fatigue and numbness of the phalanges. When the weather changes, a nagging pain is felt. Treatment for arthrosis of the fingers should begin when these initial symptoms appear.

2. Average

. The mobility of the fingers is impaired, the pain becomes longer lasting and occurs not only during the day, but also at night. A characteristic crunch, swelling, redness of the skin appears in the joint area, and a local increase in temperature is noted due to the development of an acute inflammatory process. In addition, the first signs of deformation of the joints of the fingers are observed, which begins to change the shape of the hand.

3. Heavy

. The pain is felt even at rest, and can be either acute or constant, debilitating. There is a visible significant deformation of the phalanges of the fingers, as well as a shift in the axis of orientation of the joints: arthrosis of the thumb “bends” it to the side. Rheumatoid nodules form under the skin. All these pathological changes critically impair the motor functions of the joints, lead to complete deformation of the hands and fingers, manifesting as external deformity, and significantly worsen the patient’s quality of life.

The pain syndrome will depend not only on the degree of development of the disease, but also on the motor load on the shoulder joint. If in the initial stages unpleasant sensations may bother you for a short time, then as the disease progresses, the pain will appear more often and persist for a long period of time, regardless of the time of day.

Diagnosis of rhizarthrosis

Rhizarthrosis of the hand is a rare disease, so many people do not even know about the existence of arthrosis of the thumb. In this connection, they often ignore the symptoms of rhizarthrosis of the joints of the fingers and do not undergo a medical examination. However, if you notice the symptoms described above, you must immediately contact a doctor who will diagnose and prescribe treatment.

The doctor makes a diagnosis only after interviewing the patient, examining the hands and conducting an instrumental examination.

X-rays and CT help:

1. Record the size of the interarticular space.
2. Determine the size of cartilage, bone and muscle damage.
3. Presence of osteophytes and synovitis.

Based on the medical examination data obtained, the doctor determines the stage of inflammation, and sometimes it is also possible to determine the cause of the disease.
Taking into account the condition of the joints of the thumb and the individual characteristics of the human body, the doctor prescribes a comprehensive treatment. This treatment will stop the destruction and relieve the symptoms of finger joint disease, but this disease cannot be completely cured. Since it is impossible to restore damaged tissue.

Diagnostics

The diagnosis is made based on patient complaints, external examination, and medical history. Among instrumental studies, radiography is the most informative. The resulting images visualize the main signs of arthritis:

• narrowing of the joint space;
• formed bone growths - osteophytes;
• discharge of bone structures;
• thinning of cartilage;
• the presence of areas with calcifications.

A biochemical blood test is performed to detect systemic pathologies. The levels of urea, fibrinogen, proteins, and erythrocyte sedimentation rate (ESR) are measured. If necessary, computed tomography or magnetic resonance imaging is performed.

Basic therapy methods

Treatment of arthrosis of the thumb joint is aimed at eliminating pain, swelling, stiffness of movement, and preventing the progression of the pathology. An integrated approach is practiced, consisting of a course of systemic medications, the use of ointments and balms, and physiotherapy.

The factor that caused arthrosis or its progression is excluded from the patient’s usual lifestyle. The patient is advised to balance the diet, avoid hypothermia, and promptly treat any acute or chronic pathologies.

Throughout the therapy, the patient is advised to wear orthopedic devices. For arthrosis of the thumb, a rigid orthosis for the wrist joint is recommended. As you feel better, the degree of fixation decreases by loosening the tension of the straps or Velcro fasteners. Subsequently, the patient is recommended to wear prophylactic soft bandages to fix the wrist.

Pharmacological drugs

Although the destruction of hyaline cartilage is not accompanied by an inflammatory process, nonsteroidal anti-inflammatory drugs (NSAIDs) are used in the treatment of arthrosis of the thumb. To relieve swelling and reduce the intensity of pain, tablets, capsules, dragees are prescribed: Diclofenac, Nimesulide, Meloxicam, Ibuprofen, Ketoprofen. Ointments and gels from this pharmacological group enhance and prolong the effect of systemic NSAIDs: Artrosilene, Nise, Ketorol, Dolgit, Dolobene, Fastum, Finalgel, Voltaren. Other medications are also used in the treatment of arthritis:

• glucocorticosteroids. Prescribed when NSAIDs are ineffective. In rheumatology, intra-articular administration of Triamcinolone, Hydrocortisone, Prednisolone, Dexamethasone is practiced;
• analgesics and antispasmodics. They are used to eliminate mild pain when you can do without NSAIDs, which have significant side effects. Bral, Spazgan, Trigan are most often used in the treatment of arthritis;
• muscle relaxants. Included in therapeutic regimens to relax muscle muscles and relieve painful spasms. Mydocalm, Sirdalud, Baklosan have proven themselves well in the treatment of arthritis.

As treatment aids, patients are prescribed ointments with a warming effect. They are used to improve blood circulation, reduce pain intensity, and relieve swelling. A powerful warming and local anesthetic effect is characteristic of Capsicam, Finalgon, Nayatoks, Viprosal, Apizartron.

For the treatment of arthrosis of the thumb of any degree, chondroprotectors are used - Teraflex, Chondroitin-Akos, Glucosamine Maximum, Structum, Dona. Their use helps prevent the spread of pathology to healthy joints, ligaments and tendons. Chondroprotectors are long-term medications. Depending on the severity of the disease, treatment takes from 3 months to 2 years.

Non-drug treatment

Treatment of arthrosis of the base of the thumb of the 1st degree can be carried out without the use of pharmacological drugs. Physiotherapeutic procedures—UHF therapy, electrophoresis, magnetic therapy, laser therapy, phonophoresis—help to reduce the severity of pain and swelling and eliminate stiffness of movement. To strengthen the muscle corset of the wrist joint and increase the range of motion, the patient is recommended to engage in physical therapy exercises. What exercises are most effective:

• strong squeezing and subsequent unclenching with a wide spread of fingers;
• flexion and extension of the palms, their rotation at the wrists;
• holding your palms in a bent position for a minute.

If you experience pain while doing exercises, you should rest and resume training after a while.

Kneading the thumb and rubbing peach, almond, wheat germ, and grape seed oils into the skin helps improve blood circulation and restore range of motion.

Arthrosis of the thumb responds well to treatment at the initial stage of development of the pathology. If you experience even mild and short-term pain in the morning, you should make an appointment with a rheumatologist. This will help avoid the progression of arthrosis and the occurrence of severe complications.

Treatment of arthrosis of the thumb

Correctly prescribed treatment for arthrosis of the thumb in most cases guarantees a complete recovery. For this purpose, various manual therapy techniques can be used. First, it is necessary to establish the cause of the pathology and, if possible, completely eliminate it. Physical unloading of the damaged joint is also necessary for the entire period of treatment. This means that when making small movements with the brush, you should try not to use your thumb. For this purpose, various fixing splints can be used. In case of severe pain, short-term use of non-steroidal anti-inflammatory drugs to relieve pain and inflammation is possible. However, it is not recommended to take these drugs systematically, since according to some data they can destroy cartilage tissue to an even greater extent.

Official medicine mainly offers only radical methods of recovery - endoprosthetics of the thumb joint. But there is an excellent alternative - manual therapy. Various techniques in combination with physical therapy and massage make it possible to launch the mechanism of natural regeneration of cartilage tissue. This happens due to the activation of the body’s internal reserves, improving the blood supply to damaged tissues and improving the disposition of the heads of the bones entering the joint cavity.

The only method of preventing the disease is an active lifestyle, proper nutrition and courses of special gymnastics, which improves blood circulation and prevents the development of destruction of cartilage tissue. If you have symptoms of arthrosis of the thumb, you can contact our manual therapy clinic and receive a free consultation with a specialist. If necessary, you will be prescribed individual treatment.

Degrees and signs of rhizarthrosis

In total, this disease has 3 degrees:

1. First degree. At this degree, no special changes occur in the bone articulation of the hand, only the consistency of the interarticular fluid changes. Therefore, signs of this degree are extremely rare. Sometimes a person may feel slight pain during physical activity or movement. Also, when you move your thumb, you will hear a crunching sound. Since signs of the disease practically do not appear, treatment usually does not begin on time. And because of this, the disease continues to develop.
2. Second degree. At stage 2, arthrosis of the thumb begins to show symptoms, and treatment therefore usually begins at stage 2 of rhizarthrosis. At stage 2, hand disease leads to large-scale damage to cartilage tissue. Because of this, a person often begins to feel aching and nagging pain when moving and sometimes even at rest, the finger begins to swell and become inflamed (usually in the morning), and the mobility of the thumb is limited. Due to the fact that the symptoms of the disease become obvious, most people go to medical institutions, but many continue to ignore these signs or self-medicate, which leads to arthrosis of the thumb developing to degree 3.
3. Third degree. At this stage, the disease leads to significant damage and deformation of bone tissue. Due to the fact that the cartilage is practically worn away, friction occurs, which leads to the appearance of osteophytes. And these processes cause constant pain in the thumb joint, swelling, swelling, deformation and the formation of growths. Any movement can lead to acute pain; in the absence of movement, the pain will be aching. Due to the appearance of osteophytes, it is almost impossible to achieve remission. Therefore, at stage 3, in most cases, surgical intervention is required.

Determining the stage of joint disease is important. Because, based on the medical examination data obtained, the doctor will prescribe specific types of medications that will help cure the disease.

Causes and symptoms of arthrosis of the thumb

The main cause of rhizarthrosis is hidden in regular microscopic injuries in the area of ​​the ligamentous apparatus and articular capsule in the area of ​​the metacarpal joint. This is often associated with the pathological habit of “crackling fingers.” However, it is not uncommon for arthrosis of the thumb to occur as an occupational pathology in people who, as part of their profession, are forced to make many small movements with the hand. Painters, repairmen, hairdressers, and office workers may suffer. In approximately half of the cases, arthrosis of the thumb develops against the background of household and sports injuries. There are situations when the disease occurs suddenly, years after the fracture of the ray in a typical place. In this situation, the injury occurs at the moment when there was a fall with a sharp support on the inner surface of the base of the palm. As a matter of fact, it is precisely this kind of support on the hand during a fall that causes a fracture of the radius. After the bone callus has formed, the person begins to work with his hand in the usual way, meanwhile, the joint may not fully recover by this time. Calcification begins at the site of small tears. This aggravates the disruption of the blood supply to the cartilage tissue and the process of destruction of the joint begins.

Other causes of arthrosis of the thumb include the following pathogenic factors:

• hormonal pathologies and disorders of salt and protein metabolism;
• dysplasia of cartilage tissue under the influence of certain groups of pharmacological drugs;
• imbalance in the diet between fats, proteins and carbohydrates;
• systemic diseases of the endocrine system and connective tissue.

At the initial stage, the main symptom of rhizarthrosis lies behind periodically occurring pain. They may be associated with physical activity, exposure to cold or hot water, and weather changes. In the future, deformation and crunching when moving may appear. During an exacerbation, signs of inflammation occur: redness of the skin and swelling of soft tissues, pain on palpation, immobility.

Arthrosis of the fingers, causes of the disease

Arthrosis is a polyetiological disease. The reasons for its occurrence may be:

• injuries;
• joint dysplasia;
• autoimmune diseases;
• congenital connective tissue deficiency;
• inflammatory processes;
• endocrine and metabolic disruptions;
• hemophilia.

There are a number of factors that increase the risk of developing the disease. These include:

• postmenopausal women;
• elderly age;
• increased load on the hands;
• highly traumatic surgical interventions in the problem area;
• hypothermia.

Hereditary predisposition plays an important role in the occurrence of the disease.

Symptoms of the disease

How do you understand that treatment for arthrosis of the fingers is required? The main symptom is pain, which intensifies with the first movements after prolonged immobility, physical exertion, hypothermia, increased atmospheric pressure and humidity levels, as well as at night. In addition, signs of the disease are:

• crunching in fingers;
• limitation of joint mobility;
• muscle cramps.

In the initial stages of the disease, the appearance of the joints does not change. However, later thickenings form at the edges of the joint spaces, contributing to deformation of the bone joints. At the same time, the joint capsules thicken and become inflamed. Inflammatory exudate accumulates in their cavities, which stretches the capsular walls and articular ligaments. All this, together with joint deformation, leads to the formation of contractures and disability of the patient.