Living with thumb arthritis means more than just dealing with pain. You have to adapt to a new way of life where your hands – the main tools you use to interact with everything – simply don’t work like they used to.
While there are many ways to manage the condition, sometimes surgery for arthritis in fingers becomes necessary. If you’re thinking about this option, The Nerve Surgery Centre offers high-quality surgical treatments for arthritis in the thumb and other fingers, and their specialist can guide you through this tough journey.
Now, how do you know it’s time to think about surgery? What signs show that non-surgical treatments aren’t working well enough anymore? And what can you expect if you choose to have surgery? Read on to get detailed answers to these questions and more, equipping yourself with the information you need to make a good decision about your health.
When Is Surgery Needed for Thumb Arthritis?
Surgery for thumb arthritis isn’t usually the first choice. Doctors typically suggest it when other, less invasive treatments haven’t helped enough. This might be when pain is severe and doesn’t go away, significantly affecting daily activities and quality of life.
The choice to have surgery depends on each person’s situation. Factors like how bad the symptoms are, how well other treatments have worked, your overall health, and what you prefer all play a role. Your doctor will help you weigh these factors to decide if surgery is right for you.
Non-surgical Treatment Options for Thumb Arthritis
Before we talk about surgery, let’s look at the other options available. There are many non-surgical treatments that can help manage thumb arthritis. These methods aim to reduce pain, improve how your thumb works, and slow down the condition’s progress.
Medications
Pain relief is often the first step in dealing with thumb arthritis. Over-the-counter pain relievers like ibuprofen or naproxen can help reduce both pain and swelling. These are called nonsteroidal anti-inflammatory drugs (NSAIDs).
For some people, these might not be enough. In that case, your doctor might prescribe stronger pain medications. But these can have risks and side effects, so they’re usually used for short periods or as a last option.
Splinting
Splints can really help people with thumb arthritis. They work by keeping the affected joint still, giving it time to rest and heal. You might wear a splint at night or during activities that usually make your symptoms worse.
There are different types of splints, from rigid ones that keep your thumb completely still to more flexible ones that allow some movement. Your doctor or a hand therapist can help you find the right type for you.
Physical Therapy
Don’t underestimate how much a good physical therapy program can help. A skilled therapist can teach you exercises to make the muscles around your thumb joint stronger, improving stability and function. They might also use techniques like massage or ultrasound to help manage pain and stiffness.
Physical therapy isn’t just about doing exercises, though. Your therapist can also teach you how to change your daily activities to put less stress on your thumb. This might involve learning new ways to grip objects or using tools that make tasks easier.
Lifestyle Changes
Sometimes, managing thumb arthritis involves changing how you do things. This might mean using tools with bigger, easier-to-grip handles, or learning to open jars with your palm instead of your fingers. It could also mean taking more breaks during activities that stress your thumb.
These changes might seem small, but they can add up to make a big difference in how comfortable you are and how well you can use your thumb. And the best part? They’re free and don’t have side effects.
Steroid Injections
For some people, steroid injections can provide significant relief from thumb arthritis symptoms. These injections put a powerful anti-inflammatory medication directly into the affected joint. The relief can last for several months, though the effects tend to wear off over time.
But steroid injections aren’t a long-term solution. They can have side effects if used too often, including weakening the tendons around the joint. That’s why doctors usually limit the number of injections you can have in a year.
Interesting Read: When Can I Go to Work after Carpal Tunnel Surgery?
How Effective Are Non-surgical Treatments
You might be wondering, “Do these non-surgical treatments actually work?” The truth is, that everyone’s experience with thumb arthritis is different, and what works well for one person might not help another much.
That said, many people find significant relief through non-surgical treatments. For some, a mix of splinting, physical therapy, and over-the-counter pain medications is enough to manage their symptoms and maintain a good quality of life. Others might need to add steroid injections or prescription pain medications to their treatment plan to get enough relief.
How well these treatments work often depends on how early they’re started. Catching thumb arthritis early and beginning treatment quickly can help slow its progress and reduce the chance of needing surgery later.
But it’s not just about timing. Your commitment to the treatment plan plays a big role too. Regularly wearing your splint, doing your physical therapy exercises, and making the recommended lifestyle changes can make a huge difference in how well these treatments work for you.
It’s also worth noting that the effectiveness of non-surgical treatments can change over time. What works well for you now might become less effective as your arthritis gets worse. That’s why it’s important to have regular check-ups with your doctor to see how well your current treatment plan is working and make changes as needed.
And let’s not forget about the mental aspect. Long-term pain can affect your mental health, and addressing this can improve how well you respond to treatment overall. Some people find that adding stress-reduction techniques like meditation or counseling to their treatment plan helps them cope better with their symptoms.
When effective, non-surgical treatments can provide significant relief and delay or even prevent the need for surgical intervention.
Signs That Surgery May Be Necessary for Thumb Arthritis
While non-surgical treatments work well for many people, there are times when surgery becomes necessary. But how do you know when you’ve reached that point? Here are some signs that might indicate it’s time to consider surgical options:
- Severe pain that doesn’t go away with non-surgical treatments
- Major loss of thumb function that affects your daily activities
- Trouble doing basic tasks like writing, buttoning clothes, or opening jars
- Visible change in the shape of the thumb joint
- Stiffness in the thumb that limits how much you can move it
- Pain that wakes you up at night or keeps you from sleeping
- X-rays showing severe joint damage or bone spurs
- Looseness in the thumb joint that makes it feel wobbly
- Can’t work or enjoy hobbies because of thumb pain and poor function
- Feeling very upset or depressed because of long-term thumb pain and loss of function
Types of Surgical Procedures for Thumb Arthritis
When non-surgical treatments aren’t helping enough anymore, there are several surgical options to consider. Each type of surgery has its own good and bad points, and the best choice depends on your specific situation.
Joint Fusion (Arthrodesis)
Joint fusion, also called arthrodesis, is a procedure that involves joining the bones of the affected joint together. This might sound extreme, but it can be very effective for relieving pain.
In this procedure, the surgeon removes the damaged cartilage and then uses pins, plates, or screws to hold the bones together while they heal into one solid unit. While this eliminates pain, it also means you’ll lose movement in that joint.
Despite the loss of movement, many people find they can still do most daily activities after joint fusion. And the pain relief can be significant, making it a worthwhile trade-off for many patients.
Joint Replacement (Arthroplasty)
Joint replacement, or arthroplasty, involves removing the damaged joint and replacing it with an artificial one. This can be done using metal, plastic, or even your own tissue.
The goal of joint replacement is to relieve pain while keeping some movement in the thumb. It’s often a good option for people who want to maintain more flexibility in their thumb than joint fusion allows.
But joint replacements aren’t perfect. They can wear out over time, potentially requiring another surgery in the future. And while they often provide good pain relief, they may not restore full strength to the thumb.
Osteotomy
Osteotomy is a procedure that involves cutting and realigning the bones to shift stress away from the damaged part of the joint. It’s typically used in earlier stages of arthritis when there’s still some healthy cartilage left.
This procedure can help relieve pain and potentially slow the progression of arthritis. It also keeps your own joint, which can be advantageous compared to joint replacement or fusion.
However, osteotomy is a complicated procedure that requires a longer recovery time. And while it can be very effective, it may not completely eliminate the need for further surgery in the future.
Trapeziectomy
Trapeziectomy involves removing a small bone at the base of the thumb called the trapezium. This bone is often the main site of arthritis in the thumb.
After removing the trapezium, the surgeon may fill the space with a piece of tendon (this is called LRTI – ligament reconstruction and tendon interposition) or simply allow the space to fill with scar tissue.
This procedure can provide good pain relief and maintain some thumb movement. But it may result in a slightly weaker pinch grip, which could be a consideration depending on your lifestyle and work requirements.
Factors Influencing the Decision to Undergo Surgery
Deciding to have surgery for thumb arthritis isn’t a choice to make lightly. There are several factors to consider, and what’s right for one person might not be right for another.
Severity of Symptoms
How bad your symptoms are plays a big role in the decision to have surgery. If your pain is mild and manageable with non-surgical treatments, surgery might not be necessary. But if you’re in constant, severe pain that’s affecting your quality of life, surgery might be the best option.
It’s not just about pain, though. How much it affects your daily function is important too. If you’re struggling with basic tasks like writing, using utensils, or opening doors, that might tip the scales towards surgical intervention.
Response to Non-surgical Treatments
How well have non-surgical treatments worked for you? If you’ve found good relief with splinting, medications, or injections, you might want to stick with those approaches. But if you’ve tried everything and you’re still suffering, it might be time to consider surgery.
Keep in mind, though, that non-surgical treatments can take time to work. Make sure you’ve given them a fair chance before deciding they’re not effective.
Overall Health
Your general health is a important factor in deciding whether surgery is appropriate. Surgery and anesthesia carry risks, and these risks can be higher if you have certain health conditions.
Your doctor will consider factors like your age, weight, and any other medical conditions you might have. They’ll also look at things like your bone quality, as this can affect the success of certain surgical procedures.
Lifestyle and Occupation
Your lifestyle and job requirements can influence the decision to have surgery. If you have a physically demanding job or hobbies that put a lot of stress on your thumbs, you might benefit more from surgery than someone with a less hand-intensive lifestyle.
On the other hand, if your job or hobbies require very fine motor skills, you’ll need to carefully consider how different surgical options might affect your abilities.
Personal Preferences
Your personal preferences matter. Some people are more willing to accept the risks and recovery time of surgery if it means a chance at long-term pain relief. Others might prefer to manage their symptoms non-surgically for as long as possible.
It’s important to have an open and honest discussion with your doctor about your goals and concerns. They can help you understand the potential benefits and risks of surgery in your specific case.
Future Outlook
Consider the long-term outlook of your condition. If your arthritis is getting worse quickly, earlier surgical intervention might prevent more extensive damage and potentially lead to better outcomes.
Your doctor can help you understand how your arthritis is likely to progress based on factors like your age, how severe your symptoms are, and the results of imaging studies.
Preparing for Thumb Arthritis Surgery
If you and your doctor decide that surgery is the best option for your thumb arthritis, there are several steps you’ll need to take to prepare. Good preparation can help ensure a smooth surgery and recovery process.
Medical Evaluation
Before surgery, you’ll need to have a thorough medical evaluation. This typically includes a physical exam, blood tests, and possibly other tests depending on your overall health.
Your doctor will review your medical history and any medications you’re taking. Some medications, particularly blood thinners, may need to be adjusted before surgery.
This evaluation isn’t just a formality. It’s important for identifying any potential risks and allowing your medical team to plan accordingly.
Lifestyle Adjustments
You might need to make some lifestyle changes in the weeks leading up to surgery. If you smoke, your doctor will likely advise you to quit, as smoking can interfere with healing.
You may also be advised to adjust your diet or exercise routine. Maintaining a healthy weight and good overall fitness can help with your recovery.
Think about the practical aspects too. You’ll likely have limited use of your hand for a while after surgery, so consider how you’ll manage daily tasks. It might be helpful to prepare meals in advance or arrange for help with household chores.
Home Preparation
Your home may need some adjustments to make your recovery easier. Consider things like:
- Moving frequently used items to easy-to-reach places
- Preparing a comfortable recovery area
- Getting any necessary assistive devices, like jar openers or buttoning aids
You might also want to practice doing tasks one-handed, as you’ll likely need to keep your surgical hand elevated and still for a while after the procedure.
Mental Preparation
Don’t underestimate the importance of mental preparation. Surgery can be stressful, and recovery takes time and patience. Consider talking to others who’ve had similar procedures or joining a support group.
It’s also a good idea to set realistic expectations for your recovery. Your doctor can give you an idea of what to expect in terms of pain levels, recovery time, and when you might be able to return to various activities.
Arranging Post-operative Care
You’ll need someone to drive you home after the surgery, and you may need help for the first few days of your recovery. Arrange this in advance.
If you live alone, consider staying with a friend or family member for a short while, or arrange for someone to check on you regularly.
Don’t forget about follow-up care. You’ll likely need physical therapy after surgery, so it might be helpful to research therapists and even schedule initial appointments in advance.
Thumb Arthritis Surgery: The Recovery Process
Recovery from thumb arthritis surgery isn’t quick. The process can take several weeks to several months, depending on the type of surgery you’ve had and how quickly you heal.
Right after the surgery, your main focus will be on managing pain and protecting the surgical site. Your hand will likely be in a cast or splint, and you’ll need to keep it elevated to reduce swelling. Your doctor will prescribe pain medication to help you stay comfortable during this initial phase.
As you start to heal, you’ll begin working with a physical therapist. They’ll guide you through exercises to regain strength and mobility in your thumb. At first, these exercises might seem very difficult or painful, but don’t get discouraged. Progress might be slow, but it will come.
You’ll need to be patient with yourself during this time. Simple tasks that you used to do without thinking – like buttoning a shirt or opening a jar – might be challenging for a while. But as you heal and work through your therapy, you’ll gradually regain function.
It’s important to follow your doctor’s and therapist’s instructions carefully during recovery. Pushing too hard too soon can set back your progress or even damage the surgical repair. On the other hand, not doing your prescribed exercises can lead to stiffness and reduced function.
Most people can return to light activities within a few weeks of surgery, but it may be several months before you’re back to all your normal activities. Your doctor will give you specific guidelines based on your individual case and the type of surgery you had.
Remember, recovery isn’t just physical – it’s mental too. It’s normal to feel frustrated or discouraged at times during the recovery process. Don’t hesitate to reach out to your healthcare team or a support group if you’re struggling.
Long-term Considerations
While thumb arthritis surgery can provide significant relief, it’s important to have realistic expectations about the long-term outcomes. Most people experience substantial pain relief and improved function after surgery, but your thumb may never be quite the same as it was before arthritis set in.
The type of surgery you’ve had will influence your long-term outlook. For instance, if you’ve had a joint fusion, you’ll have permanent loss of motion in that joint, but you should have excellent pain relief. On the other hand, a joint replacement might offer more mobility, but could wear out over time and potentially need revision in the future.
It’s important to maintain a healthy lifestyle after surgery to protect your hands and other joints. This might include maintaining a healthy weight, staying active, and using proper ergonomics when performing repetitive tasks. Your physical therapist can guide you on exercises and techniques to keep your hands strong and flexible.
Even after a successful surgery, you’ll need to be careful about how you use your hands. You might need to keep using assistive devices for certain tasks, or change your techniques for activities that put a lot of stress on your thumbs.
Some people worry about arthritis developing in other joints after thumb surgery. While this can happen, it’s not because of the surgery itself. Arthritis often progresses over time, and if you’re prone to it, it may develop in other joints too. However, the techniques you learn for managing your thumb arthritis can often be used for other joints as well.
Regular check-ups with your doctor are important, even years after your surgery. They can monitor your progress, spot any potential issues early, and help you maintain the best possible function in your hands.
Keep in mind that surgery isn’t the end of your journey with thumb arthritis – it’s a new phase. With proper care and management, many people enjoy significant improvements in pain and function for many years after surgery.
Final Thoughts
Deciding when surgery is needed for thumb arthritis is a personal and complex choice. It involves carefully weighing the severity of your symptoms, how they affect your daily life, and how well non-surgical treatments have worked. While surgery can offer significant relief for many people, it has risks and requires careful consideration.
If you’re struggling with thumb arthritis and wondering about your options, don’t hesitate to seek expert advice. The team at The Nerve Surgery Centre specializes in surgical treatments for arthritis in the fingers. They can provide personalized guidance based on your unique situation and help you make an informed decision about your treatment.
Don’t forget that the goal of any treatment – surgical or non-surgical – is to improve your quality of life. With the right approach and expert care, it’s possible to find relief from thumb arthritis and regain function in your hands. Whether that involves surgery or not, the most important step is reaching out for help and exploring your options.
FAQs
1. How long does it take to recover from thumb arthritis surgery?
Recovery time varies depending on the type of surgery, but typically ranges from 6 to 12 weeks for initial healing, with full recovery taking several months.
2. Will I regain full use of my thumb after surgery?
Most people experience significant improvement, but your thumb may not function exactly as it did before arthritis. Your surgeon can give you a more specific outlook based on your case.
3. Can thumb arthritis come back after surgery?
While surgery can provide long-term relief, it doesn’t cure arthritis. In some cases, arthritis can progress or affect other joints over time.
4. Are there any alternatives to surgery for severe thumb arthritis?
Even in severe cases, some people find relief through a combination of splinting, medications, injections, and lifestyle changes. Discuss all options with your doctor.
5. How do I know if I’m ready for thumb arthritis surgery?
Consider surgery if you have severe pain that doesn’t respond to other treatments, significant loss of function, or if thumb arthritis is seriously affecting your quality of life. Your doctor can help you make this decision.
References
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Medically Reviewed by Mr Tomas Madura:
Mr Tomas Madura MD(Hons), PhD, FRCS(Plast), is a highly experienced Consultant Plastic Surgeon specialising in hand and peripheral nerve surgery, with over two decades in the medical field. He has been a Consultant at the Birmingham Hand Centre and Brachial Plexus and Peripheral Nerve Injury Service at the Queen Elizabeth Hospital in Birmingham since 2017. Mr Madura’s distinguished career includes a PhD in Neurobiology from Osaka University, multiple fellowships in reconstructive microsurgery and peripheral nerve surgery, and numerous contributions to research in the field of nerve injuries and paralysis.
He is a Fellow of the Royal College of Surgeons of Edinburgh and a full member of several prestigious organisations, including the British Association of Plastic Reconstructive and Aesthetic Surgeons and the British Society for Surgery of the Hand. Mr Madura has been recognised with the Syme Medal for outstanding contributions to surgical research.
For more information, please visit his About page.
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