Advice from a Certified Hand Therapist: Surgery for Thumb Arthritis Pain
Thumb arthritis pain can be debilitating, making everyday self-care tasks intolerable. There is a surgical option when other treatments, such as injections and therapy, fail to adequately reduce pain. A carpometacarpal arthroplasty or CMC arthroplasty is a joint replacement procedure for the base of your thumb. It eliminates the grinding and pain felt from the rubbing of bone on bone after the protective cartilage has worn away, usually caused by arthritis.
Below are some commonly asked questions regarding this procedure:
Will I be in a cast?
Yes. You will likely be in a cast for 2-4 weeks. You will also use either a removable orthosis a hand therapist will custom make for you or an off-the-shelf thumb and wrist splint for a month after the cast has been removed. This will help maintain the optimum position of your thumb as you are healing and protect your new thumb joint.
What happens after my thumb has been immobilized?
Any time a joint has been immobilized, it takes time to regain your flexibility. For this surgery, the wrist and thumb are usually quite stiff. Your doctor will likely recommend you see a hand therapist to assist you with regaining the range of motion and strength safely.
How can hand therapy help?
A hand therapist is an occupational or physical therapist who specializes in treatment of the hand. A hand therapist is familiar with the latest surgical techniques and is able to assist you on your journey to get back to doing the things you love to do.
Here are some common questions related to hand therapy after this procedure:
Will my hand ever lay flat again?
Your hand may not lay flat again. The cast helped to put your thumb in a position to make it easy to pinch so you can do functional tasks such as use a key or a fork. A hand therapist can teach you how to make the most of this functional position.
My scar is really sensitive. Is there anything I can do to make my scar look and feel better?
Desensitization techniques to help reduce the pain you feel when something touches your scar may be part of your post-operative rehabilitation. A hand therapist may use vibration, a variety of textures, massage techniques, and silicone to reduce pain and to make your scar look as close to the surrounding skin as possible.
Why does the skin around my scar feel numb?
Your nerves are like the power cord between your brain and your skin. During surgery those nerves can be irritated making the skin around the incision feel a little weird. While they are healing you may feel odd sensations like tingling. This is normal and usually goes away in one to three months.
How do I find a hand therapist?
Your surgeon may recommend a hand therapist in your community. Other resources to find a hand therapist by ZIP code are www.ASHT.org and www.HTCC.org.
Gwen Morris, OTD, OTR/L, CHT is a Certified Hand Therapist and a member of the American Society of Hand Therapists.