Carpal Tunnel or Thumb Arthritis?

December 5, 2013

Think You Have Carpal Tunnel Syndrome? Your pain could actually be caused by basal joint (thumb) arthritis.

Have you been treated for carpal tunnel syndrome, but still have pain? “Many patients with arthritis in the basal joint of the thumb, just above the wrist, are misdiagnosed as having carpal tunnel syndrome,” says board-certified hand surgeon John Krebs, MD.

According to U.S. government statistics, carpal tunnel syndrome is the most common nerve compression disorder of the supper extremities. More than 8 million Americans suffer from this repetitive-strain condition.

“But when patients come in complaining of pain in the hand or wrist, my first thought isn’t carpal tunnel,” says Dr. Krebs. “If they have pain, it’s probably tendinitis or arthritis.” Repetitive strain takes its toll. “If you do things that require a lot of pinching motions—whether knitting, plumbing or factory work—it puts a lot of strain on the carpal-metacarpal, or CMC joint at the base of the thumb,” Dr.Krebs explains.

The CMC joint is prone to wear-and-tear arthritis.

“CMC or basal joint arthritis produces pain at the base of the thumb, almost at the wrist,” says Dr. Krebs. “Every time you go to pick up something, you feel a sharp, stabbing pain.” This was the case with Tim Haywood, a 61-year-old jeweler from Elyria, Ohio.

“The pain in my thumbs was caused by what I do,” Haywood explains. “I’ve sat at the jeweler’s bench for almost 30 years.” Haywood’s work involves repetitive pinching motions. “I work a lot with small diamonds, doing setting work,” he says. “And I use a buffing machine that runs at 3,500 rpm. When you buff a ring, the machine draws your hands downward and puts pressure on the joint at the very bottom of the thumb.”

Dr. Krebs diagnosed Haywood with CMC arthritis and started him on conservative treatments. “I had cortisone shots for about six months,” Haywood recalls. “Dr. Krebs told me that when the pain got bad enough, I’d know when I was ready for surgery.

“After that Christmas season, I couldn’t stand the pain anymore,” says Haywood. “My business partner walked in one day when I was buffing rings and saw that I had tears running down my face.”

Could you have ‘texter’s thumb’?

Usually, CMC arthritis occurs in people in their early 40s and up. But a recent phenomenon—texter’s thumb—caused by the repetitive strain of text messaging, is affecting younger people as well.

“Every pound of pressure caused by pushing a keypad with the thumb is magnified at the base of the thumb,” Dr. Krebs explains. “Multiply this by hundreds of keystrokes a day and the risk of basal joint arthritis increases.”

A recent British study by Virgin Mobile, a UK mobile phone provider, showed that 38% of mobile phone users suffer from sore wrists and thumbs from texting. “The thumb is not a very dexterous part of the hand,” says Alan Hedge, PhD, director of the human factors and ergonomics research CMC arthroscopy replaces the basal joint

Fortunately, a procedure known as CMC arthroscopy can relieve basal joint arthritis by replacing the CMC joint. “The beauty of this surgery is that we’re literally taking out the arthritis and we don’t have to put in any kind of metal or plastic joint,” Dr. Krebs explains. “We use the patient’s own tissue to reestablish the joint motion and relieve the pain.”

I’m pain-free!

Haywood had CMC arthroscopy on his right thumb, and on his left thumb a year later. “After surgery, my pain relief was almost immediate,” he says. “Today, I’m pain-free in both hands. It’s incredible!”

What are some differences between carpal tunnel syndrome and CMC arthritis?

With carpal tunnel, the main complaint is numbness that wakes you up at night or that gets worse with certain activities. It’s not necessarily pain in the thumb. If you have pain with carpal tunnel syndrome, it will be in the whole hand, and possibly numbness in the thumb, index and middle finger.

According to John K. Krebs, MD, “It is really designed as a stabilizer for pinch gripping with a finger.” The full-size keyboard is designed so the agile fingers can type letters and numbers rapidly. The only thing the thumbs are used for is striking the spacebar. When you switch that around, you put a lot of strain on the thumb,” Krebs explains. “So if you persist in typing a lot of information with your thumbs, you risk injury.”

Sore from texting? Call 440.329.2800

Entry Filed under: Arthritis,Carpal Tunnel,Conditions,Surgeries,Therapy and Injections. Posted in  Arthritis ,Carpal Tunnel ,Conditions ,Surgeries ,Therapy and Injections .

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