3-Point Products' Blog

Summer is here and working in the gardens and flower beds and pulling up the weeds is in full swing. This work may help the landscaping look beautiful, but for those with osteoarthritis at the base of the thumb, the force from pinching and pulling at the weeds can leave thumbs hurting. While textbooks and older research studies discuss using an orthosis, paraffin, gentle AROM, and joint protection techniques to address the pain and limited function associated with trapeziometacarpal arthritis (TMC), more recent studies highlight the potential benefit of stabilization and proprioceptive exercises for this diagnosis.

Clients with lateral epicondylitis (also known as tennis elbow) consistently appear on my schedule. As therapists, we know that swinging the tennis racket is not the only possible cause of this diagnosis. Lateral epicondylitis is due to a degenerative process at the poorly vascularized origin of the wrist extensors on the boney prominence at the lateral elbow. It is often contributed to over use of the wrist extensors. Individuals with this diagnosis often describe pain at the lateral elbow that is persistent, very uncomfortable and limiting.

Osteoarthritis (OA) at the base of the thumb is a common diagnosis among older individuals.  Research suggests that 26.2% of women and 13.4 % of men age 71-100 years old have symptoms of this diagnosis and that approximately 70% of community dwelling individuals with hand pain have OA at the base of the thumb as well.

Studies have consistently found that using an orthosis helps to decrease pain and improve function for individuals with arthritis at the base of the thumb. There is no consistent evidence to suggest that one orthosis is more effective than another, however, research does suggest that individuals prefer pre-fabricated designed orthoses.

Osteoarthritis (OA), or the degeneration of a joint, commonly occurs at the base of the thumb. OA at this joint is diagnosed with conventional radiographs (x-rays), but often can be recognized based on symptoms. Symptoms occur predominantly with pain at the base of the thumb, especially when performing tasks that require a pinch (i.e. pulling on socks).

Medial epicondylitis or golfer's elbow as it is commonly termed, is characterized by pain at or around the boney prominence at the medial aspect of the elbow where the wrist flexors and one of the forearm pronators (pronator teres) originate. This diagnosis is associated with degenerative changes of the musculotendinous origins at the medial elbow and most often involves the pronator teres, flexor carpi radialis or palmaris longus.

Causes of Deformity in the Rheumatoid Thumb

Rheumatoid arthritis (RA) is a destructive inflammatory disease that impacts soft tissue. This disease commonly involves the thumb and causes deformities to the thumb through tendon rupture or tendon subluxation and the abnormal stretching of ligaments and other joint structures.

TFCC Wrist Injuries

The Triangular Fibrocartilage Complex (TFCC) is a group of ligaments and cartilage on the ulnar side of the hand. The TFCC ligaments attach the cartilage to the small wrist bones which also suspend the ends of the two forearm bones, the ulna and the radius.

The primary cause of Ulnar Deviation of the Metacarpal Phalangeal joints (MP) of the fingers, a chronic, irreversible condition, is Rheumatoid Arthritis (RA). The MP joints are a primary site of rheumatoid deformities due to several anatomical and bio mechanical factors. Chief among the factors are:

• The shape of the metacarpal head allows for a certain degree of motion in an ulnar direction which contributes to the hands ability to create a strong grip

Instability in the ulnar carpal wrist may present with pain, swelling, and tenderness in the ulnar aspect of the wrist. Instability due to weakened or rupture ligaments, can occur between the ulna and the carpus, the lunate-triquetral joint, and/or the triquetrohamate joint.

The following describes a few important assessments to assist clinical evaluation of ulnar sided wrist pain when the symptoms are suspected to be related to ulnar carpal instability.

Scaphoid fractures most often occur in males between the ages of 15 to 30 years old and usually are sustained with wrist hyperextension and radial deviation as a consequence of a fall onto an outstretched hand. Individuals with a scaphoid fracture often present with pain, swelling, decreased range of motion, and tenderness in the anatomic snuffbox.