Monday, August 15

arthritis-related hand pain? This could be beneficial.

When osteoarthritis affects the joint between the thumb and wrist, occupational therapy reduces pain and improves function.

Hand with osteoarthritis

Some joints appear to receive all the attention when it comes to arthritis. We talk a lot about our knees and hips. Walking depends on the health of our knees and hips, and a third or more of persons over 65 develop osteoarthritis in these joints, leading to more than a million joint replacements yearly in the US.

The first carpometacarpal joint, which joins your thumb to your wrist, is another matter. That's surprisingly significant, although the majority of individuals are unable to identify it and only become aware of it if it develops arthritis. Fortunately, a new study found that this type of arthritis can be successfully treated with a standard approach that doesn't call for any medication.

The amazing opposable thumb

It helps us to move our thumb through a variety of movements and is more commonly referred to as the first CMC joint. You can appreciate the first CMC joint for the variety of applications that opposable thumbs have! We can hold objects, open jars, turn doorknobs, write, clench our fists, turn a key, and carry out many other daily tasks thanks to our opposable thumbs.

Because of this, the first CMC joint may be the body's most underappreciated joint.

How would you recognize first-CMC arthritis?

Typical signs include

Pain at the point where your thumb and wrist meet

When using keys, writing, or opening jars, the pain becomes worse.

poor functional ability, including grip weakness

a bony outgrowth over the joint, frequently caused by additional bone development

if the arthritis is severe, pain while at rest or while sleeping.

An x-ray can confirm the diagnosis of osteoarthritis of the first CMC, which your doctor may assume based on your symptoms and physical examination.

What treatments are effective?

There are few alternatives for treating osteoarthritis of any joint, including the first CMC. They also don't always function well. Only the following measures are strongly advised in the most recent US guidelines for treating hand or thumb osteoarthritis:

using a splint or brace (called an orthosis)

exercises made specifically for this joint

educational programs to help people control annoying symptoms

medications that reduce inflammation, including ibuprofen.

Occupational therapy incorporates a type of physical therapy that focuses on hand and wrist functions necessary for everyday tasks like showering and getting dressed, It is frequently used to provide a brace, exercise, and instruction. However, a thorough evaluation of occupational therapy's effects has not yet been conducted.

A recent study supports the value of occupational therapy.

180 participants with first-CMC osteoarthritis were included in the study. They were 80% women and had an average age of 63.

Randomly, half of the people with osteoarthritis were given occupational therapy, which included education, exercises, braces, and other aids, while the other half only got information about the disease.
The findings demonstrate that a three-month course of occupational therapy significantly alleviated pain at rest and after activity, and enhanced grip strength and function.

This is one of the strongest studies evaluating occupational treatment for this disorder. Nonetheless, it had some restrictions. Participants knew whether they had occupational therapy or not, thus their anticipation, as well as the placebo effect, may have influenced the results. The duration of the trial was only three months, therefore the long-term effects were not evaluated. 

The duration of the trial was only three months, therefore the long-term effects were not evaluated. 

Despite the prevalence of this type of osteoarthritis and the difficulty it creates, numerous concerns remain. It would be advantageous to know:

Why does osteoarthritis occur initially in the joints of the hand,  how can the progression of osteoarthritis be delayed, stopped, or reversed? 

Duration of the benefits of occupational therapy for persons with osteoarthritis of the first CMC.  

If symptoms resolve after an initial course of occupational therapy but return later, would further treatments be equally effective?

 Is there a gender variation in the effectiveness of occupational therapy of this type?

Would it perform equally well for moderate and severe arthritis?

What are the most essential aspects of occupational therapy, and are they generally available? For instance, is bracing more necessary than exercising, and are there superior braces or exercises? Are skilled occupational therapists readily available for the majority of those affected by this condition?

The conclusion

There is a significant chance that, if you live long enough, you will develop osteoarthritis in the joints which enables the opposable thumb to function smoothly. Hopefully, improved therapies will be available before this occurs. Although occupational therapy is reassuring, the golden grail for anyone who may develop osteoarthritis is a treatment that may avoid it, halt it from worsening, or even reverse its damage. Researchers are fortunately working diligently to identify such medicines.

No content on this site, regardless of date, should be used to replace direct medical advice from your doctor or another trained practitioner.
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