Treatment of Thumb Osteoarthritis and Pain
Hand function can be affected when Osteoarthritis in Carpal-Metacarpal joint (CMC) of the thumb appears. Current evidence support Therapeutic Exercise for managing Thumb Pain as the main treatment. In the National Congress of Hand Therapists of April 2017 that took place in Marbella (Spain), Kristin Valdes (an important Occupational Therapist and researcher) talked about tratment in detail.
Press the buttom below to read her research work about hand pathology:
Thumb Arthritis Factors
Based on some articles from 2013 to 2016, she highlighted three main factors for thumb Osteoarthritis appearance:
- 1. Compressive forces on the Joint between First Metacarpal and Carpal, known as Trapezoid-Metacarpal Joint.
- 2. Ligamentary instability caused by hiperlaxity of some important ligaments. Volar Ligaments are the most affected, caused by lack of nerve endings unlike ligaments on the dorsal side.
- 3. Alterations in Proprioceptive or SensoriMotor System, which may contribute to osteoarthritis.
Active Treatment of the Thumb improving Stability
According to those factors, Osteoarthritis treatment must include some neuromuscular training techniques for restoring Dynamic Instability in this Joint. Click below for more Thumb Exercises.
An active management with SensoriMotor Techniques focused on thumb muscles must be the main treatment of this thumb pathology. Also a specific muscle evaluation should be performed. Amongst those thumb muscles, it may highlights:
- First Dorsal Interosseous.
- Abductor Pollicis Longus.
- Extensor Pollicis Brevis.
Applications and Apps for Thumb Treatment
Social media and Newspaper constantly talk about how bad is using smartphones and tablets for your hands and fingers. But that does not have any evidence supporting that fact.
In fact, according to an article from 2014 (Valdes K & Algar L, 2014) a good way of managing thumb Osteoarthritis or Distal Radius Fracture are smartphone apps during patient´s recovery. Those tools includes some “games” or movement on the screen that could promote pain release, deformity improvement, muscle endurance and strength and active Range of Movement.
Also, those tools are a good way to work Sensori-Motor System when is affected.
Those kind of apps that Valdes K proposed has some limitations, like not able of adapting to patients evolution and pathology. That´s why ReHand App appeared, for solving those problems on a Tablet. ReHand is a combination of New Technologies and latest evidence on Hand Therapy.
ReHand app is able to adapt exercises to each patient and pathology, promoting SensoriMotor system and accelerating recovery.
ReHand Exercise in a thumb disfunction
Here we show an example of a ReHand App exercise focused on Dynamic Stability of thumb, promoting muscle activation with a visual feedback on the screen. Each exercise is adapted to his Range of Motion without pain.
Also, his health proffesional can monitor how patients do exercises thanks to the Tablet´s touch-screen.
Bertozzi L, Valdes K, Vanti C, Negrini S, Pillastrini P, Villafañe JH. Investigation of the effect of conservative interventions in thumb carpometacarpal osteoarthritis: systematic review and meta-analysis. Disability and Rehabilitation. 2015; 37(22):2025-43.
Valdes K, Von der Heyde R. An exercise program for carpometacarpal osteoarthritis based on biomechanical principles. Journal of hand therapy. 2012; 25, 251-63.
Algar L, Valdes K. Using smartphone applications as hand therapy interventions. Journal of Hand Therapy. 2014; 27: 254-257.
McGee C, O´Brien V, Van Nortwick S, Adams J, Van Heest A. First dorsal interosseus muscle contraction results in radiographic reduction of healthy thumb carpometacarpal joint. Journal of Hand Therapy. 2015; 28, 375-381.
O´Brien VH, Giveans MR. Effects of a dynamic stability approach in conservative intervention of the carpometacarpal joint of the thumb: A retrospective study. Journal of hand therapy (2013) 26: 44-52.
Pablo Rodríguez Sánchez-Laulhé
Physiotherapist and Health Researcher