Osteoarthritis of the carpometacarpal thumb joint care uk. The following hand strengthening exercises are designed to improve strength of the muscles of the wrist and hand. Adapted tools and equipment enlarged, padded handles on tools and utensils, such as pens and. The condition, also known as carpal metacarpal, affects one in four women and one in 12 men, reports the university of washington hand centers website.
Cmc joint of the thumb, often as a result of athletic injury or cumulative trauma associated with an arduous occupation or hobby. Exercising with rheumatoid arthritis symptoms vary from day to day. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Hand and finger exercises make a fist hand and finger exercises can help strengthen your hands and fingers, increase your range of motion, and give you pain relief. Exercises to promote dynamic stability of the thumb. At the recent philadelphia hand symposium, several therapists inquired about appropriate exercises for painful thumb cmc joint osteoarthritis. Exercises to strengthen the thumb muscles can reduce this imbalance and also increase musclerelated stability around the thumb cmc joint. Arthritis of the first carpometacarpal cmc joint of the hand is a common and often debilitating disease. Osteoarthritis of the carpometacarpal thumb joint this booklet has been written to provide you with information about your thumb arthritis and give you a better understanding of your thumb joint, why you experience pain, and how you can manage your symptoms.
Arthritis at the base of the thumb carpometacarpal joint is the second most common arthritis in the hand. Thumb carpometacarpal osteoarthritis cmc oa is a common disease, affecting up to 11% and 33% of men and women in their 50s and 60s, respectively, which leads to pain, laxity and weakness of the cmc joint. Doing a 10 minute warm water soak or hot pack beforehand will help you do the exercises. In general, it is a progressive instability or degenerative arthritis that occurs at the base of thumb, that over time fails conservative treatment, which includes bracing, therapy, antiinflammatory medications and. Similar to arthritis in other areas of the body, it develops from the normal wear process of our joints as we age. The following are some exercises which can help maintain your dexterity use a small marble or a very small ball and with the tip of the exercised thumb. Although there are several types of arthritis, the one that most often affects the joint at the base of the thumb the basal joint is osteoarthritis degenerative or wearandtear arthritis.
The thumb carpometacarpal joint cmc is where the metacarpal bone attaches to the trapezium carpal bone of the wrist. If you find the exercises difficult or uncomfortable check that you are doing them correctly and reduce the number of repetitions. Exercises to stretch, strengthen and stabilise the structures that support your shoulders. The purpose of exercises for thumb carpometacarpal cmc osteoarthritis is to maintain full extension and abduction of the cmc joint, since adductionflexor forces are naturally stronger. It may be beneficial to evaluate softtissue tension and the pattern of thumb use after surgery for thumb cmc joint osteoarthritis to improve postoperative functional results. Hand exercises for people with arthritis touch your fingertips bend your fingers. The thumb carpometacarpal joint is the most commonly affected in the hand and. At any state in time, symptoms can vary and at times, your thumb can become rather painful. The exercises may be suggested for a condition or for rehabilitation. Exercises for thumb osteoarthritis pdf st georges hospital. Osteoarthritis of the carpometacarpal thumb joint south tees. Nonsurgical treatments can relieve pain, improve hand. Make a gentle fist, wrapping your thumb across your fingers.
Review of thumb carpometacarpal arthritis classification. It is characterized by inflammation of the membranes lining the joints. Over time, the cmc joint is subject to large and repeated forces during use which may lead to degenerative osteoarthritis changes. Postoperative therapy for chronic thumb carpometacarpal. A tight adductor pollicis muscle contributes to thumb cmc joint instability and stretching can improve the ability to maintain the cmc joint in a stabile position. Cmc joint at the base of the thumb is the most common cause of pain in this area. Rest your hand on a table stretch your thumb away from your hand. Arthritis of the thumb cmc joint arthritis affecting the basal joint of the thumb 1st cmc joint is one of the more common. The best exercise is to maintain the thumb interphalangeal ip and mp joints flexed while extendingabducting the cmc joint lifting the cmc toward the dorsum of the hand. They will help to reduce joint stiffness and maintain the range of movement of your thumb. Exercising with rheumatoid arthritis exercise is medicine.
Typically, arthritis at this joint occurs after 4050 years of age, and is much more common in women than men. Cmc arthroplasty rehabilitation protocol thumb carpometacarpal joint arthritis can cause significant pain and instability. The use of exercise for patients with cmc joint oa has recently been questioned, based on the results of a clinical trial by rogers and wilder. Arthritis of the base of the thumb advice and exercises arthritis at the base of the thumb is very common. The postoperative protocol addressed the soft tissues using splinting and exercises aimed at lengthening and strengthening these structures, with good results. Doing a 10 minute warm water soak or hot pack beforehand will help you do the exercises with. Although osteoarthritis is the most common cause of thumb arthritis, rheumatoid arthritis can also affect the cmc joint, usually to a lesser extent than other joints of the hand. Based on the staging of the cmc oa, different forms of treatment can be used, including both conservative and surgical measures. Without this cushioning, the bones in the joint grind together wearing the joint down. Exercises and instructions aim to complete the following exercises twice daily. In late stages fine motor movement tends to become rather difficult. Managing early osteoarthritis of the thumb east sussex healthcare. Rheumatoid arthritis ra is a systemic autoimmune disease. Arthritis is a condition that irritates or destroys a joint.
While it can be painful initially, performing regular exercises to improve range of motion and strengthen the muscles can reduce pain and swelling, according to the university of washington. Pain is often one of the prime presenting symptoms. Rationale for exercise for thumb cmc osteoarthritis. The thumb cmc joint is stabilized by its joint capsule and the palmar oblique, first intermetacarpal, dorsal radial, and posterior oblique ligaments. Hand exercises for cmc joint oa are aimed at maximizing painfree range of motion, increasing functional strength, maintaining joint stability. Synovitis associated with rheumatoid arthritis may eventually erode and soften the ligaments that protect the articular surfaces. Thumb arthritis causes, symptoms, exercises, splint. Since metacarpophalangeal mp joint hyperextension often accompanies cmc joint osteoarthritis, how can you justify focusing on exercises to strengthen the. Thumb carpometacarpal cmc joint osteoarthritis oa is the second most common form of hand oa, affecting between 20% and 30% of the general population. An exercise programme is likely to be most effective in the early stages of the. Open your hand back up until your fingers are straight once again. Diseases that change the normal structure and function of cartilage, such as rheumatoid arthritis.
As a general rule, exercises are more appropriate when the joint is not inflamed and relatively painless. This is a common site for osteoarthritis of the hand due to the mobility of the joint and the large forces translated through the joint with use of the hand. Gentle thumb exercises and stretching may alleviate arthritis symptoms, which include stiffness, limited mobility and pain. Nhs buckinghamshire musculoskeletal integrated care. Diagnosis can be readily made with history, physical exam, and radiographic evaluation. Exercises should be done with your splint off, just 3 times per day. The effectiveness of a manual therapy and exercise protocol. Understanding your thumb osteoarthritis introduction o the cmc joint is one of the most important joints of the thumb and hand due to its wide range of motion. Thumb cmc joint arthroplasty surgery home program phase 2 exercises david gesensway, md exercises should be done with your splint off, just 3 times per day. Activities and jobs that put high stress on the thumb joint. The cmc joint is formed where the metacarpal bone of the thumb meets the trapezium bone of the wrist. Then, slowly bend your hand into a fist, placing your thumb on the outside of your hand. An exercise program for carpometacarpal osteoarthritis.
The purpose of active thumb extension exercises is to focus extension power at the cmc joint and not allow it to be used up by extension of the more distal joints. Osteoarthritis of the thumb berkshire healthcare nhs. Certified hand therapist laura mccarthy otrl, cht, demonstrates thumb exercises for thumb arthritis. Oa can often affect the joint at the base of your thumb. Thumb dexterity exercises hand dexterity always tends to decrease as arthritis in the base of the thumb tends to progress. Pain over the base of the thumb sussex msk partnership. This causes pain, stiffness, warmth, swelling, and potential severe joint damage. The exact mechanisms of pain relief remain theoretical, but it is hypothesized that they may be due to a combination of improved mechanics combined with a change in the processing of pain in the central nervous system. We often prescribe these exercises for our patients with osteoarthritis of a certain thumb joint, the cmc joint. Mechanoreceptors found in cmc ligaments as in shoulder, wrist, knee and ankle pacinian corpuscles. If you are currently having thumb pain, we do not recommend completing exercises.
The thumb cmc joint is a double saddle joint that is concave in one direction and convex on the other, and it moves in flexionextension, abductionadduction, and pronationsupination planes. Due to the movement required at the base of the thumb, you rely on your ligaments and bony structures to maintain stability. Nhs buckinghamshire musculoskeletal integrated care service osteoarthritis of the. Studies that have examined the role of exercise in treating thumb cmc joint oa report improvements in strength, pain, and hand function. Arthritis of the base of the thumb advice and exercises. No consensus yet for which exercises are best little is known about dosage of exercise for the small muscles of the. Generally, they should only be performed provided they do not cause or increase pain. Achieving a pain free stable thumb virginia obrien, otd, otrl, cht. Thumb cmc joint arthroplasty surgery home program phase 2.
The effectiveness of a manual therapy and exercise. The thumb cmc joint is stabilized by ligaments and muscles that help to keep it on the trapezium wrist bone. Cooney and chao 11 reported that the cmc joint is a saddle joint composed of two saddleshaped surfaces, the convexity of one fitting tightly into the concavity of the other. Although each exercise program must be individualized, stretching the adductor pollicis muscle, isolating and strengthening the first dorsal interosseous muscle.
The best exercises for your painful thumb arthritis. Arthritis occurs when the cartilage the flexible tissue that covers and protects the joints wears out. How to fix forward head posture 3 easy exercises from a chiropractor duration. I see so many patients have severe arthritis joints on xray, but totally pain free. A grind test to the cmc was positive, and the long term effect.
Again, all these exercises are aiming to strengthen the muscles around your cmc joint, to provide dynamic stability. Here are some examples of exercises for you to try. Doing a 10 minute warm water soak or hot pack beforehand will help you do the exercises with less discomfort, and will help improve your motion. Carpometacarpal cmc joint arthritis is arthritis at. To reduce pain during activities, try wearing a cmc splint and try to use some of the equipment listed in the next section.
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