Thumb Pain

thanks in the uk particularly post covid getting to see anyone in secondary care is almost impossible, seen a specialist hand physio who says to use compression bandage / taping / wrist brace for periods butt at 73 the potential for much change is limited just symptom management

@lotsofpain

I had thumb pain at age 68… I tried injections and splinting first, but to no avail. I had surgery in late January and again in first part of June of last year. Many have had the surgery up into their late 80s… it depends upon your overall health here in my area of USA.. the southwest section of Georgia.

I could not write even my name. For some reason my surgeon did not take care of the trigger thumb while doing the tight-rope surgery for the cmc joint. (I may have the letters wrong.. a bit tired from 9 days 8 nights of grandchildren 😁). So had the trigger thumb surgery in June of last year.. which I was mostly awake for.. kind of twilight for about 10 minutes. The cmc surgery was less than an hour. There are several types of surgery for it.

I had about 10 physical therapy sessions before covid hit. They were not good therapist.. they had rather look at their phones and laptops instead of showing one how to correctly do an exercise.. pretty much threw something in front of me and said do it .. and I had to ask what I was doing and the correct way to do it.

Since my therapy time was cut from the picture… mostly my choice.. I looked online for exercise videos to help me recover. I am now back to crocheting.. albeit slow going and needing rest periods. Back to other things I enjoy… writing, coloring, brushing and petting the dog.. and back to hand washing our dishes.. without dropping them. I will be 70 in a few weeks 🥳

I really wish I could be of more help. I know you are in a lot of pain. Before bed you might try a warm hand soak or heating pad or use ice if it feels better… then use a bit of arthritic cream. It only eases a little, but I take a little over nothing.
ZeeGee

Me too! I’ve had OT, splints, and cortisone shots….avoiding surgery

I know the pain. It is awful. Soaking your hand in warm water, ( I spent a lot of time doing dishes). Exercises recommended by P.T. The thumb braces work quite well ( the carpal tunnel or other hand braces may help, but are more restrictive. I had steroid injections ( which helped a lot). They will only do a few ( I believe six months apart). I eventually decided (because they would not give me more steroid shots) to have the LRTI surgery. Longer recovery than I had expected. 18 months later, the hand is still stiff at times, 85 percent strength, 90 percent flexion. But, NO CMC PAIN. I am 70 soon, the pain relief was worth the loss of strength, grip, and trust I have in my hand.

I am in the "When it is time for surgery, just do it!" group. Have had CMC tightrope surgery on both hands, and have never regretted it for a minute.

Early on, a very wise hand surgeon told me that there is a "window" for successful hand and wrist procedures- when the pain or loss of strength/ use affects your daily life, but before the damage is so bad that full fusion of the joint (with the inevitable loss of use) is needed. One day he looked at me and said "it's time to fix your wrist" - that was 10 years ago and it is still working and mostly pain free, just a little weaker. My friend did not believe his advice, and is now in her 10th month of recovery from a full fusion of the wrist.

Just something to ask the docs as you ponder when or if surgery is the right choice.
Sue

Hi Sue, I am just adding emphasis to your post. I have accepted the "do it now" refrain for my Right TKR. Trying to avoid surgery leaves you exposed to many "side effects" of that choice. First, my knee issues can only become worse requiring more invasive surgery and a longer recovery period. I thought I was taking a big step by using a cane. Guess what? All of a sudden my neck began to be painful. I have already had neck surgery so I couldn't understand that pain. Then my shoulder developed some pain and I have had a reverse shoulder replacement.

Hmmm??? What is this? When my hip started hurting I realized that my body was responding to a change in my gait and the stress of using the cane. Enough! I called for a surgery consultation right away. And I asked my MFR therapist to specifically work on those areas when I arrived for my next session.

My surgeon reiterated the problem we create when we wait too long. The surgery is more complicated and other parts of our body will need to recover from the stress of the cane. You can call me hard-headed. My father frequently referenced that characteristic in me.

May you be free of suffering and the causes of suffering.
Chris

I am 10 days out of TRS & it is a tough recovery. Weaning myself off of Percocet, only one at bedtime. I was told forget about good sleep for at least six weeks & so far that’s true.
Joe B

So, I just came back from the local lake, where I was chatting with a woman who had rotator cuff surgery on Friday, and was struggling to adjust her sling (I've had a little practice with them...)
During our conversation, I manage to help her relocate the shoulder strap to a more comfortable spot without messing up the shoulder and arm positioning.
Then I asked "where is your ice?" And she told me she used it last night. Now, I'm on my soapbox - one of the BEST pain management tools is ICE, Ice, ice... as often and as long as you can. I pointed out my daughter down on the shore, giving her Dad a paddleboard lesson, in her cast and sling, and said - "at 6 weeks, she still ices at least 4 times a day - and her recovery is going wonderfully"
Are you still icing? If not, I will recommend it heartily. One year out from thumb surgery, I still ice when my hand swells from overuse. Also, are you managing daytime discomfort with Tylenol and Ibuprofen?
Good luck.
Sue

Dear “no icers”. Sue is spot on. I have special knee icers and hand icers. Everyday they get used. I quite often get up about 5:30 and ice before I actually hit the floor running. (Fat chance of that!). I order extra gel packs for my knee icer so if it’s needed I will always have a second set ready to go.
‘
My surgeon told me that they have the actual ice machines at the Ortho Clinic. I may just purchase my own. That “tool” was my go to for both shoulder and neck surgeries. I donated it to my PT when I thought that I would never need it again. (That was another joke on me.)

Do you have an ice schedule? What are the results so far?

Be safe, protected and free of inner and outer harm.
Chris

Great pic, @barocco. I hope you'll add it to your profile.
– How to Update your Profile: https://connect.mayoclinic.org/page/about-connect/newsfeed-post/how-to-update-your-profile/

Here's hoping to better sleep for you soon. You may be interested in this discussion:
- Trouble sleeping after TKR: What helped you sleep? https://connect.mayoclinic.org/discussion/trouble-sleeping-after-tkr/