If you are experiencing arthritic symptoms in your thumb, you are in good company. Joint pain in the thumb is a very common problem and is considered to be second in prevalence only to arthritis in the knee. But, what is arthritis, really? Arthritis is a condition that affects the joints – the places where 2 bones meet. Rheumatoid arthritis is a systemic, autoimmune condition that generally affects all the joints in the body. Osteoarthritis, on which this article focuses, typically affects individual joints and is much more common. Arthritic symptoms can include joint pain, stiffness, locking and immobility, as well as swelling, tenderness, weakness and joint redness.
Thumb arthritis manifests in the basal joint, at the base of the thumb where it meets the wrist. The small carpal bone of the wrist and the first bone of the thumb, called the metacarpal, form this joint. The unique saddle-shape of the joint allows the thumb to have a wide range of motion, including up, down, across the palm, and the ability to pinch. This kind of motion is used to type and text, for example, as well as to hold a phone or steering wheel, and a fork, spoon or knife.
Not only does immobility and discomfort in the basal joint cause many problems associated with working our hands, but the predisposition to get arthritic here is also a precursor to carpal tunnel issues. While the Mayo Clinic states on their website that the exact cause of thumb arthritis isn’t known, they posit that age, weight and repetitive motion are primary causal factors. In my opinion, however, the greatest risk factor for arthritis is the position of the thumb. Conversely, maintaining the correct thumb position is also the best method to prevent arthritis in the first place.
For me, it’s a matter of biomechanics, which is largely overlooked in the western medical model. From a biomechanical perspective there’s nothing emotional about alignment. It’s not like saying this alignment looks good or doesn’t look good. It simply comes down to structure. With regard to the structure of the joint, the correct and incorrect positions are a matter of anatomy. It’s accepted knowledge in any medical or healing arena. It is not in dispute. And this is true with every joint in the body. It is a mystery to me why this very simple concept of structure and alignment is absent in the modern day consideration of joint health, especially thumb arthritis, which affects over 25 million people today.
Here’s how it works: Check out how much you can move your thumb when holding down the basal joint, where the wrist and thumb meet. Many people get into trouble as they tend to lock that joint and use the second joint as their primary source of movement for the thumb. This is the joint above the basal joint, where the webbing of the thumb connects to that of the index finger, called the metacarpalphalangeal joint. You can actually immobilize the basal joint and retain about 80 percent movement in the thumb. So we think everything’s just great and don’t realize there’s a problem until the joint becomes calcified and then arthritic. If the tension becomes great enough you also get the swelling and that’s where carpal tunnel syndrome issues come in as well. (I will address carpal tunnel syndrome in more detail in a future post so stay tuned.)
See this short video that I put together for a visual explanation of thumb positioning.
Now that you know the basics, here’s the good news. Experience has shown me that age and repetitive motion themselves do not necessarily lead to either arthritis or repetitive motion symptoms. My grandmother, for example, worked full-time as a secretary for Disney. She typed 120 words per minute for years. She knitted and crocheted regularly throughout her senior years. I had the opportunity to look at her hands when she was 94 and her hand and thumb alignment was perfect. She never had any problem with her hands despite the constant use and advanced age.
More good news is that the basal joint of the thumb is one of the easiest joints for a practitioner to adjust and position correctly. It responds incredible well to massage therapy. Even if the joint has been out of alignment for a long time. If we’re talking about a shoulder or a hip, for example, the joint can be difficult to access as layers of muscle and connective tissue shield it. In the case of an elbow or a knee, there’s actual bone in the way. But the thumb is right there for the taking. And, with the hand, unlike these other joints, the resistance is quite minimal.
At Dorfman Kinesiology we’ve had great success resolving chronic hand and thumb cases quickly and permanently using therapeutic massage to reposition the mechanics in the hand and the thumb. The design of the hand allows for that, more so than any other joint in the body.
Coming shortly, in a follow-up post, I will detail a simple program of exercises for the hand that anyone can do to prevent or alleviate hand and thumb discomfort. In the meanwhile, if you are seeking relief for stiff and painful joints, come see us at either our San Diego or Central Coast location, where our mission is to help you feel better forever.