Did you know that the most common place for arthritis in the body is at the base of the thumb? Why? Because this is the area with the largest amount of mobility. Look at the model below.
Do you see where the 1st metacarpal attaches to the bone below it? The bone below it is called the Triquetrum. This is a cup and saucer joint. And this allows the thumb to move in many different planes, unlike the rest of the fingers of the hands. As result, there is a tremendous amount of wear and tear at that joint. It often results in a little bit of swelling at the joint between the first metacarpal and the joint above it (proximal phalanx) of the thumb. My patients often mistake this for the problem. But when I press with my hand at that cup and saucer joint, they are usually exquisitely tender.
Once again, it is the ligaments!
There are multiple ligaments which are little ropes holding that joint together. In our modern society, using the keyboard, texting on the phone, cooking, cleaning, gardening, grasping while driving and a myriad of other things cause those little ropes to become frayed. Then the cup moves out of the saucer. That is when my patients tell me they feel a lot of pain. Sometimes resting or sleeping or relaxing can make the pain and swelling go away. What is happening here is that the cup has moved back in place. For those people who do not let the hand rest, these atypical pressures on the bone are the cause of arthritis.
What to do?
Don’t despair! When you have pain almost at your wrist, but directly below your thumb at the triquetrum and 1st metacarpal, you can see a practitioner who can re-align it for you. Yay!! The pain is better. But if it keeps moving in and out, then it’s time for Prolotherapy or PRP to strengthen those ligaments. There are associated tendons that help hold it in place and there will be a classic pattern of pain. We can treat all those areas which are tired from holding everything together. Ideally this is best treated before the arthritis appears, but we can still help once the arthritis starts!
Also please consider using a dictation system instead of typing by hand, and keep your driving to a minimum!
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