Are you experiencing persistent pain at the base of your thumb? Are day-to-day hand movements, tasks and activities becoming difficult? Is your thumb feeling unstable?
If you have started to notice these signs, you may well want to think about going to see a hand specialist.
This forms part of a comprehensive approach to understanding the condition. It comes under the ‘Understanding rhizarthrosis‘ section, which details the causes, symptoms and stages of progression of rhizarthrosis.
You do not always need to consult a specialist at the start
Initially discomfort in or around the thumb can be treated by a general practitioner, a rheumatologist or a physiotherapist.
They may start you on a conservative treatment (painkillers, brace/splint, physiotherapy), recommend changes in the way you move your hands or perform your tasks and activities, or prescribe scans.
But when the pain becomes more frequent or persistent, or your hand function deteriorates, consulting a hand surgeon may be a good idea, even if there is no immediate surgical indication. He/she is the specialist best placed for detailed assessment of the situation, based on the specific features of the trapeziometacarpal joint.
Signs to look out for
Certain signs may indicate that the condition is progressing, and that it would be a good idea to consult a surgeon:
In the above case, it may be a good idea to review your day-to-day hand movements and start using grip aids, or to try gentle warm-up exercises for joint relief.
The role of a specialist: pinpointing the diagnosis and offering personalised solutions
The hand surgeon will start with a thorough clinical examination and then inspect the images available (X-rays, sometimes MRI scans or ultrasound).
He/she will also examine the functional impact: What hand movements are restricted? How frequent is the pain? What is the patient looking for?
This consultation may give rise to various options:
When should you consider surgery?
Surgery is never suggested lightly. It only becomes an option when:
There are a range of surgical techniques available: trapeziectomy, trapeziometacarpal (TMC) prosthesis, or more conservative procedures, depending on the stage of progression. Choosing which one depends on the patient’s profile (age, activity, level of discomfort).
For further information on the issues, click on: Trapeziectomy or TMC prosthesis?
And for further information on post-operative recovery, click on: Duration and stages of recovery after thumb surgery
Should you wait until a certain stage before consulting a specialist?
No. It is never too early to seek a specialist opinion. A consultation can sometimes help with:
This also applies if you are affected at a young age: Rhizarthrosis in young adults is not rare and require specific treatment.
How to find a hand specialist?
Hand surgeons work in hospitals, clinics or private practices.
It is a good idea to ask your GP for a letter to make it easier to arrange an appointment within the care pathway.
