Arthritis Treatment


Dr. Brian Tobias says arthritis affecting the base of the thumb is a common issue his patients experience. Arthritis treatment can begin with a splint and oral anti-inflammatories, possibly followed by steroid injections. Surgery using minimally invasive techniques can be performed if these solutions don't provide the desired results.

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[00:00:07.280] So a common problem we see at the Hand to Shoulder Center [00:00:09.640] is arthritis at the base of the thumb. [00:00:11.160] And people will first complain of pain in this area, [00:00:13.840] especially with pinch, turning a key in the door, opening a jar. [00:00:17.400] So with thumb base and joint arthritis, [00:00:19.280] I think the first thing is for people to understand exactly what the problem is. [00:00:22.480] So we often describe this bone [00:00:24.280] as a rider sitting on a saddle on the horse. [00:00:26.320] And where the problem occurs is between the rider and the saddle. [00:00:29.400] And once arthritis sets in, [00:00:31.440] then, of course, you can have changes in the joint, [00:00:33.640] changes in the alignment of the thumb, and that can affect function. [00:00:37.400] Treatment options generally start out as nonsurgical. [00:00:40.400] That includes a splint that they'll wear [00:00:42.160] for periods of time during the day and night, [00:00:44.080] and oral anti-inflammatories. [00:00:46.080] If that does not take care of the problem, then the next step up [00:00:48.840] is to do a steroid injection into the joint, [00:00:50.720] which we do here in the office. [00:00:52.560] And then, of course, if steroid injections take care of it, [00:00:55.760] but only on a temporary basis, [00:00:57.480] then we start to talk about the surgical options, [00:00:59.600] which sometimes can include arthroscopy in this joint, [00:01:02.480] and/or reconstructions of the joint. [00:01:05.040] So what we like to do, obviously, after we meet the patient [00:01:08.840] is to listen to what their chief complaint is regarding that, [00:01:12.080] and if their description matches thumb base or joint arthritis, [00:01:15.880] then, of course, we'll get X-rays, show them the X-rays, [00:01:18.720] and use, obviously, internet pictures [00:01:20.600] to demonstrate the various treatment options. [00:01:23.000] So for arthroscopy, [00:01:25.080] generally the recovery is a post-operative dressing for a week [00:01:28.440] and then they go to the therapist, they're fitted with a splint. [00:01:32.440] There are only two one stitch incisions, so those stitches come out at two weeks. [00:01:36.600] And then at the two week to six week mark, people are put in a home therapy program, [00:01:41.280] graduate out of their split, return to their regular activities. [00:01:44.320] For the reconstructions, [00:01:45.600] the mobilization is slightly longer, usually about four weeks. [00:01:48.560] Stitches do come out in two weeks, [00:01:50.280] and then again it's a similar home therapy program [00:01:52.880] progressively graduating out of the splint, [00:01:54.680] returning to the regular activities. [00:01:56.800] For someone to decide whether surgery is appropriate for them [00:02:00.040] is generally based on the fact that their symptoms persist [00:02:03.080] despite nonsurgical management. [00:02:05.160] If they continue to have symptoms [00:02:06.800] despite being compliant with a nonsurgical management program, [00:02:09.800] and/or they've had an injection in this area and it's failed [00:02:12.760] or it just hasn't lasted that long, [00:02:14.680] then there's usually an opportunity [00:02:17.440] to talk about what the surgical options are to increase their function.

Hand to Shoulder team in the surgical suite

The Hand to Shoulder Center

At The Hand to Shoulder Center in Fort Worth, TX, our team of fellowship-trained hand, elbow, and shoulder surgeons treat any and all conditions from the shoulder to the fingertip. Our surgeons perform both elective and reconstructive procedures, including:

  • Joint Replacement
  • Traumatic Injury Surgery
  • Arthroscopic Surgery
  • Microsurgery
  • Minimally Invasive Surgery
  • Wide Awake Local Anesthesia Only Surgery

Our physicians are associated with the American Society for Surgery of the Hand and the American Board of Orthopaedic Surgery. For more information or to request an appointment, please contact us online or call (817) 420-9238.

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