Thumb Pain and Prolotherapy
Noel Peterson, N.D.
When B.B. first saw me for thumb arthritis, she had already been offered cortisone injections or surgery by her orthopedist. Her x-rays showed moderate arthritic changes to the thumb joints in both hands. She believed that taking Advil daily was too risky, and she was not willing to sacrifice her otherwise good health for pain relief. And besides, she knew drugs were not going to heal her thumb. Still, the pain was constantly present, and she had mild swelling and decreased strength and range of motion, making it difficult to do simple household tasks, such as turn doorknobs and open jars. And what was worse, the pain had forced her to give up knitting and other crafts, and now simple daily tasks at home and work were becoming painful.
The good news is that after 6 prolotherapy treatments over the course of 4 ½, months, B.B. is pain free in her thumbs and has resumed all of her activities. And B.B. was not alone…
M.B., a spry gardener in her 70’s, needed both hands to lift even small pans on the stove, or dishes from the cupboard, or to grasp her garden tools. Her X-rays showed advanced thumb arthritis. Yet, after just 6 treatments she has resumed all of her normal activities, including gardening, without pain, and no pain medications.
M.C., a semi-retired machinist and farmer, brought his x-rays showing OA of his thumbs. He can now work on the farm free of thumb pain.
S.H. had pain in both thumbs that made most gripping activities painful. She could not just stop doing the things she enjoyed just because of arthritis. Her thumbs had a grinding feel to them on examination. Still, after 7 prolotherapy treatments her pain was gone and she was using her hands normally.
H.L., a piano teacher in her 70’s, was losing the ability to reach the keys when playing difficult cords. Now she is playing Rachmananoff!
Most of my other patients with thumb arthritis have done equally well with prolotherapy.
What Causes Thumb Pain?
The thumb is generally considered to be the most important single digit in the hand. The basal joint of the thumb, or carpometacarpal joint, is made up of a wrist bone (trapezium) and the first (metacarpal) bone of the thumb is subjected to an unusual amount of stress. The thumb must be strong enough to counteract the force of four fingers put together. It has been calculated that one pound of pinch between the thumb and index finger will produce six-to-nine pounds of pressure at the basal joint of the thumb. In a normal thumb joint, cartilage covers the ends of the bones — acting as a cushion and allowing bones to glide smoothly against each other.
With thumb arthritis, the ligaments and joint capsule become thin, weak, unstable and painful. Eventually the cartilage that covers the ends of the bones deteriorates and its smooth surface roughens. The bones then rub against each other, resulting in friction and joint damage. Over time, the degeneration and pain worsens.
Conventional Treatment Options:
NASIDS: All NSAIDS (Advil, Motrin, others). Side effects may include ringing in your ears, gastric ulcers, cardiovascular problems, gastrointestinal bleeding, and liver and kidney damage. NSAIDS use causes over 20,000 deaths yearly in the US.
Injections: Corticosteroid injections can offer some temporary pain relief, but they have serious drawbacks including nerve damage, accelerated joint degeneration, and decreased resistance to infection.
Arthroscopic surgery: Most often performed during the early or middle stages of thumb arthritis.
Joint fusion (arthrodesis): Surgeons permanently fuse bones in a joint to increase stability and reduce pain. The fused joint can then bear weight without pain, but has no flexibility.
Osteotomy: In this procedure, surgeons reposition your bones to help correct deformities.
Trapeziectomy: In this procedure, the surgeon removes the trapezium bone that sits adjacent to the joint.
Joint replacement (arthroplasty): In this procedure, surgeons remove all or part of the joint and replace it with a graft from one of your tendons.
After surgery, the thumb and wrist is placed in a cast or splint for up to eight weeks. Once the cast is removed, patients work with a physical therapist to help regain hand strength and movement. Recovery is slow and patients do not generally resume normal activities for six months after surgery.
Naturopathic Treatment: Only nutrition and prolotherapy can restore the strength and restore cartilage to the surface of the joint, without surgery.
Prolotherapy: A small needle is used to inject a solution containing dextrose, glucosamine and procaine into the joint and ligaments of the thumb. This causes new tissue growth and repair. Treatments are repeated every 3-4 weeks for up to six treatments, and then repeated 1-2 times yearly to maintain the improvement.
Nutritional Supplements: Supplements designed to help repair your joints are taken daily. Side benefits include improvement of all your joints.
Contrast the benefits and economy of prolotherapy to the side effects and expense of conventional treatments and you will see why I am so excited to be able to offer prolotherapy to my patients, and why I intend to publish the results of treating 30 patients with thumb pain.
Enroll in the CTM Thumb Study
If you are having thumb pain, don’t wait until surgery is your only option. Treat this condition early with prolotherapy, while your thumbs can still be healed. Consider enrolling in our study so that the benefits of this treatment will someday be available to everyone with painful thumbs.