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OrthoAdvice™ Getting a Grip on Carpometacarpal Arthritis

By John Dietrich, M.D.

After and trigger more frequently or having difficulty per- finger, the third most common condition forming simple tasks that require pinch. we treat at Crystal Clinic Summit We confirm the diagnosis by getting is carpometacarpal (CMC) or basal their medical history, conducting a physi- arthritis. This arthritis affects the base of cal exam and ordering X-rays. the . Once CMC arthritis is identified, we As with other forms of arthritis, there start with conservative, nonsurgical is a loss of cartilage that cushions the treatments. These may include splint- bones. Perhaps the best way to under- ing, cortisone injections and activity stand this is to imagine two tires running modifications. against each other. Think of the rims as bones and the tires as cartilage, which Simple changes in your home can go absorbs shock. Over the years, the tires a long way to improve this condition. wear away and leave only the rims. This One of the best things you can do is to is essentially what happens as we age. replace items that have small handles When cartilage is lost, we end up with with thicker ones that fit in the palm bone on bone, causing pain and weak- of the hand and require gripping rather ness in the joint. than just your thumb and fingers. By gripping rather than pinching, you use Thumb arthritis is accelerated by over- your hand in a more biomechanically use and repetitive pinching motions over advantageous way. the years. Other causes include fractures or dislocations of the CMC joint at some Should these nonsurgical treatments point in life. fail, then we would consider surgery, known as CMC arthroplasty. This pro- Dr. Dietrich is a board-certified, fellow- From a young age, we are ingrained on cedure removes the arthritic bone and ship-trained orthopaedic surgeon. He how to do certain tasks and activities suspends the thumb with a from earned his medical degree at the University with pinch rather than grip. Grip uses the patient’s . People who have of Michigan. He completed his residencies the entire hand and involves muscles of this surgery are usually happy because the forearm and the back of the hand the operation is predictable in relieving in general surgery at William Beaumont to give power to squeeze. Pinch involves pain. For younger patients, we can take Hospital in Royal Oak, Michigan, and only the thumb and either the index or a different approach by building a liga- in orthopaedic surgery at the University long finger or both. ment for the thumb, which will make the of Pittsburgh. He served his fellowship in thumb more stable, but may not com- hand, upper extremity and microsurgery We primarily see CMC arthritis in pletely alleviate the pain. at Allegheny General Hospital/University women, and there are many reasons for of Pittsburgh. Dr. Dietrich specializes in that. Structurally, men have a bigger liga- If you think you may have CMC arthri- surgery of the hand and upper extremity ment that holds the thumb. Women lack tis, schedule an appointment with one this and have looser . of our specialists at Summit Hand. with an interest in disorders, fracture Other factors include occupations or Other general physicians who don’t see care, peripheral nerve surgery and arthri- hobbies, such as cooking or garden- hand conditions on a regular basis don’t tis. He has been a physician since 1983. ing, that require a pinching motion. understand the pathology and biome- Repetitive tasks over a long period of chanics the way we do. Plus, we have time wear out the joint. certified hand therapists who specialize in helping people select the most appro- Typically, when someone with CMC priate splint for their . Seeing a arthritis comes to our office, it’s because certified occupational therapist who has they are experiencing pain along with knowledge and expertise to help educate decreased grip and pinch, and they have you is well worth it. To learn more, visit crystalclinic.com noticed that they’re dropping things or call 1-888-502-3041.