Extremities

Rhizarthrosis - thumb arthrosis


Thumb saddle joint arthrosis

Signs of wear in the joints are a widespread complaint that can be accompanied by pain and restricted movement. On the hand, the thumb saddle joint is particularly often affected, which is referred to in the professional world as Rizarthrosis. Massive damage to the joint threatens with permanent loss of function.

Definition

Basically, osteoarthritis refers to excessive loss of cartilage on the joint surfaces and consequent degenerative changes in the joint. If the joint wear occurs in the so-called thumb saddle joint (named after the shape of the joint surfaces), which is formed by the first metacarpal and the large polygonal leg (Os trapezium), this is known in medical circles as rhizarthrosis. In the vernacular, there is usually talk of an arthrosis of the thumb. Other terms used are carpal metacarpal joint arthrosis, thumb saddle joint arthrosis, saddle joint arthrosis, continuum distortion of the thumb saddle joint or trigger band on the thumb.

Symptoms

The symptoms of a saddle joint arthrosis can vary significantly and are not necessarily to be seen in connection with the extent of the joint damage. It is possible that with imaging methods such as X-rays or computer tomography (CT) only slight signs of osteoarthritis can be seen and massive symptoms still occur. Despite clearly visible damage to the joints, pain and restricted movement can also be avoided.

Rhizarthrosis is the most common arthrotic diagnosis of the hand and women after menopause are particularly often affected. The joint damage often leads to pain, which initially occurs primarily under stress and usually shows up directly at the thumb saddle joint. However, the pain can also appear as a pull on the thumb and sometimes also in the forearm. In the further course of the disease, they are often also independent of stress. At the same time, there is usually a decrease in grip. Objects are difficult to hold and grip.

Joint swelling can also occur. With increasing damage, a rubbing noise can also be heard when moving, the joint can more easily disengage and there are also externally visible deformations.

Diagnosis

When diagnosing rhizarthrosis, the symptoms that occur can already provide important information, but there is usually no way around securing a diagnosis using imaging techniques. Above all, X-ray examinations but also computer tomography are frequently used methods. The changes in the joint can be determined relatively accurately in this way, and other diseases, such as tendovaginitis de Quervain or rheumatoid arthritis, can be excluded.

The diagnosis of osteoarthritis should be treated with caution, because sometimes the symptoms are not meaningful to the radiological diagnosis. This means that the X-ray image, for example, can show a lot of wear and even bony extensions, but the affected people do not complain or hardly complain. Conversely, it is also possible that the picture shows only slight signs, but the complaints are very pronounced. The extent to which therapeutic measures are required must therefore be assessed depending on the individual symptoms.

Treatment

The treatment of rhizarthrosis initially provides for various measures with which acute symptoms can be alleviated. Here, for example, anti-inflammatory non-steroidal anti-inflammatory drugs (NSAIDs) or rheumatism ointments are used to treat pain. Cortisone is also used in very rare cases. Protection down to immobilization with a special splint relieves the joint and is intended to avoid further damage. In addition, exercise and physiotherapy, with the help of which the cartilage in the joint is to be strengthened again, are also often part of the therapy.

If the thumb saddle joint is extensively damaged by the arthrosis, various surgical procedures can be used to restore its function. The damaged bones are either surgically corrected or they can also be replaced by a so-called endoprosthesis. Especially when implanting a prosthesis, problems with its durability can often be identified later. With the other surgical treatment options, complications can also follow, and long-term freedom from symptoms can by no means be achieved in all patients. Therefore, you should only think about it if the affected person suffers from clear symptoms and the other treatment options have been fully exhausted.

Naturopathy

In the naturopathic treatment of rhizarthrosis, manual therapies are mostly in the foreground, but other methods such as herbal medicine, hydrotherapy or homeopathy are also used.

The manual treatment according to the fascia distortion model (FDM) assumes in the case of punctiform pain at the thumb saddle joint from a disturbance in the bone-ligament transition, which is referred to as continuum distortion. The treatment is done with strong thumb pressure. If there is pulling pain, twisting of the fascia (connective tissue skins) is assumed to be the cause, which is treated along these lines with the thumb.

Medicinal plants that have proven themselves in various forms of osteoarthritis include, above all, dandelions and nettles. Most of these are taken as tea, but a cure with fresh dandelion stems or baths with added nettle can also help alleviate joint problems. Against the chronic pain of osteoarthritis, heat applications such as a warm hay flower sachet or infrared rays are also helpful. As a home remedy, a warm wrap with the porridge of boiled potatoes against chronic joint problems is recommended. (fp, tf)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch

Swell:

  • Rheumaliga Switzerland: occupational therapy for rhizarthrosis (access: August 14, 2019), rheumaliga.ch
  • Ruchholtz, Steffen / Wirtz, Dieter Christian: Orthopedics and trauma surgery essentials: Intensive course for further training, Thieme; 3rd edition, 2019
  • Spies, Christian Karl / Langer, Martin / Hahn, Peter / u .: Therapy of primary finger and thumb joint arthrosis, Dtsch Arztebl Int, 2018, aerzteblatt.de
  • Mayo Clinic: Thumb arthritis (accessed: August 14, 2019), aerzteblatt.de
  • American Society for Surgery of the Hand: Thumb arthritis (access: August 14, 2019), assh.org
  • American Academy of Orthopedic Surgeons: Arthritis of the Thumb (accessed: August 14, 2019), orthoinfo.aaos.org

ICD codes for this disease: M18ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


Video: 5 natural pain relieving ideas for thumb arthritis (November 2021).