Arthritis in Hands, Surgery?

[Tony (Charleston WV)]

I started developing arthritis in my wrists and hands about five years ago.  (Dad gave me the gift of kidney stones, Mom's responsible for the arthritis gene.)  Lately, in my dominant hand, it's hit my thumb pretty severely. (The thumb on the other hand is not too far behind.)  I'm  concerned that it won't be too long before I'll have to curtail the use of hand tools, or stop altogether.

The options according to the opinion of the consensus best "hand guy" orthopedist in my neck of the woods are:  NSAIDs (which will eat holes in my stomach), repeated cortisone injections (with a very low likelihood of success), or carpometacarpal (CMC) joint fusion surgery (which the doc highly recommends over the other options).  I plan to (continue to) do whatever I can to avoid further deterioration and to avoid getting sliced up, but nothing I've read suggests the condition will improve if left alone. 

I'm posting because I'd like to hear from anyone who's gone through the surgery.  Successful?  Difficulty, duration of rehab?  Mobility after surgery? Ability to continue using hand tools.  Accommodations employed to do so?  (I keep thinking about Les Paul who, after his right arm was broken in three places and his elbow totally crushed in an almost fatal car crash, had the bones in his picking arm set at 90 degrees, so that he could continue to play.) It's hard for me to understand how you can have two bones, even relatively small ones, fused and still retain a high degree of mobility, as claimed by the doc and several of the articles I've read about the procedure.)

Mods-feel free to move this to the basement if that's appropriate.  I would argue that there's a sufficient nexus with woodworking because 1) you need your hands to do it (duh!), and 2) the hand guy is a budding ww'er who just bought a Saw Stop.  (I think he should take up an instrument instead.)

Thanks,  

(Wanna hear about my prostate? 

 )

[cputnam]

To the extent that you can avoid surgery, I'd say do so, even if you have to use lower dose opiates.  Don't forget the orthopods are surgeons and what they do is cut.  Once that (pills) option is exhausted you will want to have already checked outcomes from the same procedure across the country.  Pills may get you through several more years - just don't get too far into them.  Would this doc be your surgeon?  If so, ask how many he's done and ask for the outcome distribution.

Sorry I could not be of more help.

[Howard Pollack]

NSAIDs are known for being hard on the stomach, but that is not the case for everybody.  I have a friend who has been taking Aleve every day for years and years without any side effects.  Personally, I'd try most anything before going in for the surgery.  If I were to consider that I would want to talk to as many people as possible who had been through the same surgery to see what kind of results they got.
           -Howard

[HomerLee]

It would help to know what kind of arthritis you have.

[msalomon]

First, if your arthritis is not too extensive (mine is just in the lower joint of the thumbs) ask your doc about Voltarian gel.  It's a NSAID but it is topical so you apply it to the joint rather than ingest it orally. It's a bit like Aspercreme but much, much more effective.  Next, don't discount the steroid shot--it can last for a year and be very effective.  Save the surgery for when there is not other option.

[JimBob327]

which knuckle
both of my thumbs are shot
8 months ago I had the bottom knuckle replaced on my left hand,
it involves moving a tendon in your wrist & also putting in a plastic block at the base of your thumb
couple of casts & P/T
wrist & hand still ache but vastly improved, how ever weird twitches & feelings in my index finger for some reason
going to have to do the right one soon

Bob

[Scoony]

Mine is in the main joints of the index fingers, both. It can make holding a chisel a painful task. I also have pretty bad arthritis in my back. I take Mobic when the pain starts to get bad. Exercise, running and weight lifting has really helped my back.

I have heard that a hot wax bath is good for arthritis in the hands and plan to get one soon.

[hbmcc]

After two spinal decompressions with mixed to no results I am leary of surgery and the doctors doing same. Have an on and off again relationship with shoulder replacement, a killer when planing and sawing. Both Orthos I have seen have the world records for shoulder innovations and surgeries. They have been at it long enough to have repeat customers surpassing new. They make me feel like a samurai victim; or mongolian grill dish.

I quit the designer drugs shortly after they came out, oxycodone, and another--morphine is tiny and very bitter. Shortly after those my stomach told me NSAIDS were too much. Now, I compensate by being in bed a few hours longer, and playing human rotisserie. Hips and knees are acting up. This said, have bumped into so many who make compensatory surgeries a routine habit. One lady has a 3-acre 'weed patch'--Puget Sound people understand the rampant implications--and multi multiple operations with eagerness to continue both.

(From a high of 25 a day, I have graduated to 18 pills five years later. Wanna compare ailments?)

So much for the dumb gloats....

We are all different. My mom had other complications, but went to her casket with arm movements little better than that final repose. I swore I would never be that crippled. Trump and cronies have other ideas, however. They aren't fully twisted into pretzels, so my hand gripes are whiny reactions at the moment. I can still hold a hammer and use it for about 20 minutes. Initially. Aim is pretty awful though. Maybe, that's rotation track causing missed swings.

Mom said exercise staved off deterioration.

[Ken Vick]

As a follow to the question that Homerlee asked above, have you been seen by a rheumatologist?  If not it would be a good idea to do that if nothing else but to rule out rheumatoid arthritis.  Involvement of the wrist joints is somewhat suggestive of RA which I have.  RA is a more serious systemic condition than osteoarthritis so it should have been ruled out.  There are effective treatments for it.  

I have had a couple friends have the surgery for basal joint arthritis and they say they should have had it years ago.  I also have this in addition to the RA and my rheumatologist cautioned that the operation will cause some permanent loss of strength in the thumb so I have resisted doing it but the aching and pain are reaching a level when I may have to do it.  If so, I will have it done just before my Florida sojourn so that it can heal when I am not doing woodworking before I return north.  

I have had numerous cortisone shots in finger joints, wrists, elbows, knees and ankles over the years.  They are very effective.  They can be given safely every 3 or 4 months and that usually will be often enough to relieve most of your symptoms.  I took non-steroidal drugs daily for 7 years but not for the last couple years.  They helped the arthritis symptoms but I developed a lot of stomach issues and research in the last few years have shown that regular use of them increases your risk of heart attacks.  Not worth the risk for me. 

 For me I don't dread the operation, these are as common as can be these days, but I won't like the restricted activity while it heals.  The loss of strength thing is also something to think about.  I play the guitar for my ears only and strength in your left thumb is important for that.  Good luck with what ever you decide to do--and see a rheumatologist if you haven't.  Ken

[daddo]

My fingers are getting stiffer this year. It's strange, the only regret I really have is someday not being able to play my old guitar I've befriended for 45 years.