Basal joint arthritis versus tendonitis of the thumb in a computer user

by Bill
(Sacramento)

Joshua,

I am a 39 year old male with no history of pain in my hands and very little family history of arthritis. I am a programmer and spend between 8 and 10 hours on the computer daily.

About 4 months ago, I noticed that I was having a sharp pain in the base of my thumb in the dominant hand when shaking hands with people. On closer inspection I noted some localized tenderness around the base of the thumb that seemed to be between the two sets of tendons running up the outside of the thumb.

I went to my doctor thinking that I had de Quervain's but she said that it's arthritis because the Finkelstein test didn't produce significant pain up the wrist. I started wearing a splint, using my left hand for the mouse and the space bar and taking lots of Naproxen but the pain didn't seem to go away.

I went back in to see the doctor a few weeks later and let her know that the pain seemed to be centered around the tendons. She said "Okay, well, rest it for a while. If the pain goes away, then it was tendonitis." Not a lot of help. I'm hoping you can help me figure out if I have tendonitis or arthritis.

Here are some other pertinent facts. Up until about 6 weeks ago, I sat slumped at my desk while typing with my keyboard high, relative to my chair. My wrists were resting on the desk when I was typing. I also have had knots in my right shoulder for the past year that haven't cleared up with chiropractic care. Finally, I have minor OCD and used to pinch my thumb and middle finger together for much of the day. Since I have been trying to figure out what has been causing my issues, I have corrected all of these past bad behaviors.

As far as pain goes, I feel no pain when I pinch things. I still feel sharp pain when shaking hands and slight pain when squeezing larger objects like big shampoo bottles or coffee mugs.

ROM is not really limited and I feel no grinding in the thumb. There seems to be really slight swelling in the area around the tendons but no redness or warmth. I do feel a slight pain when I stretch the thumb in a hitchhiker position but only in certain positions as I rotate it around. I feel no pain when moving the thumb toward the fingers or across the palm.

That was probably overkill on the details but I'm hoping you can help me determine if these symptoms sound like tendonitis or arthritis.



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Joshua Answers:


Hey Bill. There is no such thing as overkill on the details. The more the merrier. Saves us time and back and forth.

I doubt very much that you have arthritis. Certainly have some downides from overuse over time.

Gotta love them doctors......that's really all she did to declare that you have arthritis??

Maybe you have Tendonitis. Maybe you just have a tendonitis dynamic, meaning a progressive Pain Causing Dynamic of increasing pain and tightness.

I suspet there is some joint irritation, from tight muscles pulling the two bones together as well as increased pressure from use.

At this point, I'm going with that you have a minor bone bruise (hurts when the pressure from shaking hands compresses the bones) and some VERY tight thumb muscles and a chronic, sub-acute Process of Inflammation.

The bad news is, it hurts. The good news, it's totally reversible.

1. Ice dip and ice massage as directed on the How To Reduce Inflammation page.

2. Start poking/massaging around in your thumb pad muscles and against the joint. You will find some VERY tight small bands of thumb muscle, and likely a hot spot or three in there, on the tendon, against the bone of the joint.

First rub the muscles until they hurt less and soften up. Then start working the tendon attachements and painful bone spots.

Do this for steadily for a couple weeks. You will absolutely have less to no pain if you keep at it.


Also, those knots on the back aren't going to go away, from a chiropractor or any other source, until you change the posture of the front of your neck.

You described it well, the cliche computer user slouched forward posture. This shortens the tissue on the front of your neck and the front of your chest and shoulders. This overworks those muscles on the back.

More chiropractic just isn't going to get rid of them.


And it's great you're switching sides for the mouse. That's the best ergonomics, switching things up. See the New Ergonomics page.


More questions, more answers.







Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com