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
















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

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Nov 16, 2009
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starstarstarstarstar 		PART 2 - Shoulder DVD? - Basal joint arthritis versus tendonitis of the thumb in a computer user
by: Bill

Joshua, I can?t thank you enough for taking the time to respond to each of these e-mails individually! That is really all my doctor did for me. Getting information out of her on this particular subject has been like pulling teeth.

Your information is helping me confirm what I suspected re: pain-causing dynamic as opposed to arthritis. I had not thought of massaging the thumb pad ? I had been focusing on the outside of the thumb because that was where the pain was felt. It makes sense, though. Within two weeks of using the left hand for the mouse (prior to changing posture), I noticed some dull pain in the base of the left hand. I?ll definitely give the massage idea a whirl.

Since discovering your site, I have been ice dipping frequently and have added calcium/magnesium/vitamin D to my daily supplements. I also started increasing my healthy protein intake with chicken and grass-fed pork. Prior to noticing the pain in my hand, I had been cutting way back on eating meat to keep my cholesterol low. Between that and my posture/shoulder issues, it seems only natural that the pain would radiate to my hand eventually.

Now that I have been paying closer attention to the pains that have been cropping up, I?ve noticed that everything seems to be happening on my right side. For a couple of weeks, I had pain just above the elbow on the outside of the right arm. I've also had pain in different spots below the right elbow. In kind of a ?duh? moment, it dawned on me that I sleep mostly on my right side and that I had been waking up with pain in the shoulder. So, in addition to everything else, I?m trying to train myself to sleep on my back in order to reduce the aggravation.

With all of that said, my concern is that if I make all of these changes and my body still doesn?t respond positively, I will want to attack my shoulder pain issues more aggressively. Do you have any DVDs or would you recommend any methods for treating and relieving shoulder tightness?

Thanks again for all of your help. I have an 18 month old son and the thought of not being able to be fully active with him due to a progressive disease like arthritis has been a little overwhelming. I kid you not when I say that your site has been the only one on the web where I have found comprehensive, sensible advice written in layman?s terms.


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Joshua Comments:

Great!

The upside of pain, is that it's a great learning opportunity.


I'll hopefully have a shoulder ebook out by the first of the year. The DVD thing just seems to have become way too hard. Seems like it would have gotten easier.....

And whatever you source of motivation is, child or otherwise, keep at it!
Apr 18, 2011
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starstarstarstar 		Other options
by: Jcat

Hi! I know that this all was written in 2009, but I was reading it and maybe others are still "stumbling" upon it. I am a Licensed Massage Therapist and have been for 15 years. I've been looking up issues for MY thumbs, as I unfortunately have had "loose joints" my whole life and even though very careful when working on my clients...I will still, on occasion have problems with my thumbs/wrists, and elbows as well.
What I was hoping to hear Joshua recommend for the "chronic" shoulder tension...was massage. Chiropractic is awesome...but it only puts the spine back into alignment. If you find one that can take care of the appendages, arms, legs, hands, wrists, etc., then that's a bonus...BUT AGAIN...it ONLY deals with joints and bones. It does NOT "relax" the "stressed" or "chronically tight" muscles that are responsible for pulling the 'bones' or 'joints' "out" of alignment...in the FIRST place. You HAVE to have manual manipulation of the muscles, or rather the 'trigger points" in the muscles, to help rid the body of chronic stress and relieve pressure on the injured or swollen tendons.


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Joshua Comments:

Here's what I said about Chiropractic: "More chiropractic just isn't going to get rid of them."

Though I totally agree with what you said about that.

Here's what I said about massage: "First rub the muscles until they hurt less and soften up. Then start working the tendon attachements and painful bone spots."

I agree with what you said about massage, except where you said you HAVE to have manual therapy. There are a variety of options. Maybe a person just needs to make sure their body has enough magnesium so the muscles actually have the ability to relax. Maybe one needs to change one's posture, so the brain will stop telling certain muscles to be chronically tight.

You have thumb issues Jcat, clearly massage is not the -only- thing that makes a difference, or you wouldn't have any problems (though one could make the case that you don't massage yourself enough/get enough massage from a massage therapist).

Each problem is made up of a variety of factors. Ideally, you deal with each factor with the most effective treatment option.
May 13, 2013
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starstarstarstarstar 		Switched it up before hand surgery....
by: Darlene

I had severe pain in my right thumb. Diagnosed with Basal Thumb arthritis. Surgery required. While awaiting surgery, I totally changed to using the mouse and space bar with my left thumb/hand. So now I'm beginning to feel the same severe pain in my left. Guess I'll need to get a splint for that hand now....

My question is, can it be that the constant use of keyboard and mouse are killing my hand/thumbs??

I cannot take Nsads only use Arthritis Pain tabs.


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Joshua Comments:

Hi Darlene.

Well, it -looks- like it's the computer/mouse use, but really it's that your body isn't operating optimally and thus 'taking abuse'.

Not enough of the right nutrition for the body to work right, muscles and connective tissue too tight (and thus causing compression of the joint tha tis causing the arthritis symtoms), chronic inflammation process, and repetitive motion which now adds irritation to an already irritated dynamic.

How exactly is surgery going to help that, I wonder?

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