This column is about my experience as an alternative health care provider within the modern medical system. Although I now live in Morro Bay, I still manage a health care clinic in the San Diego area, as I have done for the past 25 years and where I still work 10 days out of each month.
Arthritis of the Thumb
byBrian Dorfman
In my last article I wrote about a situation with a young boy's thumb in which the top joint had been immobile for nearly two years following an injury he sustained by jamming the thumb. In an older person the joint would have been labeled as arthritic due to the calcification and swelling present. Within a few weeks of massage and manual manipulation of the joint, the arthritic symptoms were gone, along with the pain, and the thumb was well on the way to regaining full range of motion.
While this was a unique case—due to the young age of the patient, the traumatic nature of the injury and the particular joint affected—arthritis in the thumb is a very common problem. Arthritis in the basal joint, at the base of the thumb where it meets the wrist, is considered to be second in prevalence only to arthritis in the knee.
This joint is formed by a small carpal bone of the wrist and the first bone of the thumb, called the metacarpal. The unique saddle-shaped joint allows the thumb to have a wide range of motion, including up, down, across the palm, and the ability to pinch. This kind of motion is used to type and text, for example, as well as to hold a phone or portable gaming device and a fork, spoon, or knife.
Basal Joint (also called Carpometacarpal Joint)
Not only does immobility and discomfort in the basal joint cause many problems associated with working our hands, but the predisposition to get arthritic here is also a precursor to carpal tunnel issues. While the Mayo Clinic states on their website that the exact cause of thumb arthritis isn't know, they posit that age, weight, and repetitive motion are primary causal factors. In my opinion, however, it is the positioning of the thumb that is largely responsible for creating the arthritis, as well as repetitive motion carpal tunnel issues. For me, it's an issue of biomechanics, which is largely overlooked in the western medical model.
From a biomechanical perspective there's nothing emotional about alignment. It's not like saying this alignment looks good or doesn't look good. It simply comes down to structure. With regard to the structure of the joint, the correct and incorrect positions are a matter of anatomy. It's accepted knowledge in any medical or healing arena. It is not in dispute. And this is true with every joint in the body. It is a mystery to me why this very simple concept of structure and alignment is absent in the modern day consideration of joint health, especially thumb arthritis, which affects over 25 million people today.
Here's how it works: Check out how much you can move your thumb when holding down the basal joint, where the wrist and thumb meet. Many people get into trouble as they tend to lock that joint and use the second joint as their primary source of movement for the thumb. This is the joint above the basal joint, where the webbing of the thumb connects to that of the index finger, called the metacarpalphalangeal joint. You can actually immobilize the basal joint and retain about 80 percent movement in the thumb. So we think everything's just great and don't realize there's a problem until the joint becomes calcified and then arthritic. If the tension becomes great enough you also get the swelling and that's where carpal tunnel syndrome issues come in as well. (I will address carpal tunnel syndrome in more detail in a future post so stay tuned.)
See this short video that I put together for a visual explanation of thumb positioning.
So here's the good news. Experience has shown me that age and repetitive motion themselves do not necessarily lead to either arthritis or repetitive motion symptoms. My grandmother, for example, worked full-time as a secretary for Disney. She typed 120 words per minute for years. She knitted and crocheted regularly throughout her senior years. I had the opportunity to look at her hands when she was 94 and her hand and thumb alignment were perfect. She never had any problem with her hands despite the constant use and advanced age.
More good news is that the basal joint of the thumb is one of the easiest joints for a practitioner to adjust and position correctly—even if the joint has been out of alignment for a long time. If we're talking about a shoulder or a hip, for example, the joint can be difficult to access as it is shielded by layers of muscle and connective tissue. In the case of an elbow or a knee, there's actual bone in the way. But the thumb is right there for the taking. And, with the hand, unlike these other joints, the resistance is quite minimum.
At BDK we've had great success resolving chronic hand and thumb cases quickly and permanently because of the ease of repositioning the mechanics in the hand and the thumb. The design of the hand allows for that, more so than any other joint in the body. Coming soon, in a follow-up post, I'll present a case study of a woman who had attempted various treatments to address her debilitating hand problems, before finally finding permanent relief through the simple biomechanic-centered method described here. I will also detail simple hand exercises that anyone can do to prevent or alleviate hand and thumb discomfort. So stay tuned. In the meanwhile, if you are seeking relief for stiff and painful joints, find a practitioner who can help you benefit from this common sense notion of hand and thumb positioning. Finding relief for your painful thumb can be a snap. It's certainly worth a try.
