Thumb Pain and Treatment in Hampton Roads

By Nicolai Baecher, MD

To you, it’s pain in your thumb. As an orthopaedic surgeon with a specialty in hand surgery, I see things differently.

There are 27 bones in the hand, and 34 muscles that move the fingers and thumb. That’s 17 in the palm of the hand, and 18 in the forearm.

It’s my job to know about every intricate aspect of the hand, from flexor pollicis brevis to the metacarpophalangeal joint (also known as the MCP).

Did I lose you? Don’t worry – there’s no quiz! What I want to convey is that there’s a lot happening underneath the surface of what may seem simple.  Picking up a pen, shaking someone’s hand, opening a door — those movements are actually complex, and so is your hand. 

That’s why if you’re experiencing chronic hand pain it’s critical to see the right medical professional with the right training to treat you.

The most common hand arthritis I treat is at the base of the thumb. This is called basal joint arthritis, and it’s more common in women than men. In fact, in people over 75 years of age, 90% of women and 80% of men have some evidence of arthritis in the fingers.  Too often, patients tell me they have been experiencing this pain for years, or even decades. Many of them have managed it with over the counter medications, like ibuprofen (an anti-inflammatory) or acetaminophen, but that’s not enough anymore.  Sometimes, by the time I see these patients, surgery may be the only good option.

Some patients are fearful that if they go to see a surgeon, the answer is undoubtedly surgery—which is why they delay seeking medical advice. While I understand that fear, I’m here to say that’s not the case. In fact, I’m a big advocate of exploring non-surgical treatments before going into the OR.

Here’s what really happens in an appointment with me –

First and foremost, I get to know you: what you like to do, what you need help with, and learn about what you’re experiencing.

Many problems can be managed without surgery, and I will try to explore what we can do non-operatively to reduce pain and help you regain mobility. That may include:

  • Steroid injections.The most proactive step we can take, a cortisone injection starts to relieve symptoms after a few days and its effects can last up to a few months.
  • Hand therapy & splinting. I work closely with physical and occupational therapists who do custom splinting and hand exercises. A critical part of the care team, their goal is to work with you to control pain and swelling. Many times, patients only see their therapist a few times before experiencing great results.
  • Medications. Medications are always evolving and changing, and so is our knowledge.  Sometimes a simple change can have profound results.
  • Surgery. Of course, sometimes the best solution to the problem is surgery, and that’s why I’m here: To take care of you and your hands from the first step to the last in order to keep you doing what you love to do.

So, before surgery becomes your only good option–come see me. My goal is to help patients stay active for as long as possible. The sooner you address your pain, the sooner we can get you back to your life!

To learn more about Dr. Baecher, click here.

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