Why does the base of my palm hurt so much?

This is the 4631st article of Da Yi Xiao Hu

Uncle Wu has been running a delivery business at a courier station in recent years. He works very hard and often has pain at the base of his right palm. Recently, it has become more and more painful. Not to mention the work in the store, even housework is very difficult. Uncle Wu felt that applying ointment was not very effective. Seeing that he could not bear it any longer, he had to go to the outpatient clinic of the joint department for treatment. After the doctor examined him, he asked Uncle Wu to take an X-ray. The report indicated that Uncle Wu had degenerative changes in the first carpometacarpal joint, narrow joint space, and bone hyperplasia. The doctor told Uncle Wu that he had arthritis of the first carpometacarpal joint, and told Uncle Wu to rest well, reduce hand activities appropriately, and not to be too tired from hand activities. It would be best if he could wear a brace. He also prescribed Chinese medicine fumigation and ointment for Uncle Wu. After wearing the brace and using the medicine prescribed by the joint doctor, Uncle Wu's pain gradually improved. He also paid more attention to protection when working to avoid further aggravation of the disease.

So what is first carpal arthritis?

First carpometacarpal arthritis is inflammation and degeneration of the first carpometacarpal joint (the joint at the base of the thumb). This condition causes symptoms such as joint pain, swelling, and limited range of motion. It is usually caused by joint strain, degeneration, or other factors.

How does one get first carpal arthritis?

There may be many reasons for the occurrence of first carpometacarpal arthritis. One possible reason is degenerative changes in the joints, i.e. osteoarthritis. With age, the articular cartilage may wear away, resulting in a smaller joint space. When the thumb moves, friction may occur between the upper articular surface (base of the first metacarpal bone) and the lower articular surface (distal end of the trapezium), leading to a series of clinical symptoms such as pain, limited movement and thumb deformity. Long-term heavy manual labor on the hands may lead to local overstrain, which in turn causes carpometacarpal arthritis. At the same time, local cold stimulation may also trigger an inflammatory response.

How is carpometacarpal arthritis diagnosed?

The diagnosis of first carpometacarpal arthritis is usually combined with a doctor's physical examination and X-ray examination. The doctor can find obvious tenderness at the first carpometacarpal joint and a positive first carpometacarpal joint grinding test through physical examination. X-ray examination can show imaging changes of the joint, such as narrowing of the joint space and subchondral bone sclerosis. Combining this information, the doctor can make a diagnosis of first carpometacarpal arthritis.

What should I do if I have arthritis of the first wrist?

① Rest and reduce load

Avoid overuse of the affected wrist and give the joint adequate rest.

Cold or hot compress: Depending on your personal experience, you can try to use cold or hot compress to relieve joint pain and swelling. If there is acute severe redness, swelling, heat and pain, you can use cold compress; if the pain is not severe, the pain is dull and relieved by warmth, you can use hot compress.

② Drug treatment

Under the guidance of a doctor, nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to relieve pain and reduce inflammation, especially topical nonsteroidal anti-inflammatory drugs, which are currently widely used in clinical practice and act directly on the affected area of ​​the hand, with more obvious and direct effects.

③Physical therapy

A physical therapist can design a personalized rehabilitation plan that includes range-of-motion exercises, muscle strengthening, and pain relief techniques.

④Wrist brace or orthosis

In some cases, your doctor may recommend a wrist brace or orthosis to provide support and relieve pain.

⑤ Local injection therapy

In severe cases, your doctor may consider injecting a class of anti-inflammatory drugs called corticosteroids around the joint to reduce pain and inflammation.

⑥Surgery

In rare cases, your doctor may recommend surgery if other treatments haven't worked.

Are there any good solutions in traditional Chinese medicine?

The treatment of wrist and palm arthritis by traditional Chinese medicine mainly follows the principles of promoting blood circulation and removing blood stasis, removing rheumatism, and regulating qi and blood. First, Chinese medicine can be taken orally or applied externally to regulate the internal environment of the body and eliminate inflammation. Secondly, acupuncture therapy can stimulate acupoints, harmonize qi and blood, and relieve pain. Thirdly, massage can relieve muscle tension and promote joint movement. Finally, Chinese medicine fumigation can absorb the drug through the skin and directly act on the lesion, achieving the effect of promoting blood circulation and removing blood stasis, and relieving inflammation and pain.

How to prevent first carpal arthritis?

①Avoid overuse

Avoid prolonged overuse of the wrist-metacarpal joint, especially during repetitive activities. Proper rest and reduced joint load are important measures to prevent arthritis.

②Protect joints

When lifting heavy objects or doing strenuous exercise, pay attention to protecting the wrist and metacarpal joints to avoid injury. Wearing appropriate protective gear or support can provide additional joint stability.

③Maintain good posture

Correct posture can reduce unnecessary stress on the wrist-metacarpal joint. Maintain correct hand posture at work, especially during long-term activities such as using a computer or mobile phone.

④Exercise and stretching

Regular exercise and stretching of the hand joints can strengthen the muscles and ligaments around the joints and improve joint stability and flexibility.

In short, the treatment of first wrist arthritis is a comprehensive process, which needs to be combined with the patient's specific condition and the doctor's advice. Patients should pay attention to maintaining good living habits, strengthening exercise, and strengthening the muscles around the joints to reduce the burden on the joints. At the same time, maintain a positive attitude and cooperate with the doctor's treatment. I believe that you can recover soon. In our daily life, we should also pay attention to the protection of the hand joints, avoid excessive strain, and prevent the occurrence of diseases.

Author: Quyang Road Community Health Service Center, Hongkou District, Shanghai

Acupuncture and Traumatology Lu Wenting

Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine

Department of Joint Surgery, Orthopedic Trauma Center, Feng Shengyi and Li Bo