Rhizarthrosis - thumb arthrosis

Carpometacarpal joint osteoarthritis

The signs of wear in the joints are a widespread complaint, which can be accompanied by pain and restricted mobility. The thumb saddle joint is particularly often affected by the hand, which is referred to in the art as Rizarthrose. It threatens massive damage to the joint with permanent loss of function.

contents

• Carpometacarpal joint osteoarthritis
• definition
• symptoms
• diagnosis
• treatment
• Naturopathy

definition

Basically, osteoarthritis refers to excessive cartilage loss of the articular surfaces and consequent degenerative articular changes. When joint wear occurs in the so-called thumb saddle joint (named after the shape of the articular surfaces) formed by the first metacarpal bone and the large polygon bone (os trapezium), it is referred to in the medical community as rhizarthrosis. In the vernacular, there is usually talk of a thumb arthrosis. Other terms used are carpal artery joint arthrosis, thumb saddle joint arthrosis, saddle joint arthrosis, continuum distortion of the thumb saddle joint or trigger band on the thumb.

The saddle joint on the thumb allows high mobility, but is often affected by osteoarthritis. (Image: Jorma Bork /pixelio.de)

symptoms

The symptoms of a saddle joint arthrosis can vary significantly and are not necessarily related to the extent of joint damage. It is possible that in imaging techniques such as X-rays or computed tomography (CT) only slight signs of arthritis are recognizable and yet massive discomfort. Also, despite clearly visible joint damage, pain and restricted mobility can be avoided.

Rhizarthrosis is the most common arthritic diagnosis of the hand and postmenopausal women are particularly often affected. The joint damage often leads to pain, which initially occur primarily under stress and usually punctiform show directly on the thumb saddle joint. However, the pain can also occur pulling the thumb and sometimes in the forearm. In the further course of the disease, they are often also independent of stress. At the same time, usually a decreasing grip force is evident. Objects can be badly caught and grasped.

Arthritis in the thumb saddle joint can trigger pain, restricted mobility and deformity. (Image: Astrid Gast / fotolia.com)

Swelling of the joint can also be added. In addition, with increasing damage, a rubbing noise is sometimes audible during movement, the joint can be more easily ejected and it also shows externally visible deformations.

diagnosis

In the diagnosis of a rhizarthrosis, the symptoms can already provide important clues, but leads to a diagnosis by means of diagnostic imaging usually no way around. X-ray examinations as well as computed tomography are frequently used methods. The changes in the joint can be relatively accurately determined in this way and other diseases, such as a Tendovaginitis de Quervain or rheumatoid arthritis can be excluded.

The diagnosis of osteoarthritis is sometimes to be treated with caution, because sometimes the symptoms are in no meaningful relation to the radiographic diagnosis. This means that on the X-ray image, for example, a strong wear and even bony edge attachments can be recognizable, but those affected do not or hardly complain about complaints. Conversely, it is also possible that the picture shows only slight signs, but the complaints are very pronounced. The extent to which therapeutic measures are required should therefore be assessed on the basis of the individual symptoms.

treatment

The treatment of a rhizarthrosis initially provides various measures with which acute symptoms can be alleviated. For example, anti-inflammatory nonsteroidal anti-inflammatory drugs (NSAIDs) or rheumatic ointments are pain relief agents. Cortisone is also used in very rare cases. A protection to rest position with a special rail is used to relieve the joint and should prevent further damage. In addition, exercise and physiotherapy, with the help of which the cartilage in the joint to be strengthened again, also often part of the therapy.

If the thumb saddle joint is damaged by the osteoarthritis extensive, various surgical procedures can be used to restore its function. Here, either the damaged bones are surgically corrected or they can also be replaced by a so-called endoprosthesis. In particular, during the implantation of a prosthesis, however, problems with their durability are often found later. The other surgical treatment options can also be followed by complications and long-term freedom from symptoms can not be achieved by the operations by all patients. Therefore, it should be considered only when the sufferers have significant symptoms and the other treatment options were fully utilized.

Manual therapies can slow down further cartilage removal in case of a rhizarthrosis, relieve pain and improve mobility. (Image: Andrey Popov / fotolia.com)

Naturopathy

In the naturopathic treatment of rhizarthrosis manual therapies are usually in the foreground, but other methods, such as herbal medicine, hydrotherapy or homeopathy are used.

Manual treatment using the Fascial Distortion Model (FDM) is based on punctate pain on the thumb saddle joint due to disturbances in the bone-to-ligament transition, which is called continuum distortion. The treatment takes place here with strong thumb pressure. If there are drawing pains, it is assumed that twists of the fasciae (connective tissue skins) are treated with the thumb along these pathways.

Various medicinal plants can help against joint pain. Dandelions and stinging nettles have proven particularly useful here. (Image: shibanuk / fotolia.com)

As medicinal plants, which have proven themselves in various forms of osteoarthritis, especially dandelion and stinging nettles should be mentioned. Most of these are taken as tea, however, a treatment with fresh dandelion stalks or baths with nettle supplement can also contribute to the relief of joint problems. In addition, heat treatments such as a warm hay-flower sac or infrared rays are helpful against the chronic pain of osteoarthritis. As a home remedy, a warm wrap with the porridge of boiled potatoes against the chronic joint complaints is recommended. (fp, tf)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)