Wednesday, September 26, 2012

My Painful Aching Thumb: Thumb Arthritis

Thumb arthritis, also called basal joint arthritis, occurs when the joint at your wrist and the base of your thumb (carpometacarpal joint) develop osteoarthritis. Arthritis is the breakdown of the bone and/or soft tissues surrounding joint spaces. Determining the cause of arthritis can be difficult. Several factors may contribute to the development of this common problem; a previous injury, or wear and tear of the joint. Having thumb arthritis can cause debilitating hand pain, swelling, and decreased strength and range of motion, making it difficult to do simple household tasks, such as turning doorknobs, opening jars, sewing, and grasping tools or other items.

There is no single medication or treatment which alleviates arthritis for everyone. There are treatment options which help improve your daily life by managing pain, controlling arthritis symptoms, and reducing joint damage or deformity. Treatment options available to patients may include one or a combination of exercise, splinting and /or medication. If conservative treatments do not work for you, surgery could be an option.

  • Arthodesis (fusion): Designed to eliminate pain by allowing the bones that make up the joint to grow together, or fuse, into one solid bone. This results in loss of motion but can eliminate the pain.
  • Trapeziectomy and resection arthroplasty with ligament reconstruction and tendon interposition. Involves removal of the trapezium bone in the wrist and placing a harvested iece of the patient’s tendon into the space. Over time, this may lead to shortening of the thumb.
  • Arthroplasty (joint replacement): Removal of damaged bone, which is then replaced by an artificial joint to facilitate restoration of motion, function and strength.

Dr. Spezia is a specialist on the treatment of thumb basilar arthritis. He is involved in a multicenter study with the Nugrip Prosthesis out of the Mayo clinic in conjunction with Ascension Orthopedics. Orthopedic implants of the thumb (CMC) provide patients the benefit from the implant having a similar flexibility to cortical bone. This flexibility minimizes damage to healthy bone and surrounding tissues. The superior bone and cartilage wear properties of the implant provide long lasting use and functionality with improved range of motion. This new treatment option will eliminate your pain and get you back in the swing of things.

You do not have to suffer from thumb arthritis pain any longer. Take the first step by making an appointment with Dr. Spezia at St. Peters Bone and Joint Surgery 636-441-3444 to discuss your treatment options. We look forward to hearing from you.

What is Arthritis? How Did I Get It and How Is It Treated?

Simply put, arthritis is inflammation of our joints.  The most common form (osteoarthritis) is primarily due to loss of cartilage that lines our joints.  This loss of cartilage comes from several potential sources: 
  1.  Age – as we all age our cartilage tends to weaken and thin.
  2. Family history – if your mother or father had arthritis your risk is increased.
  3. Weight – increased weight increases the forces across a joint and damages the cartilage over time.
  4. Trauma – a previous trauma that either injures the cartilage directly or injures ligaments or a joint’s cushion (like the meniscus in the knee) leads to future arthritis.
Arthritis hurts because it causes inflammation and swelling in a joint that irritates the joint lining.  Furthermore, as the cartilage thins bone becomes exposed and spurs develop that prevent the joint from moving smoothly.

The best method for treating arthritis is to limit its onset by addressing the causes that are under our control.  For example, keeping our weight down will prevent excessive forces across the joint.  The great news is that for each pound a person loses their knee will feel like four pounds have been lost!  So, just a small weight reduction can show a major benefit for your knees. 

As arthritis progresses we can also limit impact activity across the joint.  For example, many patients with early arthritis benefit from transitioning away from running to lower impact activities such as riding a stationary bike or swimming.  These are great activities that keep joints moving and flexible without pounding on the cartilage.

Lastly, there are many additional ways to help with arthritis pain and symptoms beyond changing our lifestyle.  Mild and moderate arthritis often responds nicely to anti-inflammatory medication like Motrin or Naproxen.  As symptoms progress many patients will get months of relief from a joint injection.  Finally, when patients’ note that their day-to-day activities are limited by arthritis despite conservative treatment, many patients benefit from joint replacement procedures.  Joint replacement procedures are amongst the most common and beneficial medical procedures performed in the United States. 

The docs at St. Peters Bone and Joint Surgery want to help limit your arthritis and help you through your symptoms as arthritis affects your daily life.  We look forward to working with you to decrease your pain and improve your function.  

Written by Dane Glueck, MD

*picture courtesy of American Academy of Orthopaedic Surgeons

Wednesday, September 19, 2012

Use Caution With Sports and Energy Drinks In Children and Adolescents

The American Academy of Pediatrics recently published a report regarding the safety of energy and sports drinks in young athletes. Both types of drinks have become increasingly popular in children and teens, due to aggressive marketing and endorsement by professional athletes and celebrities. According to the AAP, there is a lot of confusion about these products and the differences between them. Some athletes are using energy drinks, which contain large amounts of caffeine, after exercise when their only goal is to rehydrate.

Sports drinks contain carbohydrates, minerals, electrolytes, and flavoring, and are intended to replace water and electrolytes lost through sweating during exercise. However, these drinks contain a large amount of sugar and should be reserved only for after prolonged exercise--usually for more than an hour. They should not be used for routine meals and snacks due to their contribution to obesity and tooth decay.

Energy drinks, while very popular in teens and young adults, are never to be used by children. A standard energy drink contains as much caffeine as 10-14 cans of cola. Caffeine is addictive and has no nutritional value. Just like in coffee, caffeine is a stimulant--a drug--and should not be used by children. They often contain additional substances such as guarana and taurine, which are also powerful stimulants. Use of large amounts of energy drinks have shown to contribute to heart problems in teens.

So what should young athletes drink after games and practices? The answer isn't all that surprising: good old water! Water does the job to replenish fluids lost through sweat. For bouts of exercise under an hour, water is all that is necessary. Sports drinks have unneeded sugar that may contribute to obesity, especially when used routinely.

To read the full report from the American Academy of Pediatrics, click the link below:

Wednesday, September 5, 2012

Vitamin D plus calcium tied to longer life: study

Vitamin D plus calcium tied to longer life: study

We know Vitamin D is great for your bone, but here's how it may be better for overall health, too!

Does Your Shoulder Keep You Up at Night?

Many shoulder problems cause difficult with sleep at night.  The #1 complaint that I hear in my practice is "I can't get comfortable at night."  In fact, my patients are often dragged in to see me by their spouse because their significant other tosses and turns all night!  Nighttime pain is often the most significant part of a problem with the shoulder.  Other complaints I often hear include difficulty with reaching above or behind, difficulty getting a bra on, or difficulty reaching into a back pocket.  Many times the pain radiates into the arm as well.

What causes nighttime pain?  One word: inflammation.  Inflammation is the root cause of many problems that affect the shoulder while resting.  Inflammation can  result from one of several different underlying problems.  Problems that cause inflammation include rotator cuff tears, "bone spurs", and arthritis in the shoulder.  Frozen shoulder also is the result of inflammation.  Of these, rotator cuff inflammation or tears are the most common.

What can we do about it?  This time, it's a two word answer: cortisone shot.  Although cortisone injections are not a cure-all, they are often very helpful with nighttime pain.  They may completely eliminate the problem, permanently.  In other cases, they may help for weeks or months.  Besides cortisone shots, other treatments for shoulder pain are available.  These include anti-inflammatory medication and physical therapy.  Rarely, surgery may be necessary to correct a significant problem, such as a severely torn rotator cuff tear or large bone spurs which cause friction and rubbing.  Even more rarely, a shoulder replacement may be the best option for a small group of patients.

Of course, an exam, x-rays, and sometimes MRI are all necessary to establish a diagnosis.  Making an appointment when things have been going on for more than a week or two is often helpful to nip the problem "in the bud" and prevent it from getting worse.  It is not normal for the shoulder to be painful, and successful treatments are available.

Written by Anthony Frisella, MD