IN THE CORNER WITH THE RING DOC: Gamer’s Thumb, When an Arthritis Diagnosis Gets a Thumbs Down

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Written by Dr. Beau B Hightower
MS, DC, CSCS, CES

Our culture continues to move into a digital age which means  more and more use of our hands due to these digital devices which include cell phones, video games, tablets, and more. Due to this reliance on technological devices, particularly with the millenial generation, it is to no surprise that we are seeing a younger and younger patient population with debilitating thumb pain. In the past, most doctors and practitioners would brush thumb pain off as arthritis or simply a part of the aging process, but as we learn more about the pathology of soft tissue injuries, we have come to realize that a simple condition known as De Quervain Tenosynovitis is the main cause for our current epidemic of thumb pain. Symptoms of this particular disease include pain, tenderness, and swelling over the thumb side of the wrist, and difficulty gripping.

Professions such as dental hygienists, office staff, and yes even UFC fighters are at high risk to develop this type of overuse injury.

 While most of the muscles associated with the thumb lie on the palm side, (this is known as the thenar eminance) the most common tendon restrictions lie on the top side of the thumb. Two specific tendons, the abductor pollicus longus and extensor pollicus brevis  are often entrapped either within the tendon sheath (the area that wraps around tendons that protects and allows proper movement) or the retinaculum ( a band of tissue that wraps around the wrist to provide support for tendons, veins, arteries, and nerves) The following image show’s finkelstein’s test, the most accurate orthopedic test to verify gamer’s thumb.

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Research shows that 90 percent of patients with gamer’s thumb will recover in one year, but most people simply cannot wait that long for resolution, as the thumb is so vital to our lives, particularly in the digital age.  Most patients can be completely healed within 1-3 treatments by using soft tissue treatment methods  such as Ortho-Therapy or instrument assisted soft tissue mobilization. Due to the frustrating nature of the injury, and the general lack of knowledge of the condition within the medical community, patients are occasionally referred for surgical consults unnecessarily. Operative procedures on the thumb can lead to debilitating bio-mechanical changes down the line. Second line therapies include efficacious treatments such as NSAIDs and Corticosteroid injections of the synovial sheath (doctors often are mistaken and attempt injections into the joint in hopes of alleviating what they perceive to be osteoarthritis)

 If you are experiencing sharp thumb pain, and you believe or have been told that you simply have arthritis, you owe it to yourself to seek out an evidence-based practitioner of physical medicine to evaluate your injury. More than likely, you will be back to texting, typing, and doing the things that you love to do in a very short period of time, simply by getting the right treatment for the right condition. You will be smiling, and will certainly give a “thumb’s up” to the healing hands of your doctor!

Disclaimer: This article is for educational purposes only. If you have a medical condition, it is prudent that you seek medical evaluation by a properly qualified and licensed practitioner.

hightower-beau 

Dr. Beau Hightower is a former collegiate athlete and avid fight fan. He serves as the President of Elite Ortho-Therapy and Sports Medicine LLC, the premier sports injury resolution center in New Mexico. He serves on the Executive Board of Directors for Parker University and their Alumni Association and treats many elite level UFC fighters in his home practice.

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