From the Guidelines
Treatment for thumb swelling should prioritize a combination of non-pharmacological and pharmacological approaches, with a focus on individualized care and consideration of the underlying cause of the swelling, as recommended by the 2019 EULAR guidelines 1. When managing thumb swelling, it is essential to consider the potential causes, such as osteoarthritis, and tailor the treatment approach accordingly.
- For patients with thumb base osteoarthritis, orthoses and exercises to improve function and muscle strength should be considered, as they have been shown to be effective in reducing pain and improving function 1.
- Topical NSAIDs, such as diclofenac gel, are recommended as the first pharmacological treatment of choice for hand osteoarthritis, due to their safety profile and efficacy in reducing pain and inflammation 1.
- Oral analgesics, such as paracetamol or NSAIDs, may be considered for short-term use in patients who do not respond to topical treatments, but their use should be carefully evaluated and monitored due to potential gastrointestinal and cardiovascular risks 1.
- In cases of severe thumb base osteoarthritis, surgery may be considered as an effective treatment option, with trapeziectomy being a recommended procedure for patients with marked pain and/or disability who have not responded to conservative treatments 1. It is crucial to note that the treatment approach should be individualized to the patient's specific needs and circumstances, taking into account factors such as the severity of symptoms, comorbidities, and patient preferences.
- A healthcare provider should be consulted to determine the best course of treatment and to rule out any underlying conditions that may be contributing to the thumb swelling.
- Regular follow-up and monitoring are essential to assess the effectiveness of the treatment and make any necessary adjustments to the treatment plan.
From the Research
Treatment for Thumb Swelling
- The treatment for thumb swelling can vary depending on the underlying cause, with options including conservative management, splint therapy, and surgery 2.
- For trigger thumb in children, conservative treatment has an overall success rate of 66%, with a higher success rate in younger age groups and those treated with splint therapy 2.
- In cases of thumb osteoarthritis, surgery may be used to reduce pain and improve physical function, with various surgical techniques available, including trapeziectomy with ligament reconstruction and tendon interposition (LRTI), trapeziectomy, and joint replacement 3.
- However, there is no evidence to suggest that any one surgical procedure is superior to another, and the choice of treatment should be based on individual patient needs and circumstances 3.
- Non-steroidal anti-inflammatory drugs (NSAIDs) may also be used to treat acute gout, which can cause thumb swelling, with moderate-certainty evidence showing that NSAIDs are probably equally beneficial to selective cyclo-oxygenase-2 (COX-2) inhibitors and systemic glucocorticoids in terms of pain relief and improvement in function 4.
- It is essential to conduct a thorough physical examination and take a complete history to determine the underlying cause of thumb swelling and develop an appropriate treatment plan 5.