Dr. Ostric explains this new, innovative, and effective surgery

Understanding the need for thumb denervation can help patients take action when they experience chronic thumb pain. Many people suffer from thumb discomfort due to various reasons, affecting their daily lives. This guide will explore the causes of thumb pain, the surgical option of thumb denervation, and what to expect throughout the process.

The Prevalence of Thumb Pain and Dysfunction

Thumb pain is common among individuals of all ages. It can stem from arthritis, injuries, or overuse. According to studies, nearly 10% of adults experience chronic thumb pain at some point. Such discomfort can lead to a reduced quality of life, making everyday tasks like gripping and typing difficult.

When Conservative Treatments Fail: Exploring Surgical Options

For many, conservative treatments like physical therapy, medication, or splinting may not provide relief. When these methods fail, surgery might be the best route. Thumb denervation surgery has emerged as a viable option for managing thumb pain by targeting the nerves that cause discomfort.

What is Thumb Denervation Surgery?

Thumb denervation surgery involves removing or disrupting nerves in the thumb that transmit pain signals. The goal is to relieve chronic pain while preserving thumb function. This procedure can lead to significant improvement in daily activities and overall quality of life. This is a quick and easy outpatient surgery that can be done in about 30 minutes or less. For patients who are young, active, and in their working years, it can be a superior choice compared to rational techniques which can reduce grip strength and result in long recovery times (3-6 months in many cases!)

Understanding the Procedure: A Step-by-Step Look

Surgical Techniques and Approaches

Thumb denervation surgery generally employs the exact same incision that it utilized in the traditional technique of thumb arthroplasty; however instead of actually removing the trapezium (part of the thumb joint) only the nerves that supply pain sensation to the the trapezium are cut. This provides pain relief with little downtime.

And No! THE IMPORTANT SENSORY NERVE OF YOUR THUMBS ARE NOT INJURED IN THIS SURGERY! That is the remarkable part of this surgery: you have all the parts of your thumb intact, except the 3 small nerve that cause you pain. It is actually a brilliant idea that has slowly introduced itself into hand surgery through years of anatomical study and dissection. In the years to come, thumb denervation might very well become the standard of care for all cases of thumb arthritis.

Anesthesia and Post-Operative Care

Anesthesia is crucial, as patients will usually receive either local or general anesthesia before the procedure. Post-operative care involves:

• Monitoring recovery
• Managing pain with prescribed medications
• Keeping the surgical site clean and protected

Risks and Potential Complications

While thumb denervation surgery is generally safe, some risks include:

• Infection
• Nerve damage
• Persistent pain

Patients must discuss these possibilities with their surgeon to make informed choices.

Candidate Selection: Who is a Suitable Candidate?

Diagnosing Conditions Requiring Denervation

A thorough diagnosis is essential. Conditions like chronic osteoarthritis, rheumatoid arthritis, or injuries that do not improve with other treatments might prompt the need for surgery.

Evaluating Patient Health and Expectations

Surgeons assess overall health before surgery. Factors like age, other medical conditions, and lifestyle play a role in determining suitability. It’s important to have realistic expectations about outcomes.

Pre-Operative Assessments and Preparations

Before the procedure, patients undergo:

• Physical examinations
• Imaging tests like X-rays
• Discussions about medical history and current medications

These assessments help tailor the surgery to the individual. And No! There is absolutely no rush to surgery. My philosophy will always be focused on absolutely exhausting all conservative measures, including splinting and steroid injections until you say that you are ready for surgery. There is never any rush for hand surgery at the MSA Hand Center. I want you to understand what is happening to you and why, and I want to develop a long lasting relationship with you that is based on trust and accurate information.

Recovery and Rehabilitation: The Path to Healing

Post-Surgery Pain Management and Physical Therapy

After surgery, managing pain is a priority. The first 2 days can be rough. In order to manage this, I recommend and will provide:

• Pain relievers
• Ice packs to reduce swelling
• Gradual physical therapy to restore movement

Expected Recovery Timelines and Milestones

Recovery can vary but typically progresses as follows:

• Week 1: Initial healing and pain management.
• Weeks 2-4: Begin gentle range-of-motion exercises, and perhaps you will need therapy.

Strategies for Long-Term Thumb Health

To maintain thumb health post-surgery:

• Stay active with exercises suggested by your therapist.
• Use splints or supports if needed.
• Avoid repetitive motions that strain the thumb.

Alternative Treatments and Considerations

Non-Surgical Management Options: Conservative Approaches

Before considering surgery, many explore non-surgical options such as:

• Physical therapy
• Corticosteroid injections
• Customized splints or braces

These methods often focus on reducing inflammation and pain.

Comparing Denervation to Other Surgical Procedures

Patients may wonder how thumb denervation compares to other surgeries, like joint fusion or replacement. Denervation aims to reduce pain without sacrificing joint movement, making it a less invasive choice.

Long-term Prognosis and Outcomes

Most patients experience significant pain relief after thumb denervation. Studies show that over 70% report satisfaction with the results. However, ongoing self-care is vital for maintaining functionality.

Conclusion: Making Informed Decisions about Thumb Denervation

Key Takeaways: What to Expect Before, During, and After Surgery

Thumb denervation surgery can offer relief for those suffering from chronic thumb pain when conservative methods fail. Understanding the procedure, recovery process, and long-term strategies is essential for success. Call MSA Hand Center today to schedule your appointment at 231-739-1933