Question and Answer for Issues of the Hand

By Garry S. Kitay, MD

Q & A with Dr. Kitay

Q: I was playing basketball, and tried to catch the ball – it pulled my thumb way back.  Now it’s sore, black and blue, and hurts. What should I do?
A: Unfortunately, you are one of the many people who sustain a thumb or finger injury playing basketball. Thumbs are relatively prone to sprains, as are the other digits of the hand. Hand specialists are particularly concerned about the thumb since it is the most important digit of the hand. There is one injury that you may have sustained where an important ligament in the thumb is ruptured and, if not treated appropriately, can lead to chronic instability, pain, and even arthritis.

Therefore, you should be evaluated by a specialist to make sure that you have not sustained a significant injury such as ligament rupture or fracture. In the meantime, use a splint to immobilize the thumb, keep it elevated, and ice the thumb until your appointment.

Q: I have pain in the finger joints – it is arthritis or carpal tunnel? What do I do to lower the throbbing?
A: There can be many causes for pain in the finger joints. However, it appears more likely that arthritis and not carpal tunnel syndrome is the source of your complaints. Carpal tunnel syndrome is a condition where a nerve is compressed, and its hallmark symptom is numbness in the fingers, particularly the thumb, index, and long fingers. Pain in the joints themselves tends to be due more to a disorder within the joints. Arthritis is a disease where the joint cartilage deteriorates, leading to pain and stiffness. The pain of arthritis can be improved with anti-inflammatory medications such as Ibuprofen. If this does not provide you with adequate relief, then evaluation by a specialist would certainly be appropriate for you to obtain x-rays and discuss other treatment options.

Q: I crack my finger joints and knuckles all the time – will it make them bigger or lead to arthritis?
A: This is a frequent question as many of our mothers and fathers have told us over the years to stop cracking our joints or it would lead to arthritis. In fact, there is no evidence to support this.

Q: I am getting little knots on my finger joints. What are they – can they be removed?
A: Knots on the finger joints can be caused by different conditions. The most common is cysts, which are fluid pockets. The lubricating fluid within each joint can be extruded from its capsule, causing a cyst. If these are small and not tender, then one can just observe these. However, if they are enlarging or painful, further evaluation is warranted. Treatment could involve needle puncture, and at times excision. At other times, these knots can be secondary to bone spurs from arthritis developing in these joints. While these nodules, cysts, or knots, can be removed, it is only worthwhile if it is causing a significant functional problem or pain. Come in for evaluation and we can discuss this further.

To schedule a new patient or follow up patient appointment with your MD, please call (904) JOI-2000 or read more here about our orthopedic telemedicine providers.

• Finally, to schedule an appointment for physical or occupational therapy, call any of the 12 area JOI Rehab Centers.

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904) JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. Also, to learn more about this service, read this article about fracture and injury care.