Arthritic Thumbs: Understanding Treatment Options & Managing Symptoms

Question
I am 65 years old and have arthritis at the base of both of my thumbs.  I have been to a hand surgeon who recommends surgery.  I can prevent pain for the most part by wearing gloves and braces at night and keeping my hands warm during the day.  But my hands seem to be losing function.  I can still type (very fast), which is important to me because I'm a writer, but as most good typists, I don't use my left thumb, and I click the space bar with my right thumb by using a flick of my very flexible last joint.  

My biggest problem is getting a good grip on things, using my hands to lift things, pull things.  Hand therapy has helped.  My right hand seems more flexible.  My hands look slightly abnormal, but mostly its just that my grips look abnormal.

I have been told that this surgery is a very good option.  What are your thoughts on the surgery?  Does it fix the problem entirely?  How bad is the pain?  How incapacitated would I be and for how long?  The idea is to replace one of the bones at the base of the thumb with a tendon.  How well would myhands work after the surgery?  What are the risks?

Also, for some reason, I have very bad fingernails on my two thumbs.  They split long wise and get pulled back.  I am wearing bandaids on my finger nails to keep them from catching.  Do you think the problem might be related?

I was able to correct the problem with my lefthand by using bandaids and lanolin, keeping the nail moist (they are very dry) and protecting it from getting torn back even further.  This treatment permitted the left thumb nail to attach better to the nailbed for some reason.  I have not had such luck with the right thumb nail.  Have you heard of such problems?  Or have any ideas for me?

Thanks.
..Lois

Answer
Hi Lois,
At this point, as you described it, surgery is a good choice. It isn't as much about pain relief as function. Ultimately arthritis in these joints will cause complete loss of thumb function. Surgery will restore function enough to do what you do and you will be pain free. The surgical pain is minimal and will not be an issue. As for your finger nails, without seeing them, it's hard to offer an idea as the causes for split nails varies.