Monday Medical: Summer gardening, without the pain
June 11, 2017
Your thumb might be green, but if you find yourself suffering from osteoarthritis of the thumb joint, your summer gardening might get put on hold.
The joint at the base of the thumb is one of the most common joints to be affected by osteoarthritis, which occurs when protective cartilage at the ends of the bones wears away.
Osteoarthritis can develop from overuse: In gardening, that might stem from long stretches of pulling weeds, which requires a pinching motion, or from afternoons spent with the pruning shears, which require a grasping motion.
"Typically, the first signs are pain, tenderness and stiffness," said Emily Tjosvold, certified hand therapist with SportsMed. "You're most likely to feel symptoms at the base of your thumb when you're trying to do tasks such as pinching, gripping or clasping with the thumb and index finger."
Though the pain might be mild at first, it shouldn't be ignored. Left untreated, pain and inflammation can continue to worsen, resulting in loss of thumb strength.
"Oftentimes, it worsens to the point that you need help with simple tasks, such as opening jars, opening doors or even doing your own buttons," Tjosvold said.
Tjosvold recommends a number of steps to prevent and lessen symptoms of osteoarthritis.
• Avoid overuse: Pain from osteoarthritis often becomes worse with overuse, so it's best to work in moderation.
"Taking frequent breaks and changing the task often helps with decreasing the thumb pain," Tjosvold said. "If you're pulling weeds for 15 minutes, move on to using your larger shears or a shovel for 15 minutes. And then you can return to weeding."
• Warm up first: Don't start a day of gardening with cold hands — warm them up before working, as warm joints move more smoothly than cold joints. Light stretching is also helpful.
• Protect those smaller joints: Use larger, stronger joints and limbs to bear the force of your tasks. Rely on forearms, shoulders and elbows for the grunt work of lifting planters and bags of soil, instead of your fingers and thumbs.
• Make gardening tools thumb friendly: Many handles of tools are narrow, requiring a tight grasp to hold them. By making those handles slightly wider, you can use a looser grip and ease the stress of on the thumb joint.
Foam tubing and grip tape can help. But don't make the handle too big, as it might then require too much strength.
• Use the right tools: Sharp tools make for easier work and help take pressure off the thumb joint. Ergonomically designed tools can also be helpful.
Just be sure to use those tools instead of your finger and thumb.
"It's better to use tools, as you can avoid putting direct pressure on your finger and your thumb," Tjosvold said. "Likewise, use a wheelbarrow or cart to haul heavy supplies around the garden, not your arms."
If you've made those simple modifications and still have pain, you might consider seeing an orthopedic surgeon, who can review treatment options.
One option might be to work with an occupational therapist and certified hand therapist, who can use various treatments, massage and basic exercises to help. A therapist can make or recommend a protective splint that provides external support and keeps your joint stable and can also help you make everyday tasks more joint friendly.
"In the clinic I can simulate and modify these gardening tasks to help patients with their specific needs," Tjosvold said. "Often by following these steps, you can be back to the activities you love soon."
Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.