I've had steadily worsening osteoarthritis in both thumb joints for that past two years. My rheumatologist can offer nothing other than steroid injections, but I've had those in other joints in the past and at least half the time I end up with worse pain and swelling as a result. I can't take any NSAID's due to cirrhosis. What I'm wondering is if I can wait it out will the joints eventually fuse themselves and stop hurting so much, or will I have to have surgery for that? Thanks for any help!
Well, it is difficult to comment on the situation without knowing the relevant clinical details, though there may be a few other modalities of treatment other than steroids and NSAIDS to reduce inflammation. If nothing works joint replacement may be a better option over joint fusion. I would suggest considering a second opinion from another rheumatologist and an orthopedician for suggestion of an appropriate management plan.
Hope this is helpful.
Thank you, Dr. Kaul. Your reply was helpful. My primary physician told me my current rheumatologist IS the best one in the area, so I went back to her fired up and more insistent. I've been taking Limbrel for years, and plaquenil on and off for years. I went back on it 3 months ago and am getting at least a tiny degree if relief from it. I don't respond well to steroid injections and don't want to try more of those. My rheumatologist suggested I try colchicine and also gave me thumb splints. When I suggested joint replacement surgery if these don't help she told me "they don't really do those" and fusion would be the only option. I'm pretty sure she is wrong, but perhaps fusions are preferred over replacements. If these newest additions don't help enough I will try to see a really excellent hand surgeon who does work in my area. Thanks for your advice!
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