Rheumatoid Disease Thriller: Mystery of the Injured Thumb
“Mysterious” experiences like these can be common with rheumatoid disease and I hope you’ll share some of yours in the comments. Now, on to my rheumatoid arthritis thumb…
Several months ago I reached out with my right hand to grasp the handle of a rolling suitcase, and my thumb did not grip. I was met with pain as I often am. The IP joint and the MP joint (see joint abbreviations below) turned red. KB and I took pictures over the next few hours as we watched my thumb joints blow up like balloons right before our eyes.
By the way in his post Joints of the Thumb – Language of Hand and Arm Surgery Series, Dr. C. Noel Henley explains the names of the thumb joints clearly. I use these abbreviations when I journal joint symptoms:
Three Joints of the Thumb
The three joints are as follows:
Carpometacarpal (CMC) Joint
Metacarpophalangeal (MP) Joint
Interphalangeal (IP) Joint
The next day I went to an orthopedist walk-in clinic.
It always seems good to let a doctor see when something is very swollen because there are so many times when swelling is subtle and inflammation would only be detected on ultrasound. The orthopedist put a cast on my rheumatoid arthritis thumb to immobilize it until it calmed down.. That’s right – a cast. He said I must have sprained my thumb somehow for it to swell like that. It looked TOO SWOLLEN to be just the rheumatoid disease. He felt there must have been an injury.
Rheumatoid arthritis thumb: Don’t be confused!
(Ok, but can we still be mystified?)
I didn’t “injure” my thumb that day. But, I’ve said before that we ought to think of rheumatoid disease in joints as “injury” – injury without an incident that we can see. We can’t see what triggers tissues to inflame as if they are injured – but something does.
That’s why Rheumatoid Disease is a mystery in the first place.
No one was hitting our hands with a hammer during the night – but it often seems so in the morning. Yet SOMETHING WAS happening. Beneath a veil of secrecy. That immunology has yet to uncover.
In the rheumatoid zone…
More RA Warrior
- Happy Halloween: RA makes every day weird
- Rheumatoid Arthritis Pain in the Twilight Zone
- Textbook Rheumatoid Arthritis: Patient Input Will Replace It
I was opening a can using a hand can opener with my right hand and holding the can in my left. I felt a sharp brief pain in my left thumb and after that I could no longer bend the first joint. Got in to see a hand surgeon and he determined that because my wrist joints were so jagged from RA, they had severed the tendon in my thumb. The surgeon said he could remove the tendon from my ring finger and put it into the thumb and then my ring finger would be immobilized, and then I would need weeks of PT. I opted out of that real quick. I get along just fine without that joint as long I remember to keep the nail short so that it doesn’t get jammed back. It’s always something new and exciting with RA isn’t it.
I’ve noticed similar situations in my own hands. Recent ultrasound on hands documented damage to MP joints in both thumbs. Both thumbs have begun locking for days at a time. This damage occurred in last 12 months despite the use of Xeljanz. My last visit with Dr C I left very frustrated as his solution at this time was to increase pain meds… 😳
This is actually one of the first mysteries to clue me in that something was wrong…a good 10 years before my official diagnosis of RA.
Of course, the mystery swellings were happening at an infrequency, and there were always many months in between their occurrences.
But now it happens nearly at a two week frequency. And call me crazy, but I can feel the damage happening a day or two before the swelling appears. The joint feels like it is burning, constant burning, and a stiffness that makes it nearly impossible to bend. Sometimes there is red, more often there is not.
I asked my Rheumy about this and he shrugged it off as just disease progression. I asked him why it was continuing to happen even after I’ve started all the DMARDS, and he basically told me it was normal.
So I’m normal by having mystery injuries. Maybe you’re normal too.
Hm. Normal as in COMMON. But not normal as in HEALTHY. And I don’t think it’s crazy – i also feel those things (on a phone plz excuse any errors )
That’s an interesting point..being healthy. Would any of you describe yourselves as healthy? I can say “I’m not sick” (meaning I don’t currently have any active infections), but I wouldn’t describe myself as “healthy” in any way. Is this something we should just accept that we are not or are we giving up if we do so?
I don’t think it’s just what we should accept as a community of patients and that has been one driver of this site from 2009. We need more effective treatments that work for more people. We still need many in the medical community to recognize the ads for current treatments dont portray the whole story.. as ads in any product present only one side.
Of course we all need to practice some level of *acceptance* of circumstances personally so we don’t go nuts / become stuck emotionally. But those are 2 different things.
Not only does my thumbs feel like they have been hit by a hammer. My elbows are even worse.
Ha! That’s so funny, I call it “hammer hand” coz it often feels like someone just slammed a hammer into my hand!!
One of my fingers started “triggering” about 4 months ago. Rheum doc gave me cortisone injections in the joints involved. 4 months later, it was no longer triggering, but was having trouble getting and staying straight when I straightened it. More injections. Plus a referral for hand therapy. Now my hips are going out. “Healthy?” I haven’t been healthy for years. Every time I go to the orthopedic surgeon, they ask me if “this is the result of an accident.” It never is. It’s RD. Neurosurgeon probably is next for neck and back.
Simponi infusions are finally helping some. Wish I could have started them sooner.
RA – the gift that keeps on taking.
Why do Drs not listen? I’m not in a hospital under a 5150. Pain? Take Tylenol? Can’t breathe? Here’s an Antibiotic. The typing is the worst. I’m a 911 operator and it’s harder and harder to type and remember. Can MTX do that? I’m new to it.
Why oh why do we constantly have to prove that yes, we actually do have RA? One (ex-)rheumatologist suggested I may have 1)carpal tunnel syndrome in my hands;2)osteoarthritis;3)fibromyalgia; 4)or bursitis. She came up with these alternate explanations for pain although I was diagnosed with RA 4 years ago(“luckily” I did have RA factor for the blood test).
I never, ever get swelling in all the joints that hurt. Swelling is so rare for me that I recently walked for 7 weeks on a broken tibia without any swelling– I just thought I had just a little more than the “usual” amount of pain in my knee because I’d fallen.
A person could get frustrated.
Ever since my daughter was five she has had strange symptoms. She’s now 38. She has Sjogrens and I have RA. At age 12 she complained of not just joint pain, but her ankle would swell up, the veins would bulge out and she was in throbbing pain. The progression from normal to swollen would happen right before our eyes and then diminish about an hour later. Strange thing Elavil a selective serotonin re-uptake inhibiter seemed to help it from occurring. I know it’s not RA, but I just thought you should know.
I was diagnosed with RA 18yrs ago. First it was hands, then wrists, then both feet (4 foot surgeries). All this time my back has been killing me. Now neurosurgeon tells me that R A has “mangled” at least the of my joints in my neck. Need sergery but R A and mess causes a problem. My rheumatologist says RA usually doesn’t affect the back. I beg to differ. Anther big surprise. They just keep coming.
Hi Diane – heres a few articles on the site taht are tagged “spine” – for your reading pleasure (joking of course). You’re right – it’s not rare for RD to affect the spine – especially the neck. https://www.rawarrior.com/tag/rheumatoid-arthritis-spine/
Thank you for this!!! I just saw my spinal surgeon last week ( working on injections and blocks for RA in my spine) and he noticed bruises on my hands and fingers during my assessment – He asked about injury I said no. They were actually something I dealt with with RA – spontaneous bruising on my hands and fingers and around joints – first there would be a bee sting like feeling and then tightness and the a bruise would appear over a matter of minutes. He had never heard of it – and I felt silly for trying to explain a condition to a Dr. I completely appreciate you and all your information because still I hear from Drs that’s not a Symptom of RA or not usual or your labs or fine that shouldn’t be a problem. etc which is deflating. Thank you xx
Lara, I might know what that is. Be back after icing fingers more -just got up
Lara,
I just checked & I don’t think I’ve posted (a blog post) on this yet. Some other PRD have told me they have this too. As far as I understnad it’s breaking of small blood vessels & forming a bruise under the skin. It’s what my mom called “breaking a blood vessel” when I was a kid, if you hit something hard with your hand. Just as you describe, it smarts for a couple minutes & then duller pain as it swells, tightens, blood beneath the skin – over the next minutes.
The strange part is that, like you said, you don’t hit the spot with a hammer or even bump it hard – it’s spontaneous. I’ve had this happen to me many many times – often I’m folding laundry. It happens to toes when I’m just standing or walking. I’ve taken pix of it along the way & brought both the pix & the live “bruises” to docs who just shake their heads saying IDK.
Ok, how could it be related to RD? The only thing I have found with is vasculitis – inflammation of blood vessels. It can happen w/ RD & I’ve had other symptoms of it.
PS: I tweeted u a pix from my phone of 1 on my toe https://twitter.com/rawarrior/status/660795358700769281
I am glad to see this because I have been wondering why my right thumb is so swollen. I started having this problem a month ago and the burning pain is terrible. I have severe RA.
Does anyone know what to do to make the swelling go away? Thanks!
Thank you Kelly!! Yes!! That’s it!! Another bizzarre RD thing.
Now you know why my digital camera gets a workout taking pictures of my inflamed joints when they happen.
The random stinging then a bruise I use to get that a lot it has stopped for the most part but stopped taking some of my meds. Less prednisone maybe??
You said it best! I am always wondering WHAT I did to make this or that hurt… That you go thru too and still is very assuring, albeit sad for you and for the whole RD community!
Being a hairdresser with RA has a few disadvantages. I have been diagnosed for about 8 years now and I would say until recently, my major complaints were joint stiffness and major fatigue. Once in a while a joint in my ankle or foot flares and I am limping around. This past year has brought thumb pain that goes through my whole hand. I have been told by drs it is carpel tunnel. I am refusing surgery because as painful as this is, one day I will wake up and not even remember exactly where the pain was. And just like that, a light switch turns it off and all pain is gone. I know that something is triggering this. My right thumb is twice the size of my left thumb. The tendons around my thumb are thickened and stick out of my thumb. My whole hand becomes weak and my grip is about gone. Ice packs help but I am so chilly in the fall that I don’t like to use them. I am sure this will pass like it has in the past. Weird to see your post as I can feel your pain.
You have described myself, it means a lot to me to know I’m not alone.
Thank you, and grateful
thanks to all.
Katy (UK)