Surgery vs. natural remedies for osteoarthritis
October 17, 2019 9:49 AM   Subscribe

I have osteoarthritis in my left thumb. It’s very painful and limits my use of that hand. I have been getting cortisone shots every 4 months since 2017. My orthopedic hand specialist does not take my new insurance and referred me to someone else.

That doctor doesn’t believe in giving any more than 3 cortisone shots in the same place over the course of a lifetime and won’t give me another shot. He has recommended one of two things, surgery (a trapeziectomy) or something called Stem Cell/PRP therapy. He said the surgery has a 90-95% success rate, would take the pain away completely, and is covered by my insurance. The stem cell has a 75-80% success rate, would only diminish the pain, and is not covered by my insurance. I am leaning toward the surgery, but I have a lot of fear about it. I would prefer to treat the pain with natural remedies such as CBD oil products, which I have no experience with. I would appreciate your thoughts on this subject.
posted by htm to Health & Fitness (14 answers total) 2 users marked this as a favorite
 
I can’t answer about the other treatments, but is definitely common to limit the cortisone shots in one spot.
posted by gryphonlover at 9:55 AM on October 17, 2019 [2 favorites]


Thank you, gryphonolover.
posted by htm at 10:03 AM on October 17, 2019


I am not sure how long you have had the pain, but as someone who's had chronic pain for years, I would urge you not to wait as long as I did to get something done. Your body sensitizes itself to pain and acute pain can become neuropathic pain. I would honestly lean toward surgery in your situation.
posted by fiercecupcake at 10:05 AM on October 17, 2019 [3 favorites]


Oh, and duh, I see since 2017. Hi, I'm having a bad pain day RIGHT NOW.
posted by fiercecupcake at 10:05 AM on October 17, 2019


My sister literally got this surgery on her non-dominant thumb a few months ago. I helped her through her early recovery and here are some observations.

- the surgery was simple and basically pretty quick. She was in a post-surgical cast for a week, a hard cast for a few weeks and then a long splint for a few weeks and now she's down to just a hand splint (she did have a basic hand splint before the surgery for a few months to see if it would help and it did not). She took a week off of work and maybe should have taken a few more days.
- the recovery period is no joke. She still gets sore if she overuses it now, a few months later. It was only the first week where she really felt like she needed more-than-Advil painkillers but she's still using Advil for pain when she sleeps
- the other thing is that there's a rigorous physical therapy schedule (and it's worth getting it set up as soon as possible after surgery so you can get started). She had to wait a few weeks and she's just now at the point where she can button a shirt or do dishes. Her thumb really needs to relearn to be a thumb and that is a thing it can do but it takes time and energy so make sure you can commit to it.
- She lives alone and was able to make it work but it's a bit of a struggle for some things (dishes, some clothing, tying shoes) so it's good to set yourself up knowing that

Honestly knowing what she knows now and even with the hassle of the pain, she feels she should have done it sooner. If I can answer any more questions (or if I can ask her) please let me know.
posted by jessamyn at 10:08 AM on October 17, 2019


People on the McDougall diet have reported relief from arthritis symptoms. You can also check his "testimonials" page. (I'm sure Dr. McDougall is on all kinds of quack lists, but a lot of people report getting better on his diet, and it certainly can't hurt you. Waiting for surgery may be a problem, but you should be able to tell if the diet works for you pretty quickly.)

If you're interested in natural remedies, I would also suggest searching "arthritis" on nutritionfacts.org. This site provides links to research articles for all studies cited. Note: Dr. Greger and Dr. McDougall are both vegan, but Dr. McDougall only became vegan because he believed animal products were bad for health. It's a little less clear why Dr. Greger became vegan.

I expect people to tell you that this is all nonsense, but I decided to suggest it anyway as something that might be helpful, and you can decide what's worth trying.
posted by FencingGal at 10:25 AM on October 17, 2019 [1 favorite]


Assuming none of them are actively harmful, it can't really hurt to try all possible things suggested as potential remedies, and I did so for many years, but IMO for me personally those years were wasted years full of unnecessary pain and endless fucking suffering and my greatest regret in life is not having had my severe chronic pain sorted out by surgery sooner.
posted by poffin boffin at 10:46 AM on October 17, 2019 [1 favorite]


Thanks much fiercecupcake, jessamyn, FencingGal and poffin boffin!
posted by htm at 11:05 AM on October 17, 2019


Does anyone know the answer to these questions: If I have the surgery is it going to “cure” my condition, so to speak, so I can go back to using my thumb as though I never had the problem to begin with? Will I be able to do the same repetitive things with my thumb that I used to? Can I go back to doing the same kind of work (in the administrative field) that I used to do before I had the pain?
posted by htm at 11:20 AM on October 17, 2019


That doctor doesn’t believe in giving any more than 3 cortisone shots in the same place over the course of a lifetime and won’t give me another shot.

Just in case you're wondering why that might be the case, there is recent evidence that cortisone injections may not be as benign as previously thought.
posted by Secret Sparrow at 3:30 PM on October 17, 2019


Thanks much, Secret Sparrow!
posted by htm at 5:41 PM on October 17, 2019


My sister's doc said the same as yours. Since there is literally a bone removed and replaced with some sort of (fake bone? padding?) my understanding is that there is no chance for the same thing to recur. My sister is a huge texter and the doc was like "Yeah don't even bother changing what you do. This will fix it" She's not far enough along in the process to know if that is the case, but that definitely seems to be what they think based on past experiences.
posted by jessamyn at 6:24 PM on October 17, 2019 [1 favorite]


Stem cell therapy or prp have little good evidence for helping. And insurance generally doesn't cover the cost because they're experimental. Most people getting SC or PRP are paying out of pocket and the companies are all about the profits. Don't pay to be in one of their "trials". There was recently an article on Science Based Medicine about PRP. I highly recommend that site.
posted by kathrynm at 7:26 AM on October 18, 2019


Thanks much, jessamyn and kathrynm!
posted by htm at 9:56 PM on October 19, 2019


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