Suggest Treatment For Painful Spasms In The Palm And Joints

Posted on Sun, 11 Jun 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 11 Jun 2017 Answered on

Thu, 29 Jun 2017 Last reviewed on

Question : About a month after moving/lifting about 3 tons of weight, over 4 days, my thumb MCP joint was sharply painful on the palm side, when I woke up. My IP joint also started triggering. Pain occurs with thumb MCP extension or with compression over the sesamoid/tendon/ligament area. Triggering also occurred on the non-dominant side, but less so and w/o the pain, and resolved "on its own". A thumb spica splint or taping keeps the MCP joint from hurting during exertion. Last night I took an 800 mg Advil before bed and noticed a little less pain in the morning. Sesamoiditis? More serious capsular ligament/tubule tear? MRI or x-Ray first?

Answered by Dr. Dr. Praveen Tayal (3 hours later)

Brief Answer:
Can be due to tendonitis or a mild capsular inflammation.

Detailed Answer:
Hello,
Thanks for posting your query.
The pain that you have can be due to tendonitis or a mild capsular inflammation. Rest is needed for proper healing. MRI scan can detect such soft tissue pathologies. Rest hot compress and avoiding all the painful movements will help. You can continue using splint and Advil for relief.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Praveen Tayal (14 hours later)

Thank you Dr. Tayal! I certainly appreciate your answer. As a physical therapist specializing in spine disorders, my thumb problem reminds me a bit of facet joint dysfunction, which involves the capsule as well. I noticed that when I stress the MCP joint in pinching it will hurt--could it be subluxed/subluxable a bit? It occurs to me that the nocturnal onset may have been due to flailing the arm/hand and hitting a bedpost/nightstand to cause a subluxation or capsular strain. I will continue to splint and take Advil. I may also try iontophoresis with 4 mg/ml dexamethasone and 2% lidocaine, to see if that will reduce the inflammation more rapidly. That works great on cervical facet capsular problems. Is there a timeframe in which I should seek a physician's counsel re: MRI (if the healing process seems to "stall-out")? Again, thank you for your kind insights Dr. Tayal.

Answered by Dr. Dr. Praveen Tayal (9 hours later)

Brief Answer:
You can try iontophoresis.

Detailed Answer:
Hello.
Thanks for writing again.
Subluxation is less likely but an inflammation is definitely there. You can try iontophoresis and do consult a physician in case this does not improve in 7-10 days.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar