This is not a blog I wanted to write. This will be easier than explaining the same thing each time anyone wants to know where I've been the last year or two.
Unfortunately, I have been dealing with chronic pain issues since June 2023. It started with pain in my right palm that came out of nowhere. I went to the doctor who said he didn't see anything on x-ray - probably just some kind of inflammation, so he gave me a cortisone shot and told me to take it easy. Not long after that I started getting occasional light pain in my left thumb. After some months, I went to a sports doctor who took fresh x-rays and said I have basal (CMC joint) arthritis in my right thumb. This was devastating. She didn't know what was going on in my left thumb (x-ray showed nothing).
I'll try to skip some of the boring details, but the pain and dysfunction in both my hands has only increased the last 20 months. I now get similar pain on both hands that moves around between the center of each palm, the first thumb joint (CMC) and the second thumb joint (MC). I don't understand why this would be affecting both thumbs at the same time, especially when the left hand x-ray didn't show significant arthritis (we all have some degree of arthritis as we age, it's mostly a matter of how quickly it affects us). I also realize there is no cure for arthritis, but I have tried almost everything imaginable and nothing even puts a dent in the pain. What I've tried so far with no effect:
- PRP (platelet rich plasma) injections (both thumbs)
- Prolotherapy injections (both thumbs)
- Cortisone shots (right thumb)
- Prednisone taper
- Just about every NSAID (Meloxicam, Celebrex, Aleve, Voltaren gel)
- Pentosan Polysulfate injections (experimental off-label treatment that works wonders for many people)
I still don't know if CMC (basal) thumb arthritis is the root of the problem, especially since I have the aforementioned pain that moves around both hands and multiple joints. One hand specialist jumped right to the CMC arthritis diagnosis after just glancing at my x-rays. Another one seemed a bit skeptical. There are a couple of other possibilities I have considered.
I had been taking a drug called Dupixent for about 15 months (for eczema/painful itching) and stopped as soon as I got the CMC arthritis diagnosis. Reason being, I read that Dupixent can cause joint pain (and anecdotally, lots of people online say Dupixent gave them arthritis, or rheumatoid arthritis). I had hoped that this was the cause of my joint pain and that it would eventually go away. But I've been off that prescription for over a year and the pain has only gotten worse, so either that wasn't the cause or the damage is permanent.
I've had my blood drawn probably almost 20 times the last 13 months, and none of my doctors think an auto-immune disease is likely. Although, it's hard to say 100% because some of the auto-immune diseases including rheumatoid arthritis can be seronegative (they don't show up on routine blood tests).
Kelley is much smarter than I and she suggested I see a neurologist in case the root cause is a pinched nerve. He did order an MRI that revealed that my neck is all kinds of fucked up. Basically, I have 2 cervical discs that are extremely degenerated (compressed) and another that's well on its way. The facet joints/foramen (where the nerve roots go through) are also very arthritic (lots of bone spur material). And the space for the spinal canal itself is narrowed. Why has all this happened? Who knows! I'm not aware of anyone in my family with spinal degeneration, so I guess I just got lucky. The awesome part is that I've been having lots of neck and back pain for the last 6-8 months. Don't know if it's a coincidence that it started right around the time of my MRI, or if I just didn't notice it before or if it's psychological...
In order to try and diagnose the pinched nerve in the neck theory, I had an epidural injection at the C6/7 level at the beginning of December and another at the C5/6 level almost two weeks ago. Neither one has given me any relief.
So yeah, that's my primary problem is that I still can't tell for sure what is causing my pain. If it was local arthritis, than one of the shit-ton of remedies I tried would have had at least a little effect, right? If it was a pinched nerve, then the epidural or the traction, stretching and physical therapy I've been doing for months would have had some positive effect, right? If it was the Dupixent it would have likely subsided by now. If it was auto-immune, one of my doctors would have found it, right?
So the next shitty part is that if it's basal thumb arthritis I have to eventually get a very involved surgery that involves removing the trapezium bone completely from my thumb, with a very long recovery time and uncertain future with regards to pain relief, proper function and durability. And I'd almost certainly have to have that done in both hands. If it's a problem in my neck, I'll probably have to have at least 2 (if not 3) of my discs removed and the joints fused. The recovery supposedly isn't too bad, that means I'll have reduced range of motion forever. And even worse, getting fusion (especially in multiple joints) often leads to degeneration of the adjacent discs above and below (because they have to do more work). So then, years later you have to get even more joints fused and lose even more range of motion! I'm going to get a second and third opinion, but the first spine surgeon I talked with said I wasn't a candidate for artificial disc replacement (which would preserve more range of motion) and I'm probably not a candidate for a more conservative decompression surgery where material is removed.
So, at some point I might have to choose between two very scary surgical options and I don't even know which one is the correct one I need. And I don't know how to be sure. Worst case, I need both, or I choose the wrong one first and have to have both.
I'm sorry this turned into a "woe is me" blog. That truly wasn't my intent, although I realize it's impossible for me to inform folks about what's going on with me without it turning into that.
I also want to say I'm sorry for being even more withdrawn than usual this last year+. I don't consider my friendship or acquaintance to be anything special, but if by chance anyone reading this is frustrated by my lack of communication with the outside world, this is why. I've always suffered from social anxiety, to the point where picking up the phone to just call someone for no reason other than saying hi is difficult. I have an inferiority complex where I figure any time I reach out to someone, it will be a bother. I feel like I got better about this during my 30s, but then Covid happened and it's like it set us all back a peg on the socializing. And now this pain situation has sent me into a rather deep depression which compounds all of that.
If you're reading this, then you are almost certainly someone I care about. I'm sorry for not showing it. I hope to have better news of some kind later this year. Of course, I also hoped that for the duration of last year. All I know is, 2024 has been the worst year of my life, so 2025 would have to work hard to top it.
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