Monday, October 18, 2010 Ruthe, Community Member, asks

Q: Swollen and painful thumb and RA

My right thumb is twice as big as my left (Oh, I do have RA of 10 years diagnosed)..and that is giving me so much pain.  I cannot bend this thumb ..luckily I can type with my fingers outstretched.  Is this a complication of my RA?  Or the start of something else?  It's really bothering me a great deal.  Hurts whether I bend the thumb or not...but is very stiff if I do try to bend it.  Swallow some pred and stop complaining....or let my rheumatologist know about this nasty digit.



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Answers (2)
V, Health Guide
10/18/10 10:07pm

I vote for letting your rheumatologist know what is going on, Ruthe. If he is a good rheumy, I think he would want to know. Peace, V

Ruthe, Community Member
10/19/10 10:04am

Thanks, V!  He is a very good rheumy...and I am still out 4 weeks before my next Remicade.  I was hoping someone else had this happen to them so they could tell me to "just ride it out..." but your advice makes sense.  Thanks!

Lene Andersen, Health Guide
10/21/10 1:38pm

if you're not having symptoms of active RA in any of your other joints, it sounds as if your thumb may be having its own localized attack of hysterics, a.k.a. a flare. Like V, I'd also recommend that you talk to your rheumatologist about this.


Have you been on Remicade for a while or are you new to it? If you're new to it, it could be that it hasn't built up enough in your system yet to keep your RA suppressed between infusions, so you may want to talk to your rheumatologist about potentially prescribing prednisone to bridge the gap until Remicade really kicks in. Your rheumatologist may also want to add another medication, such as methotrexate, as combination therapy often works better than one medication alone.


please let us know how things go?

Ruthe, Community Member
10/21/10 3:08pm

Hi Lene,

Thanks for your comments!  I have actually been on Remicade for just over four years now.  And they upped my dosage last spring.  I was given 5 mg tabs of Prednisone for relief as needed.  I use it only when I really need the other day I took some rather than call my doctor.  I figured if it didn't help, then I would call.  Well, it did help.  I still have that fat thumb, but the pain has diminished a great deal.  I have been on methotrexate for nearly ten years...we added the Remi when the MTX and Plaquenil weren't enough.  This morning my right hip gave me grief so I took it easy today (am on extended sick leave...hoping my disability gets approved) and it is doing much better now. 


I never thought that only one joint could "flare"....even though I still experience some joint pain in my distal joints and can usually handle that threshold ... it was hard not to have the use of my dominant thumb. 


Thanks again...

Lene Andersen, Health Guide
10/22/10 7:35pm

Forgive me, but I'm going to offer a suggestion. Which is that perhaps you could consider redefining what "really need it" means. We are all taught to suck it up and do the stiff upper lip thing, but if your life is being significantly impacted by the pain - and from what you are describing, it sounds as if it is - not taking the drugs that can help you isn't really doing anything for you. In a culture that tends to see taking pills as being a weakness, it can be difficult to "give in". I've been there - check out my post on working through that issue.


I'd also recommend that you call your rheumatologist. Although flares tend to be more throughout your body rather than in just one joint, it can be that focused. It sounds to me as if you're experiencing a flare and you may need some extra help. Getting checked out by your doctor may also prevent the RA from getting any fancy ideas about moving to other parts of your body, as well.


You mentioned that you feel pain in other places - would you describe that as pain of active RA or as the pain that comes from damage to the joints? In my experience, damage pain tends to be sharper and less soggy (if you know what I mean?). This again leads me to recommend that you see your doctor, just in case your RA is muttering in the background. If that is the case, the sooner you get on top of it, the better you protect your joints.


Keep us posted, please?


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By Ruthe, Community Member— Last Modified: 12/27/10, First Published: 10/18/10