CMC Joint Arthritis and Median Nerve Hydrodissection: A Modern, Non-Surgical Approach for High-Skill Professionals
- cassis101
- Nov 23
- 2 min read
By Deborah Westergaard, MD | Pain Experts | Dallas–Plano
CMC joint arthritis can quietly erode capability long before pain becomes the main complaint.
Among high-performing individuals who depend on precision—surgeons, executives, athletes CMC joint arthritis can quietly erode capability long before pain becomes the main complaint.
For one surgeon, the issue wasn’t dramatic swelling or inability to work. It was something far more concerning:
subtle grip changes
thumb pain during wrist rotation
intermittent dropping of instruments
protecting his hand during daily life so he could “save it” for surgery
These early compensations are the body’s quiet warning signs.And while traditional surgical options exist for severe CMC arthritis, they come at a cost: reduced range of motion, loss of fine motor ability, and lengthy recovery.
For a surgeon—or any professional who relies heavily on hand dexterity—that trade-off is unacceptable.
Complicating matters further, inflammation around the CMC joint often affects the carpal tunnel, compromising the median nerve. Even subtle neural irritation can diminish precision, proprioception, and endurance—magnifying the functional loss.
The Goal is to Address Both the Joint and the Supportive Structures that Protect Fine Motor Performance.
This surgeon’s evaluation showed:
Significant CMC joint arthritis
Surrounding ligament irritation
Median nerve sensitivity likely from adjacent inflammation
Functional changes affecting grip during surgery
A narrowly focused joint injection would have missed the full picture.
1. Precision-Guided CMC Joint Treatment
Using concentrated PRP customized to a potency appropriate for thumb-base arthritis the intention is to decrease inflammatory signaling and improve joint stability without compromising hand biomechanics.
This approach protects the joint rather than altering it surgically.
If needed, additional orthobiologic support using bone marrow concentrate would be considered later, based on response and functional goals.
2. Supporting Ligament Treatment
Ligaments around the CMC joint often carry a silent burden of micro-instability. Strengthening and stabilizing these structures helps reduce pain during surgical tasks requiring strong pinch, retraction, or sustained grip.
3. Median Nerve Hydrodissection
Inflammation from CMC arthritis frequently narrows the potential space where the median nerve glides.
Hydrodissection can:
restore nerve mobility
reduce adhesions along the flexor retinaculum
decrease neural irritation
improve fine motor reliability
support endurance when holding surgical instruments
A gentle mixture with platelet lysate allows for both procedural comfort and physiologic support of nerve mobility.
4. Hand Strengthening Without Overload
After inflammation decreases, occupational therapy focusing on precision strength and functional patterning helps restore confidence during high-dexterity work.
This pathway preserves the surgeon’s range of motion—unlike surgical options that risk permanent limitation.
Consider Advanced Nondestructive Options
If thumb pain, grip changes, or intermittent hand weakness are affecting your work or if you’ve been offered surgery that may limit your motion there are advanced, non-destructive options available.
Pain Experts specializes in precision orthobiologic solutions designed for individuals who cannot gamble with their hands, performance, or productivity.
Schedule a consultation to determine whether CMC joint treatment with supportive median nerve hydrodissection is appropriate for you.
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