Gail is a 54-year-old nurse who works in the neonatal intensive care unit of a hospital. She is married and the mother of three teenagers. She enjoys gardening, cooking, and crocheting in her spare time. For over a year, she has been experiencing pain in her right (dominant) thumb. She notices the pain during many of her everyday activities including using a syringe, writing, and opening various containers (e.g., medications, supplies) at work. She notices pain when lifting pots and casserole dishes as well as when she is gripping wet clothes to pull them out of the washer. Using her gardening tools has become too painful. She has basically had to give up most of the yard work and even the crocheting she enjoys. Gail discussed her concerns with her family physician during her yearly routine physical. Her physician took x-rays and examined her thumb. She tested positive for the “Grind test” (a provocative test used to determine CMC arthritis). Her physician diagnosed her with right thumb basal joint or CMC joint OA.
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