Medication Summary

Medications are primarily used to decrease pain and inflammation in cases of skier's thumb. Thus, the most commonly used medications are oral nonsteroidal anti-inflammatory drugs (NSAIDs) in conjunction with the rest of the rehabilitation plan.

Class Summary

Various oral NSAIDs can be used to decrease pain and inflammation for this musculoskeletal condition, and the drug of choice (DOC) is largely a matter of convenience (eg, what is the best dosing frequency to achieve adequate analgesic and anti-inflammatory effects?), the safety profile, and cost.

Ibuprofen (Motrin, Advil, Nuprin, Rufen)

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A commonly used NSAID. DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis. Many doses are available without a prescription.

Ketoprofen (Orudis, Actron, Oruvail)

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For the relief of mild to moderate pain and inflammation.

Small dosages are initially indicated for small and elderly patients and in those with renal or liver disease.

Doses over 75 mg do not increase therapeutic effects. Administer high doses with caution, and closely observe the patient for response.

Naproxen (Aleve, Naprelan, Anaprox, Naprosyn)

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For the relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing cyclooxygenase activity, which results in a decrease of prostaglandin synthesis.

Class Summary

Topical NSAIDs are able to deliver a large dose of anti-inflammatory medication to a focal painful area with minimal systemic effects.

Diclofenac topical (Flector)

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Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Follow-up

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Media Gallery

Anteroposterior radiograph displaying a gamekeeper's fracture.
Lateral radiograph displaying a gamekeeper's fracture.
Radiograph displaying a stress test of a torn ulnar collateral ligament.
Stress testing of the metacarpophalangeal joint of the thumb in flexion.
Stress testing of the metacarpophalangeal joint of the thumb in extension.
Ruptured ulnar collateral ligament.
Completed repair using suture anchors for fixation.
Anterior view of a hand in a thumb spica splint.
Lateral view of a hand in a thumb spica splint.

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Author

Patrick M Foye, MD Director of Coccyx Pain Center, Professor of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School; Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, University Hospital

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Coauthor(s)

Muqadas H Malik, MD Pre-Residency Intern, Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School

Disclosure: Nothing to disclose.

Jonathan Raanan, MD Assistant Professor of Physical Medicine and Rehabilitation, Department of Neurosurgery, Stony Brook University Medical Center

Jonathan Raanan, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Physiatric Association of Spine, Sports and Occupational Rehabilitation

Disclosure: Nothing to disclose.

Todd P Stitik, MD Professor, Department of Physical Medicine and Rehabilitation, Director, Outpatient Occupational/Musculoskeletal Medicine, Rutgers New Jersey Medical School

Todd P Stitik, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Phi Beta Kappa, Physiatric Association of Spine, Sports and Occupational Rehabilitation

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Ossur, Fidia.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Henry T Goitz, MD Academic Chair and Associate Director, Detroit Medical Center Sports Medicine Institute; Director, Education, Research, and Injury Prevention Center; Co-Director, Orthopaedic Sports Medicine Fellowship

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

Anthony J Saglimbeni, MD President, South Bay Sports and Preventive Medicine Associates; Private Practice; Team Internist, San Francisco Giants; Team Internist, West Valley College; Team Physician, Bellarmine College Prep; Team Physician, Presentation High School; Team Physician, Santa Clara University; Consultant, University of San Francisco, Academy of Art University, Skyline College, Foothill College, De Anza College

Anthony J Saglimbeni, MD is a member of the following medical societies: California Medical Association, Santa Clara County Medical Association, Monterey County Medical Society

Disclosure: Received ownership interest from South Bay Sports and Preventive Medicine Associates, Inc for board membership.

Gerard J D'Onofrio, MBA Rutgers New Jersey Medical School

Gerard J D'Onofrio, MBA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association for Physician Leadership, American College of Physicians, American Medical Association, Beta Gamma Sigma, Biomedical Entrepreneurship Network

Disclosure: Nothing to disclose.

Rustambir Singh, MD Pre-Intern, Rutgers New Jersey Medical School

Rustambir Singh, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Gurbind Jussa Singh Sidhu, MD Pre-Intern, Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School

Gurbind Jussa Singh Sidhu, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Acknowledgements

Dena Abdelshahed Rutgers New Jersey Medical School