Arthritis of the thumb usually occurs at the joint found at the base of the thumb, where the thumb meets the wrist. This joint, called the carpometacarpal (CMC) joint, is important when trying to grip or pinch. Thumb arthritis is more common in women than men, and increases in frequency over the age of 40 years.
What are the symptoms of thumb arthritis?
Symptoms common in patients who have thumb arthritis are:
- pain at the base of the thumb
- swelling at the base of the thumb
- a grinding sensation when moving the thumb
- painful and limited motion of the thumb
- difficulty gripping
- pain when opening jars, turning keys, etc.
By examining your thumb, your doctor can usually make the diagnosis of thumb arthritis without any special tests. An x-ray will show the extent of the arthritis. The x-ray may also offer some indication of how successful nonoperative treatments may be in your situation.
What are the treatments for thumb arthritis?
The treatments for thumb arthritis include:
- Anti-inflammatory medications
A simple anti-inflammatory medication is often a good first step in the treatment process. You should talk to your doctor to discuss the safety of these medications, and the appropriate dose. Often, these medications can relieve symptoms of thumb arthritis.
- Thumb abduction splints
A splint can rest the arthritic joint, and relieve the inflammation associated with thumb arthritis. The splint should be worn during activities that aggravate your symptoms.
The thumb abduction splint is the simplist brace to use for this purpose, but in patients with more severe symptoms, a more significant brace may be needed. In these patients, a thumb spica brace is appropriate. The thumb spica brace is more supportive to the thumb, but more awkward to use in your daily activities.
- Cortisone injections
A cortisone injection places a powerful anti-inflammatory medication directly at the site of the arthritis. This injection usually provides quick relief of symptoms, but the symptoms may return over time.
Is surgery ever necessary for treatment of thumb arthritis?
Yes. Surgery can be a helpful treatment for patients with severe thumb arthritis. The usual surgical treatment is to remove the arthritic bone, relieving the pain and inflammation of the worn-out joint. There are different surgical procedures to accomplish this goal. In some situations, your surgeon may choose to replace the removed bone with a tendon graft, with an artificial implant, or with nothing at all. Alternatively, your doctor may consider fusing the joint, to eliminate all motion at the base of the thumb.
The good news about surgery, is that in appropriately selected patients, surgical treatment of thumb arthritis is very successful. Patient satisfaction with surgical treatment is about 90-95%, meaning most patients feel very good after surgical intervention. There are potential complications of surgery, including infection, nerve injury, and persistent pain. Talk to your doctor if you want to know more about the surgical treatment of thumb arthritis.
What else can cause thumb pain?
There are other potential causes of thumb pain they need to be considered, especially if simple treatments for some arthritis do not help. Possible causes of thumb pain include:
Barron OA, Glickel SZ, Eaton RG. "Basal Joint Arthritis of the Thumb" J. Am. Acad. Ortho. Surg., September/October 2000; 8: 314 - 323.