Thumb arthritis, also called basal joint arthritis, occurs when the joint at your wrist and the base of your thumb (carpometacarpal joint) develops osteoarthritis.
Having thumb arthritis can cause debilitating hand pain, swelling, and decreased strength and range of motion, making it difficult to do simple household tasks, such as turning doorknobs and opening jars.
Treatment for thumb arthritis may include self-care measures, splints, medication or corticosteroid injections. In severe cases, you may need surgery to treat thumb arthritis.
Thumb arthritis occurs at the joint between your wrist and the base of your thumb. Osteoarthritis occurs when the cushioning cartilage between the bones in your joint wears away, causing the smooth ...
The first and most common symptom of thumb arthritis is pain. Pain occurs at the base of your thumb when gripping (which applies the most force to this joint), grasping, pinching an object between your thumb and forefinger, or applying force — such as when turning a key, pulling a zipper or opening a jar. Eventually, you may even experience pain when not using your thumb.
Signs and symptoms may include:
The pain, stiffness and decreased movement may be minimal or significant, depending on the severity of the condition and how you use your hands in work and recreation.
When to see a doctor
Also seek medical advice if you experience side effects — such as nausea, abdominal discomfort, black or tarry stools, constipation, or drowsiness — from arthritis medications.
The exact cause of thumb arthritis, as with osteoarthritis in general, isn't known. Researchers suspect that it's a combination of factors, including being overweight, the aging process, joint injury or stress, heredity, muscle weakness, and "cumulative load" to the joint. Cumulative load refers to repetitive use of your joint, such as in assembly line work.
Made up of the small bone at the base of your thumb (trapezium), the first bone of your thumb (first metacarpal) and the wrist's scaphotrapezio-trapezoidal joint, the basal joint allows your thumb its wide range of motion and allows your hand to pinch, grip and grasp objects.
In a normal basal joint, cartilage covers the ends of the bones — acting as a cushion and allowing bones to glide smoothly against each other. With thumb arthritis, the cartilage that covers the ends of the bones deteriorates and its smooth surface roughens. The bones then rub against each other, resulting in friction and joint damage.
Your body goes to work repairing the damage, but the repairs may be inadequate, resulting instead in growth of new bone along the sides of the existing bone (bone spurs), which can produce noticeable lumps on your thumb joint.
The exact cause of thumb arthritis is unclear, but these factors increase your risk:
Preparing for your appointment
While you might first discuss your symptoms with your family doctor, he or she may refer you to a rheumatologist — a doctor who specializes in the treatment of arthritis and other inflammatory conditions — for further evaluation.
What you can do
What to expect from your doctor
Tests and diagnosis
Your doctor may use a variety of methods to diagnose thumb arthritis, including a physical examination and certain X-ray imaging techniques.
During a physical exam, your doctor will ask about your symptoms and look for noticeable swelling or lumps on your joints.
Your doctor may conduct a test in which he or she holds your joint while moving your thumb, with pressure, against your wrist bone. If this movement produces a grinding sound, or causes pain or a gritty feeling, it means the cartilage has worn down and the bones are rubbing against each other.
Imaging techniques can reveal bony projections that grow along the edges of bones (bone spurs), worn-down cartilage and loss of joint space — each indicating the presence of thumb arthritis. Your doctor may recommend the following techniques:
Treatments and drugs
Treatment focuses on helping to:
Your doctor may recommend a combination of treatments, including self-care measures, activity modification, splints, medications and physical therapy. In early stages, nonsurgical treatments are usually effective. In severe cases, surgery may be necessary.
Several types of splints are available. Some are prefabricated, and you can find them in medical supply stores or drugstores. Others can be custom-made to fit your hand. They may be soft and cloth-like or made of plastic. Your doctor or an occupational or physical therapist with special training in treating hand disorders (hand therapist) can help you decide which kind of splint is right for you.
NSAIDs have risks of side effects that increase when used at high doses for long-term treatment. Side effects may include ringing in your ears, gastric ulcers, cardiovascular problems, gastrointestinal bleeding, and liver and kidney damage.
When surgery is necessary
During arthroscopy, your surgeon makes a tiny incision in the area around your joint and inserts a tubular instrument called an arthroscope. The arthroscope contains a light and a small camera, which projects an enlarged image of the interior of your joint onto a video monitor so that your surgeon can view it. If your joint needs repairing, the surgeon can insert surgical instruments into the joint through the arthroscope or through additional small incisions.
Based on what your doctor discovers during arthroscopy, or based on your history, physical exam and imaging studies, he or she may recommend the following treatments:
Each of these surgical procedures can be done on an outpatient basis. After surgery, you can expect to wear a cast or splint over your thumb and wrist for up to six weeks. Once the cast is removed, you may work with a physical therapist to help regain hand strength and movement. Although recovery is slow, you should be able to resume your normal activities within six months of surgery.
Lifestyle and home remedies
Self-care measures can help relieve pain, improve mobility and ultimately increase your independence. Here's what may help:
Because many complementary medicine methods haven't been studied extensively by researchers using mainstream scientific methods, it's difficult for the scientific community to evaluate their effectiveness and safety. Some "low-tech," nontraditional approaches to manage diseases such as arthritis may not get as much attention from the research community as they deserve.
For these reasons, many Western physicians just don't know enough about these methods to endorse them. Nonetheless, a growing body of evidence indicates the complementary medicine practices could have a role in treating and managing some diseases.
Take care and consult your doctor when considering alternative therapies. Many are expensive, and some may be harmful or have the potential to interact with medications. Before taking any complementary medications or dietary supplements, talk with your doctor to learn about potential dangers, particularly if you're taking other medications.
Coping and support
Adaptive equipment can help make daily tasks easier and less painful. For instance, buy a jar opener for opening lids in the kitchen. Consider replacing traditional door handles in your home with levers, which don't require the use of your thumb. Equipment is available for turning keys and modifying kitchen and household tools, as well.
Making smart choices also plays a part in coping with this condition. For example:
Talk to your doctor about other equipment and ideas that may be helpful for you.
Last Updated: 2010-03-09
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