How to Treat the Gripping Pain of Thumb Arthritis
By Eric D. Strauss, MD, Hand Surgeon, Virtua Hand Surgery & Rehabilitation
You probably don’t think about it, but your thumbs help you do many things like text, turn knobs, grip steering wheels and carry bags. Since you use your thumbs in nearly every hand movement, thumb pain can be especially disabling.
If you experience this pain, you may have arthritis at the base of your thumb, also called basal thumb arthritis. What’s key is that you don’t have to “just deal with it.” This condition is treatable through conservative management, and in advanced cases, surgery.
What is basal thumb arthritis and what causes it?
Basal thumb arthritis is a condition that causes pain in the carpometacarpal (CMC) joint located at the fleshy part of your thumb near your wrist. To explain, the ends of the bones in all your joints are covered with smooth cartilage. This cartilage allows bones to move easily and freely. When bones lose their cartilage cushioning, they begin to rub against each other. This causes friction that leads to joint damage.
Arthritis at the base of the thumb often is attributed to osteoarthritis, a degenerative joint condition that causes the cartilage within your CMC joint to wear away with everyday use. However, basal thumb arthritis also is caused by rheumatoid arthritis, a condition that causes joint swelling, or post-traumatic arthritis, a condition that sometimes follows a joint injury.
Basal thumb arthritis is common in women age 40 and older, but men also are affected. Prior injuries to the CMC joint or performing repetitive activities using your thumb also puts you at higher risk for basal thumb arthritis.
What are the symptoms of basal thumb arthritis?
Because your CMC joint enables your thumb to swivel, pivot, grip and pinch, basal thumb arthritis causes pain when making just about any thumb motion. Tasks such as opening a jar or turning a key can be especially painful. Common symptoms of basal thumb arthritis include:
- Pain or loss of strength when gripping or pinching
- Swelling or tenderness around the joint
- Limited range of motion in the thumb
- Aching or discomfort after prolonged use
How is basal thumb arthritis treated?
If your doctor diagnoses you with early-stage basal thumb arthritis, he or she may recommend conservative treatment that includes:
- Over-the-counter anti-inflammatory medications such as ibuprofen
- Splinting, which restricts movement and allows the joint to heal
- Activity modification, such as avoiding certain repetitive movements or refraining from pinching small objects
If the pain doesn’t improve with conservative treatment or worsens over time, your doctor may recommend a steroid injection into the joint. Steroid injections can’t be repeated indefinitely, but may provide pain relief for several months. If steroid injections are no longer effective, your doctor may recommend basal thumb surgery.
If I need hand surgery for arthritis, what are my options?
Ligament reconstruction and tendon interposition (LRTI) is one of the most popular and effective surgical treatments for basal thumb arthritis because it eliminates pain and restores full thumb motion.
During an LRTI procedure, the hand surgeon removes the arthritic joint surfaces and replaces them with a “cushion” made of a small piece of tendon that’s taken from your forearm through a tiny incision. This tendon helps keep the bones in your CMC joint separated so they don’t rub together when you move your thumb.
Another treatment method for basal thumb arthritis is a minimally invasive (arthroscopic) CMC joint replacement, which replaces the damaged CMC joint with an artificial joint made of plastic or metal parts. An LRTI is considered a better solution than a CMC joint replacement because it uses tissue from your own body. Also, metal and plastic parts can wear out or fail, increasing the likelihood for another surgery.
Joint fusion is another treatment option for basal thumb arthritis. Although it’s effective at treating pain, it’s performed only in rare circumstances because it completely prevents your joint from moving.
What can I expect when recovering from hand surgery?
From surgery to complete recovery, surgical treatment for basal thumb arthritis takes about three months. After surgery, you will have to wear a thumb splint for 4-8 weeks, depending on what surgical procedure is used. Once you’re done with the splint, a progressive physical therapy program helps you regain mobility and strength in your hand.
Call 1-888-847=8823 to schedule a consultation with a Virtua hand surgeon.
Updated November 7, 2019