Description

Thumb arthritis is common with aging and occurs when cartilage wears away from the ends of the bones that form the joint at the base of your thumb — also known as the carpometacarpal (CMC) joint.

Thumb arthritis can cause severe pain, swelling, and decreased strength and range of motion, making it difficult to do simple tasks, such as turning doorknobs and opening jars. The treatment typically involves a combination of medication and splints. Severe thumb arthritis might require surgery.

Symptoms

The pain is the first and the most common symptom of arthritis of the thumb. The pain may occur at the base of your thumb when you grip, grasp, or pinch an object, or use your thumb to apply force.

Other signs and symptoms may include:

  • Swelling, stiffness and pain in the base of the thumb
  • The decreased strength when pinching or grasping objects
  • Decreased range of motion
  • Enlargement or bony appearance of the joint at the base of the thumb

When to see a doctor

Consult your doctor if you have persistent swelling, stiffness, or pain at the base of the thumb.

Causes

Thumb arthritis commonly occurs with aging. Previous trauma or injury to the thumb joint can also cause arthritis of the thumb.

Normal of the thumb joint, the cartilage that covers the ends of bones — that acts as a shock absorber and allowing the bones to glide smoothly against one another. With the thumb of 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 damage to the joints.

The damage to the joint may result in the growth of new bone along the sides of the existing bone (bone spurs), which can produce noticeable lumps in your thumb joint.

Risk factors

Factors that may increase your risk of thumb arthritis include:

  • The female sex.
  • Age older than 40 years.
  • Obesity.
  • Certain inherited conditions, such as joint ligament laxity and abnormalities in the joints.
  • Injuries to the thumb joint, such as fractures and sprains.
  • Diseases that change the normal structure and function of cartilage, such as rheumatoid arthritis. Although osteoarthritis is the most common cause of thumb arthritis, rheumatoid arthritis, can also affect the CMC joint, usually to a lesser extent than the rest of the joints of the hand.
  • Activities and jobs that put high levels of stress on the joint of the thumb.

Diagnosis

During a physical exam, your doctor will ask about your symptoms and look for noticeable swelling or lumps on your joints.

Your doctor might hold 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, the cartilage has likely worn down, and the bones are rubbing against each other.

Imaging techniques, usually X-rays can reveal signs of arthritis of the thumb, including:

  • Bone spurs
  • Worn cartilage
  • The loss of joint space

Treatment

In the early stages of the arthritis of the thumb, treatment usually involves a combination of non-surgical therapies. If the thumb of the arthritis is severe, surgery may be necessary.

Medicine

To relieve the pain, your doctor might recommend:

  • Topical medications, such as capsaicin or diclofenac, which is applied to the skin over the joint
  • Over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve)
  • Prescription pain medications, such as celecoxib (Celebrex) or tramadol (Conzip, Ultram)

Splint

A splint can support the joint and limit movement of your thumb and the wrist. You can wear the splint only at night or during the day and night.

Splints may help:

  • Decrease pain
  • To encourage the proper positioning of the joint while you complete tasks
  • Rest of the joint

Injections

If pain relievers and a splint are not effective, your doctor may recommend an injection of long-acting corticosteroid in your thumb joint. Corticosteroid injections may provide temporary pain relief and reduce inflammation.

Surgery

If you do not respond to other treatments, or if you're just able to bend and twist your thumb, your doctor may recommend surgery. The options include:

  • Joint fusion (arthrodesis). The bones in the affected joint are permanently fused together. The cast of the joint can bear weight without pain, but don't have the flexibility.
  • The osteotomy. The bones in the affected joint are repositioned to help correct deformities.
  • Trapeziectomy. One of the bones of the thumb joint (trapezoid) is removed.
  • Joint replacement (arthroplasty). All or part of the affected joint is removed and replaced with a graft of one of your tendons.

These surgeries are performed on an outpatient basis. After the surgery, you can expect to wear a cast or a splint on the thumb and wrist for up to six weeks. Once the cast is removed, you can have physical therapy to help regain the strength of the hand and the movement.

Lifestyle and home remedies

To relieve the pain and improve the joint mobility, try the following:

  • Modify hand tools. Consider the purchase of adaptive equipment, such as opening jars, key turners and large zipper pulls — designed for people with limited hand strength. Replace the door handles, which should capture with your thumb, with levers.
  • Apply cold. The icing on the articulation of five to 15 minutes, several times a day can help relieve the swelling and the pain.
  • Apply heat. For some, the heat can be more effective than the cold in the relief of pain.

Preparing for your appointment

You may be referred to a doctor who specializes in disorders of the joints (rheumatologist).

What you can do

  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down your key medical information, including other conditions, and the entire history of the injury of the painful joint.
  • Write down key personal information, including any major changes or factors of stress in your life.
  • Make a list of all your medications, vitamins or supplements.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.
  • Write questions to ask their doctor.

Questions to ask your doctor

  • What is the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What treatments are available?
  • Are there any restrictions that I need to follow?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask other questions.

What to expect from your doctor

Your doctor may ask you a series of questions. Be prepared to answer them you can let go the more points you want to discuss it in depth. You can ask:

  • When the pain started?
  • How severe are the symptoms? Are continuous or occasional?
  • What, if anything, seems to improve or worsen your symptoms?
  • Have you ever injured your hand?
Symptoms and treatment of arthritis of the Thumb