What is Thumb Arthritis?
Arthritis in the thumb is the most common site of arthritis in the human body, which certainly makes sense when we realize how crucial our thumbs are to our lives. In a real sense, every human uses their thumbs regardless of lifestyle, occupation, or hobbies. When we talk about thumb arthritis, we are typically referring to the thumb carpometacarpal joint (CMC joint for short) or sometimes referred to as the “basilar joint.” This is at the base of the thumb where the thumb metacarpal bone joins with the trapezium bone which is a small bone of the wrist. Over time and use, the cartilage cushion between those two bones begins to wear down and eventually is lost. This process causes inflammation and a “grinding” pain.
Do I have thumb arthritis?
Patients with symptomatic thumb arthritis can present with several symptoms but commonly, it causes an aching or sharp pain at the base of the thumb when you grip a jar or pinch something tightly. It can even cause a lot of pain while writing or gripping tools. This of course gets very irritating for patients even while using their computer at work or gardening outside. Golfing can be annoying or painful. Cooking and cleaning can be even more irritating than the tasks themselves.
How is thumb arthritis treated?
Like most things in the hand surgery realm, there are plenty of treatments shy of surgery to treat the problem and that’s where patients typically begin. Many times, regimens of oral anti-inflammatory medications can be helpful or even the topical varieties. There are many styles of splints on the market to help protect this specific joint as well. The purpose of the splints is to offload the thumb joint from needing to lock in so tightly while you use your thumb throughout the day. The splints only work while they are worn but can be a fantastic tool to employ throughout the day and keep the symptoms at bay.
When splints and oral anti-inflammatory medicines are no longer effective for relieving symptoms appropriately, there are many patients that have remarkable success with corticosteroid (cortisone) injections. These can be used at semi-regular intervals to provide many months of relief. Typically, there comes a time when the steroid injections are less effective than they used to be.
There is a surgery to eliminate the painful symptoms from thumb CMC arthritis and it is one of the more common surgeries that fellowship trained hand surgeons such as those of us at The Hand Center perform every week. The standard surgical technique involves removing the trapezium bone in the wrist which is the bone the thumb locks into as its foundation (but also the bone it is grinding against in an
arthritic state). Hand surgeons vary in the preference for how to address the gap now left with that trapezium bone removed, but the crux of the operation is indeed appropriate removal of that trapezium bone, and the other variances of soft tissue techniques are not shown to be better nor worse from a pain relief standpoint. It would be great to speak directly to your surgeon about their specific technique.
At The Hand Center, we evaluate and treat thumb arthritic conditions every day and would be happy to meet with you to talk much more about it. We are here to help your hands. Call us, or use this website to make an appointment.