Basal Joint Arthritis or Thumb Arthritis

What is Thumb Arthritis?

Thumb arthritis is the most common form of osteoarthritis affecting the hand. Also called basal joint arthritis, thumb arthritis occurs when the cushioning cartilage wears away from the adjoining ends of the bones that form your thumb joint (carpometacarpal joint).

Thumb arthritis can cause severe 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. If you have severe thumb arthritis, you may need surgery.

What are the Causes of Thumb Arthritis?

The disease usually develops over a period of several years. Occasionally, it is accelerated by an injury or fracture. However, arthritis conditions are typically the result of the natural aging process and the wear and tear that comes with daily use. Women over 40 generally are more often affected by arthritis of the thumb base than men are by a ratio of 10 to 1.

Swelling at the thumb base, occasional warmth about the area, tenderness to the touch and pain when pinching or grasping, can indicate arthritis of the thumb base. Turning door knobs or jar lids and opening car doors can become difficult for those with this condition. The pain limits function and its intensity varies depending on your activity level. As the disease progresses, the joint at the thumb base may appear enlarged and swollen. Eventually it becomes more difficult to open the hand around large object.

Symptoms of Thumb Arthritis

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

Other signs and symptoms may include:

• Swelling, stiffness and tenderness at the base of your thumb
• Decreased strength when pinching or grasping objects
• Decreased range of motion
• Enlarged, bony or out-of-joint appearance of the joint at the base of your thumb

What are the Risks Factors of Thumb Arthritis

These factors may increase your risk of thumb arthritis:

• Being female
• Being age 40 or older
• Having certain hereditary conditions, including joint ligament laxity and malformed joints
• Experiencing injuries to your basal joint, such as fractures and sprains
• Having diseases that change the normal structure and function of cartilage, such as rheumatoid arthritis
• Performing certain activities and jobs that put high stress on this joint

Treatment of Thumb Arthritis

Arthritis is different in each individual. There are a variety of treatments that may work for your particular symptoms.

Initial treatment options involve exercises, application of ice, medications, splinting, or steroid injections. If these methods do not relieve pain and improve function, the joint may need to be reconstructed using surgery.

As with any form of arthritis, it is important to talk to your doctor before treating your condition, especially before taking any medications.

Surgical Solutions

If exercise, medications, and splinting do not sufficiently reduce pain and restore range of motion and strength, surgery may be required. Possible surgeries for thumb arthritis include:

• trapeziectomy: One of your wrist bones involved in the thumb joint is removed.
• osteotomy: The bones in your joint are moved and aligned correctly. They may be trimmed to remove excess growth.
• joint fusion: The bones in the joint are fused. This improves stability and reduces pain. However, there is no longer flexibility in the joint and you will no longer be able to perform certain tasks.
• joint replacement: The joint is replaced with tendon grafts.