Thumb Arthritis

Arthritis of the thumb can be an extremely painful condition affecting the joint found at the base of your thumb.

We often categorise thumb arthritis as a type of osteoarthritis, which is primarily caused by general wear and tear of the cartilage.

If you believe you have arthritis in your thumb, you will likely be suffering from pain in the base of your thumb, pain, which is heightened when you grasp objects, grip onto things, or use your thumb in any way, especially when applying force.

Arthritis of the thumb can become incredibly painful if left untreated, where even the simplest of tasks, such as tying shoelaces, putting on clothes, brushing your hair, etc. can become a painstaking task.

Arthritis of the thumb treatment

Getting to the thumb of it

The problematic joint found at the base of your thumb is known as the first carpometacarpal joint (or CMJC for short). This joint attaches to the wrist and is the joint, which ultimately allows the thumb to move in any direction which you choose. Problematic however, because this is the joint that is most susceptible to arthritis.
A brief breakdown of the carpometacarpal joint

Connecting the thumb to the wrist is the first metacarpal bone.

The small collection of bones that make our wrists are known as the carpus.

Within the carpus is a specific bone known as the trapezium.

It is the trapezium that is of particular importance as this is the bone on which the first metacarpal bone pivots, allowing the thumb to move.

When these bones connect, the first carpometacarpal joint or the trapeziometacarpal joint (TMC) is formed.

This joint provides all of the movement we need in order for our thumbs to carry out daily activities which include the actions of gripping, twisting, and manipulating.

However, when arthritis begins to develop, we understand that many of these regular movements and activities can be negatively affected, having a profoundly negative effect on your quality of life.

Common symptoms of arthritis in the thumb

  • Swelling of the thumb (around the base in particular)
  • The base of your thumb may also be sore or tender to touch
  • Your thumb might appear or feel stiff/achy
  • You may also experience a reduction in the strength of your thumb
  • You experience limited movement in your thumb.

Fortunately, there is a range of different treatments available, both non-surgical and surgical.

At The Manchester Hand Surgeon, we consult with our patients on an individual basis, assessing your needs, matched with your symptoms, and also the severity of arthritis in the thumb.

    Causes of thumb arthritis

    Unfortunately, thumb arthritis is not a condition that we can 100% prevent; however, it is a condition that The Manchester Hand Surgeon can make more bearable.

    We find the most common cause of thumb arthritis is aging, as well as past trauma or injury to the thumb and thumb joint.

    Arthritis of the thumb is ultimately caused by a degradation of the cartilage that protects your bones surfaces, limiting movement, causing muscle loss, and increasing weakness in the overall joint.

    Many of our patients have reported that the first symptoms they notice relating to the thumb is a dull ache at the base. This aching sensation can often feel like it is in the thumb itself, as well as in the wrist and forearm, depending on the severity of osteoarthritis in the first CMC joint.
    You can be at increased risk of suffering from arthritis of the thumb if:

    • You are female
    • You’re aged over 40
    • You suffer from obesity
    • You suffer from hereditary conditions – in particular, malformed joints and ligament laxity
    • You have suffered a fracture or sprain
    • You suffer from rheumatoid arthritis
    • You work in a job role that places excessive pressure on the thumb joint

    At The Manchester Hand Surgeon, we also have increased reports of arthritis in the thumb affecting postmenopausal women in particular. With such patients having approximately twenty times higher incidence of first CMCJ arthritis than any other person.

    Diagnosis

    We would recommend consulting your doctor as soon as possible if you become aware of any of the symptoms we have mentioned above.

    When you attend your initial appointment at The Manchester Hand Surgeon, our team will carry out a physical examination of your hand, paying particular attention to any unusual swelling, lumps or lack of movement in and around the thumb.

    In most examinations, we will apply a little pressure on the joint while manipulating the thumb; in these instances, we are feeling and listening for a grinding noise as the thumb joint moves. We will also observe for pain and a gritty sensation under the skin, where we will be able to feel if the cartilage is worn.

    In some cases, we may also examine the joint further through the use of our x-ray machines, allowing us to see more clearly the extent of worn cartilages, potential bone spurs, as well as a loss of space between the joints.

    Treatments and further care

    At The Manchester Hand Surgeon, we categorise treatment to control the pain of first CMCJ arthritis into three main areas. These include:

    • Support and Protection
    • Joint Therapy
    • Surgery

    Support and Protection

    A brace or splint can help to reduce the pain you experience in your thumb, by helping to reduce the movement of your thumb and wrist.

    This initial type of treatment will be recommended to you if the arthritis is in the early stages.

    Helping to manage the pain associated with specific tasks, splints can be ready-made supports or made to measure, and we will work with you to find the best and the most appropriate brace for you.

    We will work through a thorough treatment plan with you, providing recommendations on how long splints should be worn for and if this is to be day and night or just at night.

    For many patients, braces in this respect can help to reduce pain, offer support and appropriate rest, and help with correct positioning of your joint while you carry out particular tasks.

    Joint Therapy

    Physiotherapy is a great way to achieve positive results in strengthening your wrist joint while providing much-needed pain relief.

    Our physiotherapists will work with you, providing you with specific exercises and stretches to help maximise joint movement in the thumb.

    Certain medications may also be offered, such as diclofenac or capsaicin, which can be applied directly to the joint area.

    Store bought painkillers may also be an option.  Painkillers such as ibuprofen and acetaminophen that can help to reduce inflammation and ease the pain. 

    Cortisone injections are a popular option for many patients who find that their thumb arthritis is no longer at the early stage but is still not severe enough for surgery.

    This medication is injected directly into the problematic joint, helping to reduce inflammation, and providing pain relief for weeks, if not up to a year for some patients.

    Surgery

    If your results determine that the arthritis in the thumb is too severe and the pain has become unmanageable, and you are no longer able to move your thumb, then we will recommend surgery as a treatment option for you.

    At The Manchester Hand Surgeon, we offer three different types of surgery on the thumb:

    Trapeziectomy

    This procedure involves removing the trapezium bone found at the base of your thumb. We will then create a fibrous `false` joint, using soft tissue from the adjacent area. This procedure helps to dramatically reduce pain and provides the thumb with adequate movement afterward. After the surgery, your wrist and thumb joint will be in a cast for approximately six weeks, allowing a stable joint to form correctly.

    Joint Fusion

    Also known as arthrodesis, this type of surgical procedure involves fusing the trapezium bone and scaphoid bone together, creating a stable base for movement, reducing friction in the affected areas, and allowing the joint to bear weight without pain. However, this type of surgery does reduce flexibility.

    Joint Replacement

    Also known as arthroplasty, this procedure involves removing all the affected joints and replacing it using a surgical implant.   This isn’t always the most favourable type of surgery, as there is an increased likelihood that you will require further surgery. We will discuss this procedure with you further in your initial consultation. Recovery from this surgery is approximately six weeks, and we would recommend you returning to normal activities within three months. However, for some patients, it can take a year to regain full strength, movement, and stamina in the thumb.

    Aftercare

    Depending on the treatment you receive will depend on your unique treatment plan. Our team will work with you to provide the best and most suitable aftercare plan available.

    After surgery we will advise that the hand should be elevated as much as possible for the first five days, with gentle exercises and stretches carried out from day 1.

    If a splint is provided after surgery, this is usually worn for approximately 6-8 weeks depending on recovery rates.

    Most patients begin to notice a change in their thumb and hand within 8 weeks, with improved results between 6 – 12 months.

    We also aim provide recommendations for at-home remedies too.

    Remedies and solutions such as specially designed jar and tin openers, specialist key turners, larger zipper pulls, etc. – all now available and designed to help when strength in your hand is limited.

    Applying ice and heat to the joint can also help to reduce swelling and ease the pain for a limited period too, and again we will discuss these options with you after your full examination.

     

    Book your consultation today

    If you’re experiencing problems with your thumbs and you’re suffering from pain at the base of your thumb, limited movement, and swelling – call us today to make your initial appointment. 

    Let us help ease the pain and get you back to your everyday activities in no time.

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