Thumb Arthritis

Thumb arthritis, also commonly referred to as basal joint arthritis, carpometacarpal (CMC) joint arthritis, or trapeziometacarpal joint arthritis, is a common form of hand arthritis.  

Anatomy and Causes

The thumb carpometacarpal (CMC) joint is a complex joint at the base of the thumb.  In its healthy state, the shape of this joint allows for a wide range of motion of the thumb and is essential in pinching activities.  This joint experiences significant force with many pinching and gripping activities, and can degrade over time.  This wear and tear causes the cartilage to thin and wear down, leading to pain at the base of the thumb and difficulty with many daily activities.

Symptoms and Associations

Initial symptoms of thumb arthritis are intermittent pain or soreness in the base of the thumb.  This pain is occasionally in a “C-shaped” distribution around the thumb, and is usually worse with any gripping and pinching activities.  Patients may notice a bump or other deformity at the base of the thumb.  Thumb motion can be affected in severe thumb arthritis, and in some cases this can lead to compensatory hyperextension of one of the other nearby joints, the metacarpal phalangeal joint.  Thumb arthritis can also be associated with irritation of several of the tendons around the wrist and thumb.

Treatment

Treatment for thumb arthritis is aimed at reducing pain.  Unfortunately there are currently no treatments that have been shown to stop or reverse arthritis, but there are excellent options for improving symptoms.

Non-operative

Non-surgical treatments for thumb arthritis are aimed at reducing pain and maintaining activities.  Initial treatment typically includes using removable braces during high-demand activities to stabilize the joint.  Treatments can also include oral or topical anti-inflammatory medications.  Steroid injections into the joint can also reduce inflammation and pain.  These non-surgical measures can be very successful in managing the symptoms of thumb arthritis.

Operative

In cases where non-operative measures have failed to improve symptoms, surgery may be a good option.  Surgery for thumb arthritis involves removing the offending bone, the trapezium, and reconstructing the ligaments to support the base of the thumb.  Surgery is performed on an outpatient basis with no requirement to stay overnight in the hospital.  After surgery, your surgeon will immobilize your thumb in a splint for several weeks to allow the thumb to heal in the correct position.  Thumb arthritis surgery is very effective at reducing pain, but does have a significant recovery time before full functions can be performed.