Thumb Arthritis – More Than A Pain
A joint is where bones connect and move. Arthritis is thinning of the cartilage, which is the smooth covering of the joint. The body reacts to loss of the joint surface by forming bone spurs (osteophytes) (see Figure 1).
Arthritis at the base of the thumb is a genetic predisposition: like graying and thinning of the hair, it comes with age and it shows up earlier in some families. Unlike thinning of the hair, women tend to get thumb arthritis sooner than men do.
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.
Signs and Symptoms
Patients with arthritis of the base of the thumb report pain and weakness with pinching and grasping. For in-stance, opening jars, turning doorknobs or keys, and writing are often painful.
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
The diagnosis is made by talking with you and examining you. The appearance of the thumb can change with the development of bone spurs and stretching of soft tissues (ligaments) (see Figure 2). A grinding sensation may also be present at the joint (see Figure 3). X-rays are not necessary to make the diagnosis, but they can help you understand the disease and they can help when surgery is being considered.
Never before have I had the dexterity that I now have in my hand after getting treatment from Dr. Mahoney of the Phoenix Hand Surgery Center.Scott Verti
Thumb arthritis usually occurs as a result of trauma or injury to the joint. Some people also develop thumb arthritis in association with osteoarthritis in larger joints.
The basal joint gives the thumb a wide range of motion, allowing you to pinch, grip and grasp objects. The bones in the thumb’s basal joint are the first metacarpal bone, which runs through the heel of your hand, and the trapezium (truh-PEE-zee-um), a small bone at the base of your thumb.
In a normal basal joint, cartilage covers the ends of the bones — acting as a cushion and allowing bones to glide smoothly against each other. With thumb 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 joint damage.
The damage to the joint may result in growth of new bone along the sides of the existing bone (bone spurs), which can produce noticeable lumps on your thumb joint.
As with other aspects of aging, we adapt to thumb arthritis and treatment is often unnecessary. Options for treatment include non-surgical methods and surgery. Treatments without surgery range from ice/heat, pain med-icines, splinting, and injections.
Surgery consists of removing the joint either by removing a bone or connecting the bones together. There are options for moving one of your tendons to secure or cushion the bone, and each hand surgeon has a different opinion on whether this is helpful (see Figure 4). After surgery, a splint or cast is worn for several weeks.