Osteoarthritis of the thumb is a common condition affecting both males and females, however is more common in the female population. It commonly occurs with age and is caused by a narrowing of the joint space and a breakdown of the padding, called cartilage, that covers the ends of the bones at the base of your thumb, also known as the carpometacarpal joint (CMCJ).
Thumb arthritis is often very painful during both activity and at rest and can cause swelling, decreased range of motion and reduced strength. Simple tasks such as turning on a tight tap, opening a jar or holding your phone can become difficult.
Causes
Osteoarthritis is the most common form of arthritis in the thumb and is caused by a gradual breakdown of the cartilage at the ends of the bone. This leads to the bones rubbing together, friction and joint damage. It usually occurs as part of the natural aging process and is most common in adults over 50. Previous trauma to the thumb can also cause osteoarthritis.
Other risk factors may include:
- Overuse, particularly activities or jobs that place high demands on the thumb
- Genetic predisposition
- Gender (female)
- Previous trauma to the joint (e.g. fracture or dislocation)
Signs & Symptoms
Pain is generally the first symptom of thumb arthritis. People can experience pain with gripping pinching, holding an object with pressure on the thumb or even at rest. People can also experience a decreased range of motion of the thumb with a distorted appearance, often appearing large and “boney” at the base of the thumb.
Other symptoms include:
- Swelling, stiffness or soreness at the base of the thumb
- Decreased strength with gripping or pinching objects
- Sharp pain or aching at the base of the thumb
- Decreased range of motion
Treatment
Early stages of thumb arthritis are best treated by a combination of non-invasive and non-surgical techniques. Treatment involves exercises, joint protection techniques, splints and medications.
If your thumb arthritis is severe you may require invasive treatments such as steroid injections or surgery.
Therapy
To help alleviate symptoms therapy can:
- Provide exercises to increase range of motion, keep ligaments and tendons supple and improve stability
- Provide strengthening exercises to strengthen muscles around the thumb to support posture and strength
- Assist with oedema control and management
- Assess your individual thumb biomechanics to help correct thumb posture during movement
- Provide education on joint protection techniques
- Provide custom made splints.
Splinting
Your hand therapist can provide you with a splint. Splinting is the mainstay of conservative management of an unstable and painful thumb. The splint may be used during the day for functional tasks, at rest or both to help:
- Decrease pain
- Correct thumb posture during functional tasks to take the pressure off the arthritic joint
- Rest the joint and allow inflammation to settle
Medications
To help relieve pain and/or inflammation your doctor might recommend trying:
- Topical gels or creams such as voltaren gel which you apply to the skin over the affected area
- Over the counter oral medications such as panadol osteo.
- Prescription pain or anti-inflammatory medications.
Injections
If pain is still persisting after trying conservative management techniques your doctor or surgeon may suggest a long acting cortico-steroid injection directly into the joint at the base of your thumb. Like oral medications this can help reduce pain and inflammation.
Surgery
If you haven’t responded to any of the mentioned treatment options and pain and reduced movement are significantly impacting your ability to function your doctor or surgeon may recommend surgery. Surgical options include:
- Suspension plasty: One of the small bones at the base of your thumb (the trapezium) is removed and replaced with a tendon to provide cushioning and stability.
How Can I Prevent Thumb Arthritis?
In some instances thumb arthritis is a result of trauma to the joint. There is also a genetic predisposition and other factors that are not always preventable. However, there are a number of ways you can protect your thumb joint against thumb arthritis or reduce the severity of the disease if you are in one of the risk categories or are in the early stages.
- Reduce unnecessary repetitive actions of the thumb including holding the thumb in positions of load for extended periods e.g. holding a book
- Maintain a good range of motion of your joints through regular exercise prescribed by a hand therapist
- Avoid gripping narrow and small objects tightly.
Melbourne Hand Therapy Can Help You
Our experienced therapists can help you manage your symptoms and slow the progress of this condition. We teach you joint protection techniques, prescribe exercises to improve stability and strength and recommend splints to rest and support your painful thumb. All of our clinic locations have modalities such as the paraffin wax bath which may also assist with pain relief.
To learn more, book an appointment below today!
