Base of thumb arthritis

Base of thumb arthritis, also known as thumb basal joint arthritis or carpometacarpal (CMC) joint arthritis, refers to the degeneration and inflammation of the joint at the base of the thumb. This joint is known as the carpometacarpal joint, and it is located at the junction where the thumb metacarpal bone (the bone connecting the thumb to the wrist) meets the trapezium bone (one of the small bones in the wrist).

Base of thumb arthritis commonly occurs as a result of wear and tear over time. The cartilage that covers the joint surfaces gradually breaks down, leading to bone-on-bone contact and the development of arthritis symptoms. It is most often seen in patients over the age of 40 and more commonly affects women.

Symptoms of base of thumb arthritis include:

  1. Pain: Persistent pain at the base of the thumb, which may worsen with activities involving gripping, pinching, or twisting motions.
  2. Swelling: The joint may appear swollen, tender, or warm to the touch.
  3. Loss of strength and range of motion: Reduced grip strength and difficulty with activities that require thumb movement, such as writing, grasping objects, or opening jars.
  4. Thumb instability: The joint may feel loose or unstable, causing difficulty with precision movements.
  5. Enlarged joint: As the condition progresses, the joint may become visibly enlarged due to bone spurs or joint deformities.
hand pain

Hand Pain

Hand pain can be caused by various conditions leading to stiffness, weakness and nerve irritation

normal thumb CMCJ

Normal thumb X-Ray

In a normal thumb X-Ray, the thumb joint (circle) has smooth edges with no signs of deformity or spurs

thumb arthritis

Thumb arthritis X-Ray

In a thumb with arthritis, the X-Ray show a thumb joint (circle) with narrowing and multiple bone spurs

Treatment

Treatment for base of thumb arthritis can vary depending on the severity of symptoms and your specific situation. Non-surgical treatment options may include:

  • Pain management: Over-the-counter pain medications or topical creams to relieve pain and reduce inflammation.
  • Splinting: Wearing a thumb splint to provide support, reduce joint movement, and alleviate symptoms.
  • Hand therapy: Specific exercises to improve strength, range of motion, and joint stability.
  • Lifestyle modifications: Avoiding activities that aggravate symptoms and modifying daily tasks to reduce thumb stress.
  • Assistive devices: Using assistive devices such as ergonomic tools or adaptive equipment to minimise thumb strain.
  • Corticosteroid injections: Injecting anti-inflammatory medication into the joint to provide temporary pain relief.

In more severe cases or when conservative measures fail to alleviate symptoms, surgery can be considered.

Surgery for base of thumb arthritis

When conservative treatments fail to provide relief, trapeziectomy may be considered as a surgical option. Trapeziectomy is a surgical procedure that involves the removal of the trapezium bone, which is one of the small bones located at the base of the thumb. As part of the operation, the thumb is stabilised using a specialised suture button implant (suspensionplasty).

Following the surgery, a splint is applied for six weeks to protect the thumb and promote healing. Hand therapy may be recommended to regain strength, range of motion, and functional use of the hand and thumb.

Trapeziectomy can provide significant relief for individuals with severe thumb basal joint arthritis. However, as with any surgical procedure, it carries risks and potential complications, such as infection, stiffness, nerve injury, or persistent pain.

base thumb arthritis

Thumb arthritis

Base of thumb arthritis causes pain, stiffness and weak grip strength

thumb trapeziectomy

Trapeziectomy

Trapeziectomy involves removing the arthritic trapezium

thumb suspensionplasty

Thumb stabilisation

Stabilisation of the thumb with a suture button implant (suspensionplasty)

Get Expert Help

It’s important to note that not everyone with hand pain falls into one specific diagnosis and your individual symptoms can vary. If you are experiencing hand pain, limited mobility, or other concerning symptoms, Dr. Arthur Turow can assess your hand, provide you with an accurate diagnosis and suggest appropriate treatment options specific for your individual needs.

Please use above information as a guide only. More detailed information specific to your condition and your recovery will be given in your consultation with Dr. Arthur Turow, who will also provide additional resources to supplement your discussion. For more information, please contact the rooms of Dr. Arthur Turow on (08) 8236 4179.