The thumb is a busy finger that aids in practically everything you do with your hands and actually provides about 70 percent of the hand’s total function. But a lifetime of wear can lead to thumb arthritis, a condition where the cartilage in the thumb joint becomes thin. This can cause a painful grinding sensation when using the thumb and eventually an unsightly bony spur at the joint.
"The joint at the base of the thumb is the most common joint in the upper extremity to get arthritis,” said Erin Campaigniac, MD, a hand surgeon at Samaritan Orthopedics – Luis Vela, DO. “Over the course of a lifetime of using your thumb normally, the ligaments stretch out and wobble, which leads to wearing down the cartilage. You end up with bone-on-bone at the joint which causes pain when you try to grasp or pinch.”
Gripping, grasping, twisting and pinching movements can all aggravate the basal joint, located between the metacarpal and trapezium bones, and cause pain. According to Campaigniac, she often sees an increase in patients reporting pain around the holidays when people are cooking more, and in the spring when people are prepping their gardens. She also notes that women are more likely to get the condition, which usually shows up in their 50s, although people who have occupations with a lot of grasping or twisting like mechanics and manual laborers may notice thumb pain as early as their 30s.
"We can’t cure arthritis, but 75 percent of patients can manage the pain successfully without surgery if caught early,” said Campaigniac.
To help with pain, Campaigniac recommends patients begin with some combination of these five treatments:
- Thumb Splint — A device that stabilizes the joint can help reduce swelling and inflammation. Campaigniac often recommends a thumb splint at night or more often during the day as needed.
- Physical Therapy — Specialized exercises from a hand therapist can strengthen surrounding muscles to support the thumb in ways the ligaments can’t anymore.
- Steroid Injections — These can reduce the inflammation and ease pain in the joint, however steroid injections may cause the surrounding soft tissues to deteriorate even further. You may be limited to three or four injections depending on how effective they are.
- Pain Relievers — Over-the-counter or prescription medication can treat pain as it occurs.
- Home Aids — Jar openers, electric can openers, metal grabbers and oversized pens can reduce the number of things you do that might irritate the joint and cause it to become inflamed and painful.
Although the options above can offer long-term results for most people, reconstructive surgery on the joint can offer relief if you are still experiencing pain that interferes with daily life.
During surgery the arthritic joint is removed and a new one is constructed with a tendon from the wrist. The new joint is a similar size to the original, so the thumb will not be longer or shorter after surgery. Pain is eliminated with the reconstructed joint but if a deformity has developed, that will remain. Although the recovery period is long — often three to six months — Campaigniac reports that the relief from pain is worth it for most people who undergo the surgery.
"When we analyze grip strength after surgery, patients don’t necessarily have any more strength but their perception is that they do because they feel so much better,” said Campaigniac. “They don’t have pain anymore."
Surgery for thumb arthritis generally has a high success rate. The results may last for 10 years or more and Campaigniac notes that even those who put heavy use on their joints can be good candidates for the surgery.
"It’s a procedure that really holds the test of time,” said Campaigniac.
Ready to discuss your options for thumb pain? Take the next step and talk to a hand surgeon.
To learn more about thumb arthritis, visit the American Society for Surgery of the Hand.