Arthritis of the Thumb
The joint at the base of the thumb is known as the basal joint. It is near the wrist and at the fleshy part of the thumb, and enables the thumb to swivel, pivot, and pinch so that you can grip things in your hand.
Arthritis is a condition that irritates or destroys a joint. Although there are several kinds of arthritis, the one that most often affects the basal joint is osteoarthritis (degenerative or “wear-and-tear” arthritis).
In a normal joint, cartilage covers the end of the bones and serves as a shock absorber to allow smooth, pain-free movement. Arthritis of the thumb occurs when the cartilage begins to wear away. Without the cartilage, bones rub against each other, causing friction and damage to the bones and joint.
Arthritis of the base of the thumb is more common in women than in men, and usually occurs after 40 years of age. The exact cause is unknown, but genetics, previous injuries such as fractures or dislocations, and generalized joint laxity may predispose some people toward development of this type of arthritis.
Common symptoms include: pain with activities that involve gripping or pinching, swelling and tenderness at the base of the thumb, aching discomfort after prolonged use, loss of strength in gripping or pinching activities, an enlarged, “out-of-joint” appearance, development of a bony prominence or bump over the joint, and limited motion.
Dr. Pianka can test for arthritis of the thumb with an in-office exam and x-rays, which may reveal deterioration of the joint as well as any bone spurs or calcium deposits that have developed. Many people with arthritis at the base of the thumb also have symptoms of carpal tunnel syndrome.
In its early stages, arthritis at the base of the thumb will respond to nonsurgical treatment. You can ice the joint for five to fifteen minutes several times a day; take anti-inflammatory medication such as aspirin or ibuprofen to help reduce inflammation and swelling; and utilize a supportive splint to limit the movement of the thumb and allow the joint to rest and heal.
Because arthritis is a progressive, degenerative disease, the condition may worsen over time. The next phase in treatment involves a steroid solution injection into the joint. This will usually provide relief for several months. However, these injections cannot be repeated indefinitely.
When nonsurgical treatment is no longer effective, surgery is an option. Dr. Pianka performs this surgery on an outpatient basis. Options include surgery to fuse the bones of the joint together or surgery to remove part of the joint and reconstruct it using either a tendon graft or an artificial substance.
After surgery, you will need to wear a splint for several weeks. A rehabilitation program, often involving an occupational therapist, will help you regain movement and strength in your hand. While there is usually some initial discomfort, it will diminish over time, and most patients have a full recovery within several months.