Thumb arthritis

Thumb arthritis is the second most common type of arthritis in the hand. As the joint becomes worn, which is common as you age, the cartilage wears away from the ends of the bones that form the joint at the base of your thumb.

Because you use your thumb in many daily activities, you may first notice an issue performing simple tasks, such as turning doorknobs and opening jars. Thumb arthritis can cause severe pain, swelling, and decreased strength and range of motion.

Symptoms

You may experience the following signs and symptoms in your thumb:

• Pain when you grip an object or apply force to the area
• Swelling, stiffness and tenderness
• Decreased range of motion
• Enlarged or bony appearance at the base of the joint

Risk factors

Some of the risk factors for thumb arthritis include:

• Gender – women are more likely than men to develop thumb arthritis
• Being over the age of 40
• Obesity
• Previous or current injuries to your thumb, such as fractures and sprains, or certain hereditary conditions, such as malformed joints
• Medical conditions, such as rheumatoid arthritis or lupus
• Activities and jobs that put high stress on the thumb joint

Diagnosing thumb arthritis

Your hand specialist with review your symptoms and then examine your hand, looking for noticeable swelling or bumps on your joints. The specialist may also hold your joint while moving your thumb to see if the movement produces a grinding sound or causes pain.

An X-ray may be ordered to reveal signs of thumb arthritis, including bone spurs, worn-down cartilage or a loss of joint space.

Treating thumb arthritis

Your hand specialist will evaluate your condition to develop a plan for you. There are a variety of non-surgical therapies to treat thumb arthritis. Your doctor may recommend a combination of some of the following treatments:

• Topical medications. These are applied directly to the skin over the joint to reduce pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter medications that reduce inflammation.
• Exercises for the thumb. Your doctor may recommend some simple exercises with a hand therapist to help improve mobility in the thumb.
• Prescription pain relievers. Your doctor may prescribe you specific prescription medications that help with arthritis.
• Splint. You can wear a splint at night or throughout the day to support your thumb joint and limit the movement of your thumb and wrist.
• Injections. Corticosteroids can be injected directly into the thumb joint to offer temporary pain relief and reduce inflammation.

If you don’t respond to non-surgical treatments or if you have severe limitations in your thumb joint, your hand specialist may recommend surgery. Options for surgery include:

• Joint fusion. The bones in the affected joint are permanently fused together. This procedure is generally used for younger patients.
• Osteotomy. The bones in the affected joint are repositioned to help correct deformities. This surgery is typically most effective for those with mild arthritis.
• Trapeziectomy. One of the bones in your thumb (trapezium) is removed.
• Joint replacement. This procedure is usually done in conjunction with trapeziectomy and involves using a tendon graft or synthetic suture material to replace the joint and suspend the thumb.  

All of these surgeries can be performed on an outpatient basis. If surgery is needed, your surgeon will review your options with you and determine what course of treatment is the best for your specific condition. After surgery, you can expect to wear a cast or splint for up to six weeks over your thumb and wrist. Once this is removed, your surgeon may recommend physical therapy to help you regain your strength and mobility.