Thumb Arthritis

What is thumb arthritis?

Arthritis in your thumb occurs when the protective cartilage cushioning your thumb joints starts to wear out and deteriorate. This type of arthritis is called osteoarthritis. In your thumb, osteoarthritis develops most often in the basal joint at the base of your thumb. This is also called your thumb carpometacarpal (CMC) joint. The CMC joint is located near your wrist at the fleshy part of your thumb. It helps your thumb move around in different directions so you can grip things in your hand.

Thumb arthritis is the second-most common kind of arthritis that affects your hand, after arthritis that affects the last joint in your fingers.

Another name for thumb arthritis is basal joint arthritis.

What are the symptoms of thumb arthritis?

Thumb arthritis symptoms may include:

• Pain in your thumb when grasping, gripping or pinching.
• Swelling, stiffness or tenderness at the base of your thumb.
• Loss of strength and motion in your thumb.
• Aching or discomfort after using your hand for an extended period of time.
• An enlarged thumb joint.
• Development of a bony bump (bone spur) over at the base of your thumb.

What does arthritis in your thumb feel like?

If you have thumb arthritis, you’ll feel pain at the base of your thumb when you use your thumb. You’ll feel the most pain when you’re gripping, grasping or pinching. This can involve activities like opening a jar, turning a key or snapping your fingers. As your condition progresses, the pain may increase.

What causes thumb arthritis?

Thumb arthritis occurs when the cartilage that surrounds and cushions your thumb joints starts to break down (degenerate). This is a very common type of arthritis called osteoarthritis.

Cartilage enables your bones to glide easily in your joints. When it starts to deteriorate — typically due to age and use — your bones rub against each other, which causes friction and damage.

What are the risk factors for thumb arthritis?

Risk factors for thumb arthritis include:

• Being assigned female at birth (AFAB). The condition can affect people assigned male at birth (AMAB), but it’s more common in people AFAB.
• Being age 40 and older. All types of osteoarthritis affect people more as they age.
• There’s a known genetic predisposition for developing this type of arthritis.
• Fractures and other injuries to your thumb can increase your risk.
• Other health conditions. Other health conditions like lupus and rheumatoid arthritis can lead to thumb joint deterioration.

How is thumb arthritis diagnosed?

A healthcare provider will ask about your symptoms and if you have any prior injuries to the area. They’ll ask about your pain patterns and what aggravates your condition.

Your provider will also perform a physical examination, carefully examining your thumb and hand. They may hold your joint firmly while moving your thumb. They may suspect thumb arthritis if:

• This motion hurts.
• You experience a “gritty” feeling.
• They hear a grinding sound (crepitus).

Your provider may also request an X-ray to confirm the diagnosis.

What can be done for arthritis in the thumb?

Thumb arthritis treatment varies based on the severity of your symptoms. In its early stages, you can treat thumb arthritis with at-home methods, including:

• Ice and/or heat: You can apply ice to your thumb joint for five to 15 minutes a few times a day. You can also place a heating pad over the joint for five to 15 minutes several times a day. Try both options to see what works best for you.
• Pain medication: You can take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®) or aspirin to help reduce swelling and inflammation. Or you can try acetaminophen (Tylenol®). Some people alternate with a combination of both.
• Splint: You can wear a soft, supportive splint to help stabilize and limit the movement of your thumb. This will allow your thumb joint to rest and can protect your wrist and thumb. You can wear a splint from time to time during the day or overnight.

Despite at-home treatment, your condition may continue to worsen over time because arthritis is a progressive, degenerative disease. At this point, your healthcare provider may recommend steroid injections. Your provider can inject a steroid solution directly into your thumb joint. This typically provides pain relief for several months. But you can’t use the injections forever because they become less effective over time.

Thumb arthritis surgery

When nonsurgical options are no longer providing you relief, your healthcare provider may recommend surgery. Options for thumb arthritis surgery include:

• Denervation: This doesn’t directly alter the joint itself but aims to remove the pain signals coming from the nerve ending at the joint from relaying those pain signals back to your brain.
• Fusion (arthrodesis): Arthrodesis involves fusing the bones of your thumb joint together. This procedure can reduce pain and increase strength, but it may limit movement.
• Ligament reconstruction and tendon interposition (LRTI): LRTI involves removing all or part of your thumb joint and suspending the rest of your thumb using a tendon from your wrist. This procedure can reduce pain while allowing continued movement.
• Trapeziectomy with suspensionplasty: Removing part of your thumb joint and suspending your thumb using nearby tendons or sutures. This allows motion while reducing pain.
• Total joint replacement (arthroplasty): Arthroplasty involves the removal of all or part of your thumb joint and replacing it with an artificial implant.

How soon after surgery will I feel better?

Depending on which procedure you’ve had, it can take anywhere from two months to a year for complete recovery. To help in your rehabilitation, your provider will likely recommend some type of physical therapy. An occupational therapist, like a certified hand therapist, can help you regain strength and movement in your hand and thumb.

Can thumb arthritis be prevented?

All types of osteoarthritis occur due to age and use. The best way to prevent thumb arthritis is to maintain good overall health. Steps you can take to lead a healthy lifestyle include:

• Don’t smoke or use other tobacco products.
• Try to get some physical activity at least three days a week.
• Follow a nutrition plan that’s healthy for you.
• Always wear your seatbelt.
• Wear a bike helmet and other protective equipment during sports and activities.
• Visit a healthcare provider regularly.

What is the outlook (prognosis) for people with thumb arthritis?

Thumb arthritis is a very treatable condition. Many people see relief from their symptoms with nonsurgical treatment methods, including ice/heat, pain relievers, splints and steroid injections. When nonsurgical options don’t relieve your symptoms, treatment with surgery can help. Most people are eventually able to return to their typical activities. Not everyone with thumb arthritis will require surgical intervention.

How do I take care of myself?

In addition to at-home treatment options like pain relievers and splints, you may want to find some ways to limit the use of your thumb. Some tips include:

• Use a battery-operated or an electric can opener.
• Avoid repetitive activities like sewing or cutting with scissors.
• Use foam tubing to build up the handles on your gardening tools and kitchen utensils so you won’t have to grip them so tightly.
• Use the speakerphone on your phone rather than holding it, when possible.
• Carry a backpack or bag instead of carrying things in your arms.

When should I see my healthcare provider?

If at-home treatments like ice, heat or pain medication are no longer providing relief, you may want to consider calling your healthcare provider. They can talk to you about your arthritis pain and recommend additional treatment options.

What questions should I ask my healthcare provider?

If you have thumb arthritis, you may want to ask your provider the following questions:

• How can I make my daily tasks easier?
• What options do I have for pain relief?
• What other treatment options do you recommend?
• How can I prevent thumb arthritis in the future?