Thumb arthritis, or basal joint arthritis, is a form of osteoarthritis that occurs in the thumb joint. It occurs at the base of the thumb, where the thumb meets the wrist. It is common, especially in people over the age of 50. In fact, 25% to 33% of people over 50 are estimated to have some degree of thumb arthritis. It is also more common in women, especially post-menopausal women, than in men. Some studies suggest that women are two to six times more likely to develop this condition than men.
While not everyone with thumb arthritis experiences significant symptoms, it can cause pain, swelling, and limited thumb movement for those affected. Treatments for thumb arthritis usually aim to relieve pain, improve function, and slow the progression of the condition. The options range from conservative, non-surgical approaches, to more invasive and innovative surgical interventions. The solution that is right for you depends on the severity of the arthritis.
Conservative treatments manage pain and improve thumb function without surgery. Sometimes lifestyle modifications are effective. These include avoiding activities that worsen symptoms, like heavy gripping or pinching or using tools or gadgets to reduce thumb strain during daily task, but sometimes additional interventions are needed:
- Splinting/Bracing:
- Wearing a thumb splint (especially at night or during activities) to stabilize the joint and reduce movement, which can alleviate pain.
- Medications:
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Over-the-counter medications like ibuprofen or naproxen to reduce pain and inflammation.
- Topical analgesics: Creams or gels like capsaicin or diclofenac that can be applied directly to the thumb joint for pain relief.
- Physical Therapy:
- Exercises to strengthen muscles around the thumb and improve range of motion.
- Occupational therapy may also include tips on joint protection techniques and activity modification.
- Corticosteroid Injections:
- Steroid injections directly into the thumb joint to reduce inflammation and pain, though the relief may be temporary (lasting from weeks to months).
- Heat and Cold Therapy:
- Applying heat to relax muscles and improve blood flow or cold to reduce swelling and numb pain.
When non-surgical treatments fail to provide sufficient relief, surgery may sometimes be considered. The most common surgery for thumb arthritis, involving the removal of the trapezium bone (the small bone at the base of the thumb). This can be combined with a tendon transfer to stabilize the joint. A fusion can also be performed and this involves permanently fusing the bones of the thumb joint to eliminate pain. However, it reduces mobility and is typically reserved for younger or very active patients. For some patients, a joint replacement may even be a possibility. In this case, the damaged thumb joint is replaced with a prosthetic implant, similar to hip or knee replacements. This aims to maintain the thumb’s range of motion while still reducing pain.
Choosing the Right Treatment
It’s important to talk to your doctor about your lifestyle to help chooses the right treatment. Your options will depend on how severe the symptoms are and the health of the joint. While many people with manage early-stage thumb arthritis effectively with non-surgical treatments, as it becomes more advanced it may eventually require surgery. It’s important to consult with a hand specialist to tailor the treatment plan to your needs.
