What is arthritis at the base of the thumb?
In a normal joint, cartilage covers the ends of the bones and allows them to move smoothly and painlessly against one another. In osteoarthritis (or degenerative arthritis), the cartilage layer wears out, resulting in direct contact between the bones. In the hand, the second most common joint to develop osteoarthritis is the joint at the base of the thumb. The thumb basal joint, also known as the carpometacarpal (CMC) joint, is a specialized saddle-shaped joint that is formed by a small wrist bone (trapezium) and the first of the three bones in the thumb (metacarpal). The specialized shape of this joint allows the thumb its wide range of movement—up and down, across the palm, and the ability of the patient to pinch with the fingers (see Figure 1)
Who gets arthritis at the base of the thumb?
Arthritis at the base of the thumb is more common in women and usually starts after age 40. The cause of this form of arthritis is unknown in most cases. Past injuries to the joint, such as fractures or severe sprains, and generalized joint laxity may increase the chances of developing this form of arthritis at a younger age.
Arthritis, the most common joint issue for the thumb, can cause problems with the range of motion and lead to wrist arthritis or rheumatoid arthritis in a patient. The surgical center and the trusted surgeons at OrthoBethesda can repair an impacted joint in your hand to help relieve pain and swelling. Surgical orthopedic treatments for wrist arthritis or the thumb, joint, or hand can often be performed as an outpatient procedure.
What are the symptoms and signs of arthritis at the base of the thumb?
The most common symptom of thumb basal joint arthritis in a patient is a deep, aching pain at the base of the thumb, the most important finger. The pain is often worsened with activities that involve pinching, including opening jars, turning doorknobs or keys, and writing. As the disease progresses, patients may experience pain even when not in use, and at night, and patients often note the loss of pinch and grip strength. In severe cases, progressive destruction and mal-alignment of the joint can occur. This causes a “bump” to develop at the base of the thumb, which is caused by the thumb metacarpal moving out of position in relation to the trapezium. At this point, thumb motion becomes limited and the space between the thumb and index finger narrows, making pinch activities much more difficult (see Figure 2). The next joint up may hyper-extend to compensate. Getting ahead of rheumatoid arthritis, inflammatory arthritis, thumb arthritis, or osteoarthritis with orthopedic surgery or non-surgical treatment methods can help ease your pain, inflammation, and other symptoms, and improve your overall condition.
How is the diagnosis made for arthritis at the base of the thumb?
The appearance of the thumb and the location of the pain are both details usually very helpful in identifying this condition in your finger or wrist. Applying longitudinal pressure to the full length of the thumb and twisting or grinding the basal joint is also helpful in reproducing symptoms (see Figure 3). Although x-rays help confirm the diagnosis, symptom severity often does not correlate directly with the joint’s appearance on the x-ray. Once the surgeon has conducted a thorough evaluation of your symptoms, he or she will decide whether you should undergo surgery for your osteoarthritis conditions. No two patients are the same, which is why the surgeon will build an individualized treatment plan after diagnosis.
Physical therapy and other treatment options for arthritis at the base of the thumb
Less severe thumb arthritis will usually respond to non-surgical care. Pain medication, topical agents, splinting, activity modification, and limited use of corticosteroid injections may help alleviate pain due to wear and tear. A hand physical therapist might provide a variety of rigid and non-rigid splints to support the thumb during activities. Physical therapy is an excellent option for treating thumb arthritis of the joint, helping improve range of motion. A physical therapist will provide you with exercises to perform at home to improve your hand, finger, and joints, and will help alleviate the impacts of arthritis and osteoarthritis.
Patients with advanced arthritis of the thumb (rheumatoid arthritis) or who do not respond to non-surgical treatment may be candidates for surgical reconstruction. A variety of surgical techniques are available that can successfully reduce or eliminate pain and improve thumb position and function. Common surgical procedures include removal of the arthritic bone and joint reconstruction (joint arthroplasty), bone fusion or realignment techniques, and sometimes arthroscopic procedures in select cases. A consultation with your treating surgeon in Bethesda can help decide the best options for you when suffering from thumb, finger, wrist, joint, hand pain, and other condition (see Figure 4).
Figure 1: Thumb Basal Joint
Figure 2: In severe cases, the thumb collapses into the palm, causing a zig-zag deformity
Figure 3: Grind Test
Figure 4: Treatment Diagram
Testimonials for Dr. Mahidhar M. Durbhakula, Bethesda, MD, Resident Hand and Wrist Doctor:
A short report and note of thanks to you, and the rest of the OrthoBethesda team, for your excellent repair of my left elbow, which I fractured while out walking in early June. It was a great relief that OrthoB triage was able to get me in to see Dr. Durbhakula when I called the day after the injury and that he was ready and able to do the recommended surgery, in a convenient outpatient center, a week later. When post-op therapy was scheduled, I was delighted to learn that I was assigned to Christine Zammett, my favorite therapist. My recovery and therapy went well. I was comfortable with the covid precautions OrthoB has implemented, and very confident and pleased with the care and information that Christine and Dr. D. provided. My last visit with Dr. D. was Aug. 15; PT with Christine concluded on Aug. 27. I’ve continued exercises as they recommended. – N.G.
Schedule an Appointment at OrthoBethesda Today
Swelling, pain, and arthritis in the foot, ankle, hand, joint, finger, or other areas of the body are difficult issues to live with in Maryland. The experienced and trusted team at OrthoBethesda in Bethesda, Maryland, can properly evaluate your orthopedic situation and make a diagnosis. We build treatment plans based on the individual patient and their orthopedic conditions. We also provide you with various treatment options and procedures including physical therapy, so you have options to fight these degenerative diseases.
Stop suffering from unbearable pain caused by arthritis, the most common degenerative disease. Call us in Bethesda, Maryland, today at (301) 530-1010 to make an appointment at our surgery center for your symptoms. Our patients suffer from common osteoarthritis conditions that can be treated using arthroplasty. Surgical procedures to treat inflammatory arthritis of the joint can make it easier to perform day to day activities. Your health is always our number one priority and you can rest assured that we are taking every precaution possible to stem the spread of Covid 19 in our office.
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Contact OrthoBethesda to Treat Your Painful Arthritis in Your Thumb
If you are experiencing constant pain from arthritis at the base of your thumb, you may require orthopedic treatment. OrthoBethesda is proud to offer our quality orthopedic treatment in Bethesda and the surrounding areas. Contact us to make an appointment or call us at (301) 530-1010 today!