Arthritis of the Thumb

Definition: Arthritis of the thumb, also known as thumb basal joint arthritis or carpometacarpal (CMC) joint arthritis, involves the degeneration of the cartilage in the joint at the base of the thumb. This condition is common and can cause significant pain and loss of function in the thumb.

Causes:

• Aging: Wear and tear over time can lead to cartilage degeneration.
• Genetics: A family history of arthritis may increase the risk.
• Injury: Previous injuries to the thumb joint can predispose it to arthritis.
• Repetitive Use: Activities that put excessive strain on the thumb joint.
• Gender: Women are more commonly affected than men, especially post-menopause.

Symptoms:

• Pain at the base of the thumb, particularly during gripping, pinching, or twisting motions
• Swelling and tenderness around the joint
• Stiffness and reduced range of motion
• Decreased strength in the thumb
• Enlargement or bump at the base of the thumb
• Grinding or popping sensation in the joint

Diagnosis:

• Physical Examination: Assessing pain, swelling, and thumb movement.
• Imaging Tests: X-rays to visualize joint space narrowing, bone spurs, or other changes indicative of arthritis.

Treatment:

• Medications: Over-the-counter pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation.
• Splints or Braces: To support the thumb joint, reduce movement, and alleviate pain.
• Physical Therapy: Exercises to improve strength, flexibility, and range of motion.
• Corticosteroid Injections: To reduce inflammation and provide temporary pain relief.
• Topical Treatments: Creams or ointments containing anti-inflammatory or analgesic medications.

Surgical Options: In cases where conservative treatments are ineffective, surgery may be considered. Options include:

• Trapeziectomy: Removal of the trapezium bone in the thumb joint.
• Joint Fusion (Arthrodesis): Fusing the bones in the joint to reduce pain, but also limiting movement.
• Ligament Reconstruction and Tendon Interposition (LRTI): Replacing the damaged joint with a piece of tendon.

Prognosis: With appropriate treatment, many individuals with thumb arthritis can manage their symptoms effectively and maintain thumb function. Early intervention is crucial to prevent further joint damage and improve outcomes. Lifestyle modifications, including using supportive devices and modifying activities, can also help reduce strain on the thumb joint and alleviate symptoms.