Thumb base arthritis

Thumb base arthritis is common as you get older, in fact it is thought that as many as 1 in 3 women over the age of 50 will have it. This type of arthritis occurs when cartilage wears away from the ends of the bones that form the joint at the base of your thumb — also known as the carpometacarpal (CMC) joint. Fortunately not everyone has symptoms with this.

However, thumb arthritis can cause severe pain, swelling, decreased strength and range of movement. This can make it difficult to do simple tasks, such as turning doorknobs, peeling open packages and opening jars. Treatment usually involves a combination of medication, splinting and activity modification. Severe thumb arthritis might require injections and/or surgery.

What are the usual symptoms?

Pain is the first and most common symptom of thumb arthritis. Pain can occur at the base of your thumb when you grip, grasp or pinch an object, or use your thumb to apply force. Also if you knock your thumb.  You may experience swelling, stiffness and tenderness at the base of your thumb.  Often there is decreased strength when pinching or grasping objects. The base of your thumb may become more prominent and enlarged.

You should consider seeing an orthopaedic surgeon if these symptoms are particularly troublesome.

How is it diagnosed

The diagnosis is made by examination of the hand and with the help of a radiograph (X-ray).

How is it treated

Most cases can be treated using anti-inflammatory medication and or a splint. On occasions when this fails a steroid injection may alleviate the symptoms and inflammation, especially in early cases

Surgery

When other measures have failed an operation called a Trapeziectomy can help. This involves taking out the trapezium which is on one side of the painful joint. This removes the painful area and allows the hand function to improve.

The operation is done as a day case and usually provides excellent pain relief and improved function. There are many other more complicated procedures but none have been shown to be significantly better than a trapeziectomy.

A comparison of trapeziectomy with and without ligament reconstruction and tendon interposition

H J Belcher ¹, J E Nicholl

https://pubmed.ncbi.nlm.nih.gov/11058002/.

Mr Marcos Katchburian

MBBS; MBraz Soc Orth; FRCS (Tr & Orth)