A condition that can irritate or even destroy a joint, arthritis comes in several different forms. The one that most commonly affects the basal joint of the thumb is osteoarthritis – also called degenerative or “wear-and-tear” arthritis.
As with other joints in the body, smooth cartilage covers the ends of the basal joint in the thumb to enable the bones to glide easily. Without that cartilage, the ends of the bones rub against each other, resulting in friction, damage, and pain. Osteoarthritis is characterized by the wearing down of that vital cartilage.
The basal joint is located at the base of the thumb, near the wrist and thick part of the thumb. It allows your thumb to swivel, pivot, and pinch so you can grip things in your hand.
Arthritis of the thumb is found more often in women than in men, and typically occurs after the age of 40. Past fractures and joint damage may increase the likelihood of this condition forming.
- Pain during activities that require gripping or pinching
- Tenderness or swelling at the base of the thumb
- Discomfort after prolonged use
- Loss of grip-strength
- Limited range of motion (ROM)
During testing, your doctor may hold the joint firmly while you move your thumb. If there is a painful or gritty feeling, the bones are rubbing directly against each other.
An x-ray may reveal deterioration of the joint or any bone spurs or calcium deposits that have built up as well.
Arthritis of the thumb responds well to nonsurgical treatment in its early stages.
- Ice the affected joint for 5-15 minutes multiple times per day
- Take a non-steroidal anti-inflammatory drug (NSAID) like aspirin or ibuprofen to help reduce swelling
- Limit your thumb’s movement by using a supportive splint so the joint can rest and heal properly
Arthritis is a degenerative disease, so the condition may worsen over time. The next phase in treatment typically involves an injected steroid solution which can provide relief for months at a time. Injections cannot be repeated indefinitely, however.
When nonsurgical treatments fail, surgery is an option. The procedure is typically performed on an outpatient basis, and there are a couple different options available.
The bones that make up the joint can be fused together, but this will limit mobility.
Another popular option is to remove part of the joint and reconstruct it using a tendon graft or artificial substitute.
If surgery is needed, you will wear a cast for 4 to 8 weeks, depending on the surgical procedure chosen. Rehabilitation often involves a physical therapist who helps you regain movement and strength in your hand. There may be some discomfort initially, but this will diminish over time.