Thumb Arthritis
Overview
Thumb arthritis happens when the protective cushion (cartilage) on the bones of the thumb joint wears down. This joint, called the carpometacarpal (CMC) joint, is where the thumb meets the wrist.
As people get older, this cartilage can naturally wear away, leading to thumb arthritis. This wearing down of the cartilage in the joint at the base of your thumb can cause discomfort and stiffness.
Thumb arthritis often causes pain and swelling in the thumb. It can also make it harder to use your thumb for everyday tasks, like turning doorknobs, opening jars, or gripping objects. Your thumb might not move as easily as it used to.
Treatment usually involves a combination of pain relievers and supportive devices like splints. These help reduce pain and inflammation. If the arthritis is severe, surgery might be necessary to repair or replace the damaged joint.
Symptoms
Thumb arthritis often starts with pain. This pain is usually felt at the base of your thumb, especially when you grip, hold, or pinch things, or use your thumb to push or pull hard.
You might also notice other signs, like:
- Swelling: The area around the base of your thumb might feel puffy.
- Stiffness: Your thumb might feel less flexible than usual.
- Tenderness: The base of your thumb might be sore to the touch.
- Weakness: You might find it harder to grip or pinch things.
- Limited movement: Your thumb might not move as far as it used to.
- A change in appearance: The joint at the base of your thumb might look bigger or more bony.
If you're experiencing any of these problems, especially persistent swelling, stiffness, or pain at the base of your thumb, it's important to see a doctor. They can diagnose the problem and recommend the best treatment options.
When to see a doctor
If you're experiencing ongoing swelling, stiffness, or pain in your thumb's base, it's important to see a doctor. This could be a sign of a problem that needs medical attention. Don't ignore these symptoms. Visiting your doctor can help determine the cause and get you the right treatment.
Causes
Thumb arthritis is a common problem that often develops as people get older. It can also be caused by past injuries or trauma to the thumb joint.
Healthy thumb joints have cartilage, a smooth, protective tissue, covering the ends of the bones. This cartilage acts like a cushion, allowing the bones to move easily against each other. In thumb arthritis, this cartilage wears down and becomes rough. This means the bones rub together, causing friction and damage to the joint.
This damage can lead to the formation of extra bone, called bone spurs, along the sides of the existing bone. These bone spurs sometimes show up as noticeable bumps on the thumb joint.
Risk factors
Several things can make you more likely to develop arthritis in your thumb.
Who is at higher risk?
- Women: Women are more prone to thumb arthritis than men.
- Older adults: If you're over 40, your risk increases.
- People with a higher body weight: Being overweight or obese can put extra stress on your joints, increasing the chance of arthritis.
- Genetics: If you have a family history of loose ligaments or joints that aren't shaped correctly, you might have a higher risk.
- Past injuries: A broken thumb or sprained thumb can increase your risk of developing arthritis later in life.
- Other health conditions: Conditions that affect the cartilage in your joints, like rheumatoid arthritis, can also lead to thumb arthritis. While osteoarthritis is the most common cause of thumb arthritis, rheumatoid arthritis can sometimes affect the thumb's base joint (the CMC joint), but usually less severely than other joints in your hand.
- Repetitive use: Jobs or activities that involve a lot of use of your thumb, like certain types of manual labor or repetitive hand movements, can increase the strain on the thumb joint and make arthritis more likely.
Understanding these factors can help you take steps to protect your thumb joint and potentially reduce your risk of developing thumb arthritis.
Diagnosis
During a checkup, your doctor will talk to you about your symptoms and check for any noticeable bumps or swelling in your joints.
They might also use pictures, often X-rays, to look for signs of thumb arthritis. These pictures can show things like:
- Bone spurs: Small, extra bits of bone that grow on the joint.
- Worn-down cartilage: The smooth tissue that cushions your joints has started to wear away. This makes the joint feel rough and painful.
- Narrowing joint space: The space between the bones in the joint has gotten smaller. This is another sign that the cartilage is wearing down and the bones are rubbing against each other.
Treatment
Thumb arthritis can be treated in several ways, depending on how bad it is. For mild to moderate arthritis, your doctor will likely start with non-surgical methods. Severe cases may need surgery.
To ease the pain, your doctor might suggest:
- Topical creams: These creams, like capsaicin or diclofenac, are rubbed onto the affected skin around the thumb joint.
- Over-the-counter pain relievers: Common options include acetaminophen (like Tylenol), ibuprofen (like Advil or Motrin), or naproxen (like Aleve). These help reduce pain and inflammation.
- Prescription pain relievers: If over-the-counter options aren't enough, your doctor might prescribe stronger pills, like celecoxib (Celebrex) or tramadol (Conzip or Ultram).
A splint can also help. A splint supports your thumb and wrist joint, limiting movement. You might wear it all day or just at night, depending on your needs. Splints can:
- Reduce pain: By holding the joint in a comfortable position, they lessen discomfort.
- Improve alignment: Splints help keep your joint in the right position while you use your hand, which can lessen pain and improve function.
- Give your joint a break: Wearing a splint allows the joint to rest and heal.
If pain relievers and a splint aren't enough, your doctor might inject a corticosteroid into the thumb joint. Corticosteroids are powerful anti-inflammatory medicines that can provide temporary pain relief.
Surgery may be necessary if other treatments don't work or if your thumb is very stiff. Several surgical options exist:
- Joint fusion (arthrodesis): This involves permanently joining the bones in the thumb joint. While it eliminates pain, it removes flexibility.
- Osteotomy: The bones in the joint are moved to correct any misalignment or deformity.
- Trapeziectomy: This surgery removes one of the bones in the thumb joint (the trapezium).
- Joint replacement (arthroplasty): In this procedure, the damaged part of the joint is removed and replaced with a piece of tendon.
These surgeries are often performed as outpatient procedures. After surgery, you'll likely wear a cast or splint on your thumb and wrist for about 6 weeks. Physical therapy after the cast comes off can help you regain hand strength and movement.
Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.