Thumbs Down: Basal Joint Arthritis Symptoms and Treatment
What Is Basal Joint Arthritis?
Basal joint arthritis is the result of the wearing away of cartilage in the bones of the thumb. That’s why it is also known as thumb arthritis. The basal joint allows your thumb to move around so you can perform small motor tasks. Without plenty of cushioning cartilage, the bones become rough and grind over each other when you move, causing more joint damage. According to the Mayo Clinic, thumb arthritis is the most common form of osteoarthritis (wear-and-tear arthritis) of the hand. It can also be caused by injury to the thumb.
Symptom: Hand Pain and Stiffness
Usually, the first sign of arthritis in the thumb is pain, tenderness, and stiffness. You’re most likely to feel it at the base of your thumb as you try to grip or clasp something between the thumb and index finger. You might also feel a pain when you try to apply mild force, such as when you twist a key in a lock, turn a door handle, or snap your fingers. You might also be left with a lingering ache. A high level of pain doesn’t always mean your arthritis is more severe.
The thumb may appear swollen, especially at its base, and you may develop a bony bump. Overall, the thumb can take on an enlarged appearance. One alarming sign of thumb arthritis is improper alignment of the joint as it shifts from its normal positioning. This may affect the joint above the base as well, creating a bent-back appearance (hyperextension). In particularly severe cases, the thumb can collapse into the palm.
Symptom: Decreased Strength and Range of Motion
Over time, pain and inflammation can rob your hand of strength and restrict your range of motion. These restrictions become especially obvious when you try to pinch something or clasp an object tightly. You might find it increasingly difficult to open jars, hold a drink, or use buttons, zippers, and snaps. For those with a severe case of arthritis in the thumb, small motor tasks that were once a matter of routine become too painful to attempt, or almost impossible to accomplish without assistance.
Treatment: Self Help
Try to avoid clenching your hands when you carry things—this can aggravate symptoms. You should also avoid repetitive movements that involve pinching or twisting. Apply alternating heat and cold to relieve inflammation and pain. A physical or occupational therapist can teach you how to perform range-of-motion exercises to improve function.
To help out around the house, take advantage of assistive devices designed to make it easier to write, open jars, grasp objects, and open doors.
Try an over-the-counter pain reliever or anti-inflammatory medication. If you they don’t work, ask your doctor if there is a stronger prescription medication that may help. Your doctor may recommend corticosteroids, which are usually injected directly into the affected joint. Corticosteroids can relieve pain and reduce inflammation for a longer period of time than some other medications.
A splint can provide temporary support for your thumb and wrist, limiting movement so your joints can rest. The added support may ease pain for a while. It can also help with training your joints back into the correct position. You can wear a splint whenever you feel the need throughout the day, or even while you sleep. Check with your doctor or physical therapist to make sure you’re using the splint correctly.
If nothing else works, there are some surgical procedures that may help. A surgeon can fuse the bones of your joint together. This will decrease pain, but leaves you without flexibility. The bones can be cut and repositioned, or one of the bones in your thumb joint (trapezium) can be removed. A surgeon can also remove most of the joint, replacing it with graft from other tendons. Surgery can be accomplished on an outpatient basis, but it takes time to regain strength and range of motion. If it gets to this stage, be sure to discuss these options carefully with your doctor.
- Arthritis: Base of the Thumb. (2009). American Society for Surgery of the Hand. Retrieved September 16, 2013, from http://www.assh.org/Public/HandConditions/Pages/ArthritisBaseofthe.aspx
- Arthritis of the Thumb. (2007, July). American Academy of Orthopaedic Surgeons. Retrieved September 16, 2013, from http://orthoinfo.aaos.org/topic.cfm?topic=A00210
- Page, C. (2009, November 4). Basal Joint Arthritis: How Therapy Can Help. Hospital for Special Surgery. Retrieved September 16, 2013, from http://www.hss.edu/conditions_basal-joint-arthritis-therapy.asp
- Thumb arthritis: Causes. (2012, June 19). Mayo Clinic. Retrieved September 16, 2013, from http://www.mayoclinic.com/health/thumb-arthritis/DS00703/DSECTION=causes
- Thumb arthritis: Definition. (2012, June 19). Mayo Clinic. Retrieved September 16, 2013, from http://www.mayoclinic.com/health/thumb-arthritis/DS00703
- Thumb arthritis: Lifestyle and home remedies. (2012, June 19). Mayo Clinic. Retrieved September 16, 2013, from http://www.mayoclinic.com/health/thumb-arthritis/DS00703/DSECTION=lifestyle-and-home-remedies
- Thumb arthritis: Symptoms. (2012, June 19). Mayo Clinic. Retrieved September 16, 2013, from http://www.mayoclinic.com/health/thumb-arthritis/DS00703/DSECTION=symptoms
- Thumb arthritis: Treatment and drugs. (2012, June 19). Mayo Clinic. Retrieved September 16, 2013, from http://www.mayoclinic.com/health/thumb-arthritis/DS00703/DSECTION=treatments-and-drugs