Treatment for Thumb Arthritis
By the Creaking of My Thumbs…
Osteoarthritis in the thumb is the most common form of arthritis that affects the hands. It can affect the basal joint, which is the joint near the wrist and the fleshy part of the thumb. This joint normally allows you to pinch, pivot, and swivel your thumb for hundreds of tasks every day.
The cushion-like cartilage inside the joint breaks down over time, leading to bone rubbing against bone. Symptoms of thumb arthritis can become crippling, partly because the thumb is needed so often each day. Click “Next” to learn more about treatments for thumb arthritis.
Symptoms of Thumb Arthritis
Thumb arthritis leads to pain in the basal joint when you try to use your thumb. Decreased grip strength, decreased range of motion, and swelling and pain throughout your hand may occur. You may find it difficult to open jars, twist open a doorknob, or even snap your fingers.
Aching and tenderness can result even in mild cases after prolonged use of your thumb. Over time, swelling can result in an enlarged, offset appearance of the thumb, as though it is “out-of-joint.” A bony protuberance or bump can develop over the joint as well.
Why Me? Causes of Thumb Arthritis
The cartilage can wear away in any joint, bringing about osteoarthritis. Injury or trauma to the joint may have occurred at some point, such as a fracture in a metacarpal bone or developing carpal tunnel syndrome. The resulting inflammation at the site may have caused osteoarthritis to develop.
If you have osteoarthritis in other joints—such as your knees, hips, or elbows—it may make thumb osteoarthritis more likely. Women are more prone to thumb arthritis, especially those with very flexible or lax thumb ligaments. Statistically, women are six times more likely than men to develop thumb arthritis.
Rheumatoid arthritis is another type of arthritis that can develop in the basal joint.
Arthritis is different in each individual. There are a variety of treatments that may work for your particular symptoms.
Initial treatment options involve exercises, application of ice, medications, splinting, or steroid injections. If these methods do not relieve pain and improve function, the joint may need to be reconstructed using surgery.
As with any form of arthritis, it is important to talk to your doctor before treating your condition, especially before taking any medications.
Exercise for Your Thumbs
Your doctor or a physical therapist may recommend hand exercises. You can do these exercises to improve range of motion and improve your arthritis symptoms as well.
Simple exercises can include a thumb stretch, in which you attempt to touch the tip of your thumb to just under your pinky finger. Another stretch called IP flexion requires that you hold your thumb stable with your other hand and attempt to bend just the upper part of the thumb. Another exercise is to simply touch the tips of each of your fingers to the tip of your thumb.
You should only do these exercises after consulting with your doctor or physical therapist. Be sure to get instruction on how to do them correctly.
Medications for Thumb Arthritis
Medications used for pain include over-the-counter medications, prescription medications, and injectable medications.
OTC medications that can help with pain include acetaminophen (Tylenol), nonsteroidal anti-inflammatory drugs (NSAIDs), and supplements.
OTC NSAIDs include ibuprofen (Motrin, Advil) and naproxen (Aleve). NSAIDs in high doses may cause health problems, so be sure not to take more than is recommended on the package or by your doctor.
There are supplements with some evidence of efficacy. These include glucosamine and chondroitin, which are available as pills and powders. Additionally, capsaicin skin creams applied to the thumb may help relieve pain.
Prescription medications for arthritis include COX-2 inhibitors like celecoxib (Celebrex) and meloxicam (Mobic). Tramadol (Ultram, Conzip, etc) may also be prescribed. These medications may cause side effects at high doses, such as ringing in your ears, cardiovascular problems, liver and kidney damage, and gastrointestinal bleeding. You may need to have certain blood tests while taking these medications.
Corticosteroid injections to the thumb joint may help relieve swelling and pain. These can only be done two or three times a year. The relief these injections provide is temporary but can be significant. Be careful to avoid excess physical activity while on a steroid medication; otherwise you risk damaging the joints.
Your doctor or physical therapist may recommend a splint for your thumb, especially at night. A thumb splint may look like a half glove with reinforcing material inside. Wearing this splint can help decrease pain, encourage the correct position for your thumb, and rest the joint.
This type of splint is sometimes called a “long opponens” or “thumb spica” splint. Splinting is often done continuously for three to four weeks. Then, the splint is worn some of the time, either at night or during certain daily activities that may strain the joint.
If exercise, medications, and splinting do not sufficiently reduce pain and restore range of motion and strength, surgery may be required. Possible surgeries for thumb arthritis include:
- trapeziectomy: One of your wrist bones involved in the thumb joint is removed.
- osteotomy: The bones in your joint are moved and aligned correctly. They may be trimmed to remove excess growth.
- joint fusion: The bones in the joint are fused. This improves stability and reduces pain. However, there is no longer flexibility in the joint and you will no longer be able to perform certain tasks.
- joint replacement: The joint is replaced with tendon grafts.
- 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
- Dias, R et al. (2007). Basal Thumb Arthritis. Postgrad Med J., 83(975), 40-43. Retrieved September 16, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599975/
- Medications, Injections and supplements for Arthritis. (2011). National Institutes of Health. Retrieved September 16, 2013, from http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000374.htm
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- Thumb Arthritis: Exercises. (2010) Kaiser Permanente. Retrieved September 16, 2013, from http://mydoctor.kaiserpermanente.org/ncal/Images/Thumb%20arthritis%20exercises_tcm28-181399.pdf