Osteoarthritis in the thumb is the most common form of arthritis that affects the hands. Osteoarthritis results from the breakdown of joint cartilage and the underlying bone.
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.
In people with thumb arthritis, the cushion-like cartilage inside the joint breaks down over time. This causes the bone to rub against bone.
Symptoms of thumb arthritis can become crippling, partly because the thumb is needed so often each day. The following symptoms may occur:
- decreased grip strength
- decreased range of motion
- swelling and pain throughout your hand
You may find it difficult to open jars, twist open a doorknob, or even snap your fingers.
If you have arthritis in other joints like your knees, hips, or elbows, it may make thumb arthritis more likely.
People assigned female at birth are more prone to thumb arthritis, especially those with very flexible or lax thumb ligaments. Statistically, females are 30 percent more likely than males to develop osteoarthritis at the base of the thumb.
Rheumatoid arthritis is another type of arthritis that can develop in the basal joint.
Arthritis is different in each person. There are a variety of treatments that may work for your particular symptoms.
Initial treatment options involve:
- applying ice
- steroid injections
If these methods do not relieve pain and improve function, the joint may need to be reconstructed with surgery.
As with any form of arthritis, it is important to talk with a doctor before treating your condition, especially before taking any medications.
Exercise for your thumbs
Your doctor or physical therapist may recommend hand exercises. You can do these exercises to improve your range of motion and your arthritis symptoms.
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, uses flexion. It requires you to hold your thumb stable with your other hand and attempt to bend just the upper part of the thumb. An additional 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 instructions to make sure you’re doing the movements correctly.
Medications for thumb arthritis
Medications used for pain include:
- over-the-counter (OTC) medications
- prescription medications
- injectable medications
OTC medications that can help with pain include:
- acetaminophen (Tylenol)
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- ibuprofen (Motrin, Advil)
- naproxen (Aleve)
NSAIDs in high doses may cause health problems, so be sure to follow the recommended dosages on the package or from your doctor.
Some topical NSAIDs, like Voltaren gel, can be rubbed onto the joint and don’t have as many adverse effects throughout your body.
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 cyclooxygenase-2 (COX-2) inhibitors like celecoxib (Celebrex) and meloxicam (Mobic). Tramadol (Ultram, ConZip) may also be prescribed.
When taken at high doses, these medications may cause side effects, such as:
- ringing in your ears (tinnitus)
- cardiovascular problems
- liver and kidney damage
- gastrointestinal bleeding
You may need 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 excessive 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
- rest the joint
This type of splint is sometimes called a “long opponens” or “thumb spica” splint. Splinting is often done continuously for 3 to 4 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.
While there is no cure for arthritis in your thumb, there are various simple treatments that can help relieve symptoms for many people. Talk with a doctor or physical therapist about which treatments might work best for you.