By the creaking of my thumbs …
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. 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.
If you have arthritis in other joints like your knees, hips, or elbows, it may make thumb arthritis 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:
- application of 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 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.
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. And 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. And 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, and injectable medications.
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) 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.
While there is no cure for arthritis in your thumb, there are various simple treatments that can help relieve symptoms for many people. Talk to your doctor or physical therapist about which treatments might work best for you.