Basal Thumb Arthritis

What is Basal Thumb Arthritis?
Basal Thumb Arthritis is a very common form of joint degeneration that occurs at the base of the thumb. It is usually caused from wear and tear over a lifetime of gripping, pinching, twisting holding and carrying objects in the hand. However, it can also be caused by trauma to the hand such as a fall or “old football injury” where the individual thought they recovered, but years later the joint becomes painful due to the slow deterioration of the joint.   Basal joint arthritis occurs more frequently in women than men.

What are Symptoms of Basal Joint Arthritis?
Pain is usually the first sign of Basal Thumb Arthritis. The pain can range from a dull constant ache at the base of the thumb to sharp, shooting pain in the thumb and wrist particularly with grip and pinch activities (holding a plate, opening jars/water bottles, writing, buttoning/snapping etc.). Some people have swelling and stiffness in the thumb and hand. In advanced joint changes, some people lose the ability to extend the thumb away from the hand, which limits grasp ability due to decreased strength and range of motion.

How is Basal Thumb Arthritis Treated?
Treatment for Basal Thumb Arthritis can range from activity modification to surgery, depending on the severity of symptoms and the success of less invasive treatments. When treating arthritis, it is essential to start with the easiest and least invasive treatment. Dr. Rose advises the following treatments for thumb and other arthritis:
  1. Activity Modification: Identification and avoidance of painful activities is often an easy way to avoid surgery for arthritis.  An assessment by Dr. Rose or a hand therapist can often lead to advice about activity modification that is very helpful to patients.
  2. Antiinflammatory medications, rest, heat, and exercises can often be of help with artritis pain.
  3. Steroid Injections: Injections of an anti-inflammatory steroid into the joint will often reduce pain and improve function.  These injections are not curative but can be long lasting and can be repeated from time to time.
  4. Splinting: Wearing a splint can assist in pain management. The splint will allow the affected joint to rest while allowing use of the hand for normal activities. Many options are available for hand splinting, including over-the counter splints and custom fit splints made by a hand therapist. 
  5. Surgery:  When all other options have failed, surgery is an excellent option for Basal Thumb Arthritis. Multiple different surgical options exist and can provide excellent pain relief, however, as with any surgery, patient expectations must be appropriate. 
Which treatment is right for me?
Each patient requires individual assessment of their symptoms prior to deciding the optimal treatment. Dr. Rose has experience with all the above techniques and can provide an assessment and explanation of the options available to you for Basal Joint Arthritis.  Please contact us to schedule an appointment.

References:
American Academy of Orthopaedic Surgeons Patient Information
American Society of Surgery of the Hand Patient Information