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What is Thumb Arthritis?

Inflammation and cartilage loss is one of the most characteristic features of arthritis. There are various different forms in which arthritis can be seen in patients. Out of these types, osteoarthritis, is the one that is commonly seen in a majority of people. Thumb arthritis is most of the time, due to osteoarthritis, which occurs after years of wear and tear in the elderly population. The most common place where thumb arthritis occurs is the carpo-metacarpal joint (CMC joint), which lies at the junction of wrist and thumb. Thus, the main reason why thumb arthritis causes unavoidable pain is because it affects a part that is highly critical in our day to day activities, such as writing, gripping, and so on.

CMC Joint of Thumb

CMC Joint of Thumb

Source: Wikimedia Commons

As per the sex comparison, thumb arthritis is most commonly seen in case of women as compared to men. This can be due to the fact that women are more susceptible to osteoarthritis in general due to the hormonal imbalance at the time of menopause. So thumb arthritis can be seen as a part of the spectrum of changes that occur in an elderly woman, especially the one’s who have not taken any hormonal replacement or treatment for osteoporosis.

Symptoms of Thumb Arthritis

There are a wide variety of symptoms, which a patient suffering from thumb arthritis exhibits. Some of the classical signs can also be used to clinically detect this condition. The first and the most important symptom is the swelling and the compelling pain in the joint between the thumb and the wrist. Initially, this is only during the use of thumb, during writing or holding something, but later it may even occur at rest. Many patients of thumb arthritis also complain about a grinding sensation occurring towards the lowermost portion or base of the thumb. The patient feels the motion of his or her thumb quiet restricted compared to the other fingers. This is mainly because a person refrains from using the thumb due to pain, which later leads to shrinking and degeneration of the joint capsule. Apart from this, there are also difficulties experienced in performing turning movements. Thus, if you are suffering from thumb arthritis, you would find opening jars and turning keys pretty hard to manage.

Diagnosis of Thumb Arthritis

The diagnosis of thumb arthritis is not very difficult, especially for an orthopedic doctor. Though, a normal physician may tend to ignore the complaints due to ignorance about thumb arthritis as a cause. An expert orthopedist can even make the diagnosis from clinical judgment without a single investigation. However, practically a few investigations can help to confirm the diagnosis of this condition. Getting an X ray done would be the first step to rule out any other cause of thumb pain like a fracture or other bony injury. It may not actually diagnose thumb arthritis in all cases, but still is an important investigation. The next step would be to get an MRI or CT scan done, which would confirm the diagnosis and also provide important clues as to the exact location and structure involved. But due to the cost of these investigations, they may only be done when in doubt regarding the diagnosis.

Thumb Arthritis Treatment

Thumb arthritis treatment depends on several factors, like the amount of disability caused by it, painful or not painful, overall severity of the disease, and so on. The following are some of the better known ways of treating thumb arthritis.

1. Anti-inflammatory medications:

As per the very first treatment for thumb arthritis is concerned, a doctor would generally put you on to an anti–inflammatory medications. Such anti-inflammatory medications can help you to easily control and eventually do away with the minor symptoms of thumb arthritis. However there is a very important catch here, these medications are only meant for short term use. Long term use especially in the form of pain pill addiction by taking these medications on their own can be disastrous and life threatening.

2. Thumb abduction splints:

It may be quite helpful to allow an arthritic thumb to heal in a stable position with the help of a thumb splint. This is because thumb arthritis weakens the thumb joint, due to degenerative changes in important supporting structures of the joint. Thus, it is quite appropriate to first provide essential support to the thumb. Doing this would mean inducing contractures on the thumb joint capsule. It would be advisable for you to wear these splints all the time and especially in situations where you would be using your thumb for activities which affect the joint. Such a thumb brace should be properly selected to be simple and convenient to wear at all times during the day. A slightly inconvenient and bulky but more effective form of thumb splint is the thumb spica. This is available in splint and cast form and can be chosen as per the needs of a patient by the orthopedic doctor.

3. Cortisone injections :

An additional strategy to counter the pain of thumb arthritis is by using Cortisone injections. These are special anti-inflammatory medications used to provide targeted pain relief to patients suffering from thumb arthritis. The best part about these injections is that they are given right at the site of thumb arthritis and so do not cause the normal steroid treatment related side effects and most importantly they provide instant and long lasting pain relief. However, they are not a permanent cure to the primary problem of thumb arthritis and many patients have reported recurrence of symptoms of thumb arthritis after a period of few months. Thus, local steroid injections can be used till the effect of other forms of treatment begins to show for a period of 3-6 months.

4. Surgery:

This is the last resort treatment in case of thumb arthritis. The general course of such a surgery involves the removal of the arthritic bone and addition of a metallic plate for support. This provides much relief to the worn out thumb joint and also gives the much needed respite from inflammation. However, the movements of thumb joint are completely lost unless a replacement of the CMC joint is done simultaneously. Hence, surgical treatment is only used in those patients, who cannot be cured through the earlier mentioned modalities of treatment.


Posted by in Diseases and Conditions

3 Responses to “What is Thumb Arthritis?”

  1. LouAnn says:

    I am only 43 and have had thumb arthritis for 10 years. My 20 year old som also has it and it’s quite dibilitating as he is a guitar player. Docs have done little to nothing to help and we have been to everything from regular docs, to chiropractors, and orthopedics. I worry about my son’s ability to function well as an adult in his career if he cannot get real help. Thank you for this article. It’s the first time I’ve been able to find anything decent on the subject.

    • igauresh says:

      I think your family could have some connective tissue disorder. These disorders are complex for diagnosis and many doctors with inadequate experience may not be able to recognize it. Kindly refer to an expert hand surgeon and follow his advice properly without any if’s and but’s and things could be different.

  2. George says:

    Hi: Is this seen as due to repetitive stress sometimes? I was just diagnosed in both thumbs and have always suspected it’s due to 20+ years as a cross country ski guide — the pole straps come across the thumb exactly where the injury is. I was probably skiing 500+ miles per year for 20 years. One thumb was first diagnosed after I took a fall against the pole and dislocated the thumb, though there was almost nothing holding it by that time.

    I’m trying to decide if it’s worth it to pursue a worker’s comp claim. Skiing was the only activity I did that put a lot of stress on the thumb joints.

    Appreciate any thoughts you have.

    Thanks

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