Arthritis in the Thumb

Pamela L. Jones, MD
Orthopedic Surgeon and Hand Specialist

When we talk about arthritis in the thumb we are primarily referring to a condition in the basal joint of the thumb, which connects the wrist bone to the first bone of the thumb. This joint is located very near the wrist, and under the fleshy part of the thumb.

About arthritis in the thumb
Arthritis is a common term meaning inflammation of a joint. Although arthritis can apply to more than 100 different diseases, the three most common types affecting the basal thumb joint are osteo, or degenerative, arthritis, rheumatoid arthritis, and traumatic arthritis, which is usually the result of a fracture in the joint.

Arthritis in the base of the thumb is more common in women than in men, and usually starts after age 40. Symptoms include pain and swelling of the thumb and wrist, which may come and go throughout the day, and may be most prominent when gripping an object with the thumb and fingers, such as when turning a doorknob or opening a jar. Sometimes, a bump may also appear at the joint or the joint may just look abnormally big.

Diagnosis and treatment of arthritis in the thumb
To diagnose the condition, your physician will perform a series of tests and x-rays to determine the extent of the loosening of the joint, as well as the smoothness of cartilage surfaces, and the overall severity of the disease.

Treatment will then depend on the symptoms and stage of the condition. For mild to moderate symptoms of pain and swelling, your doctor will more than likely prescribe a course of action including anti-inflammatory medication, rest, and splinting.

For more severe symptoms, you and your doctor may decide that surgery is the best option. Because basal joint arthritis of the thumb is such a common problem, many types of surgeries have been developed to treat it. In general, however, these procedures fall into two categories: one which involves a fusion of the two bones making up the joint, in essence eliminating the joint altogether; and one which involves removing the arthritic surfaces and replacing them with a new material such as natural tendon from another part of your body. Both types of surgeries have their advantages and drawbacks, so you and your doctor will need to work together to determine which is best for you.

Post-op expectations
Following surgery, a course of physician therapy may be recommended to increase mobility in the joint and strengthen the thumb. A specialized hand therapist would guide you through this therapy.

If you are experiencing pain that you believe might be associated with arthritis in the thumb, see your physician. Early diagnosis and treatment can minimize your discomfort, as well as give you an opportunity to learn more about the arthritic process and how to protect damaged joint surfaces.