Arthritis at Base of Thumb
What is arthritis at the base of the thumb
Arthritis refers to any condition that irritates or destroys a joint. The most common type of arthritis is degenerative or osteoarthritis. This occurs when the normal joint lining (cartilage) wears out. The joint space then narrows. Bone spurs may form as a result of the process. During the transformation of the normal thumb joint to an arthritis joint, patients may experience increasing pain, weakness, stiffness and deformity.
Patients with arthritis at the base of the thumb often complain of difficulty with pinching, including opening jars, turning doorknobs or keys, and writing. As the disease worsens, some patients may describe pain at rest and at night, and patients often note loss of pinch and grip strength. In severe cases, progressive destruction and mal-alignment of the joint occurs and a “bump” develops at the base of the thumb, which is caused by the thumb metacarpal moving out of position in relation to the trapezium.
The picture below demonstrates a patient with arthritis at the base of the thumb. The arrow is pointing to a bump that may form in severe cases of thumb arthritis.
An xray of this patient is below. One can appreciate the narrowing of the joint along with spuring. The picture on the left is an arthritic thumb joint. The picture on the right is a thumb joint without any arthritis. If you compare where the arrows are pointing to, you can perhaps tell the difference in the radiographic appearance of arthritis.
Arthritis at the base of the thumb is more common in women and usually starts after age 40. The cause of this form of arthritis is unknown in most cases. Past injuries to the joint, such as fractures or severe sprains, and generalized joint laxity may increase the chances of developing this form of arthritis at a younger age.
The diagnosis of thumb arthtritis can be made with a good history, physical examination and the use of x-rays. The appearance of the thumb and the location of the pain are usually very helpful in identifying this condition. The treatment options for thumb arthritis vary depending upon several factors. For less severe thumb arthritis, some patients will usually respond to non-surgical care. Pain medication, topical agents, splinting, and limited use of corticosteroid injections may help improve pain.
Patients with advanced arthritis or who do not respond to non-surgical treatment may be candidates for surgical reconstruction. A variety of surgical techniques are available that can successfully diminish or eliminate pain and improve thumb position and function. Common surgical procedures include removal of arthritic bone and joint reconstruction (joint arthroplasty), bone fusion or realignment techniques. A consultation with your treating surgeon can help decide the best options for you.