The base of the thumb joint (CMC or carpometacarpal joint) is responsible for the thumb’s range of motion allowing firm grasping and pinching.  In thumb osteoarthritis, the cartilage wears out, resulting in bone on bone contact and producing pain and deformity. Thumb basal joint is one of the most common places in the hand where degenerative arthritis occurs and is more commonly seen in women over 40. Another common cause of thumb pain can be tendonitis, as known as De Quervain’s.

Symptoms of Thumb Arthritis

The most common symptom of thumb arthritis is pain at the base of the thumb joint. The pain can be aggravated by daily activities such as pinching, opening jars and writing. In severe cases of thumb basal joint arthritis, a bony bump develops at the base of the thumb as its collapses into the palm, causing a zig-zag deformity.

The diagnosis of thumb arthritis is made by history and physical evaluation. Frequently, people with thumb arthritis have decreased grip strength, loss of strength, limited motion, pain with activity such as twisting. X-rays are used to confirm the diagnosis, but symptoms often do not correlate with x-ray findings.

Treatment For Thumb Arthritis

Less severe thumb arthritis will usually respond to conservative management and nonsurgical treatment such as anti-inflammatory medication. Arthritis medication, bracing, and corticosteroid injections are treatment options that may provide pain relief. An occupational therapist can recommend activity modifications and provide a variety of rigid and non-rigid splints which can be used while sleeping or during activities. 

Bracing options recommend can be found in office and on Amazon.

Surgical Treatment

Patients with advanced disease and who fail conservative treatments have surgical options. Various surgical options and surgical techniques can successfully reduce or eliminate pain, including surgical reconstruction and joint replacement. Dr. Chambers performs a tendon-sparing and LRTI CMC arthroplasty depending on the patient.  A majority of people get greater than 90% of their motion and an initial return of their strength by the third month, if not earlier. Pain relief is generally excellent from this surgery. In conclusion, CMC arthritis is a degenerative joint disease that affects the base of the thumb and can cause pain, swelling, stiffness, and weakness. Diagnosis and treatment of CMC arthritis depend on the severity of the condition and may include conservative measures or surgery. Prevention can be achieved by taking appropriate precautions to maintain joint health, avoiding repetitive or strenuous thumb movements, and using proper hand and wrist posture when performing manual tasks.

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The first video provides more information about CMC Arthritis and the second video discusses therapy.