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Thumb arthritis is a common condition that develops as people age and is brought on by the wear and tear of the cartilage on the ends of the bones that make up the joint at the base of the thumb (carpometacarpal joint).
People can typically perform hundreds of daily chores with their thumb by pinching, pivoting, and swiveling it. Doing simple tasks like turning the doorknobs and opening jars while having thumb arthritis may cause symptoms of severe pain, swelling, weakness and decreased range of motion. Typically, splints and medicine are used in conjunction for treatment. Surgery may be necessary for severe thumb arthritis.
Symptoms
The primary and most common symptom of thumb arthritis is pain. When the patient hold, squeeze, or pinch anything or apply force by using your thumb, pain may develop near the base of their thumb.
Signs and symptoms of thumb arthritis may include the following:
- Pain, stiffness, and swelling near the base of the thumb
- Decreased grip strength
- Decreased in range of motion movement
- An enlarged or bony-looking joint at the base of your thumb.
It is recommended to seek medical help if the swelling, stiffness, or pain near the base of the thumb continues and is persist.
Causes
The ends of the bones in a thumb joint are covered with cartilage, which serves as a cushion and permits the bones to move smoothly against one another. The smooth surface of the cartilage that covers the tips of the bones in the thumb becomes more uneven due to arthritis. This causes friction and joint injury when the bones rub against one another.
When people get older, thumb arthritis is common. Thumb arthritis may also be brought on by previous trauma or injury to the thumb joint.
Bone spurs, which grow along the margins of the existing bone as a result of joint damage, might cause the thumb joint to become noticeably lumpy.
Risk factors
The chances of developing thumb arthritis may be affected by the following factors:
- Age: People who are above 40 years could frequently be affected by thumb arthritis.
- Gender: This condition more common in females than males.
- Body weight: Obesity could lead into the development of thumb arthritis.
- Hereditary conditions: Joint ligament laxity and malformed joints could also lead to thumb arthritis.
- History of trauma: sprains and fractures that affect the thumb joint.
- Other diseases: Osteoarthritis is the most common cause of thumb arthritis. Illnesses like rheumatoid arthritis can alter the structure and function of cartilage. Rheumatoid arthritis can also affect the CMC joint, though often to a smaller extent than other hand joints.
Diagnosis
The following procedures could help the healthcare provider diagnose thumb arthritis.
- Physical examination: The healthcare provider will inquire about the existing symptoms and check the joints for swelling or lumps. The doctor may apply pressure and hold your joint while moving your thumb and pressing against your wrist bone. If this movement causes a grinding sound, pain, or a gritty sensation, the cartilage has probably worn away and the bones are rubbing against one another.
- Imaging test: such as X-ray will be recommended by the healthcare provider to assess for any presence of bone spurs, loss of joint space, and to assess the worn-down cartilage.
Treatment
Although there is no known cure for thumb arthritis, many people can find relief from symptoms with a variety of simple therapies. Treatment for thumb arthritis in its early stages typically consists of several non-surgical treatments. Surgery may be required if your thumb arthritis is severe.
- Thumb exercise: The doctor will recommend that the patient do hand exercises to improve the range of motion and symptoms.
One easy exercise is the thumb stretch, where the patient try to touch the tip of their thumb to the area just under their pinky finger.
The IP stretch makes advantage of flexion. Patients must use their other hand to steadily grasp their thumb while attempting to only bend the upper portion of the thumb. Simply touching the tips of their fingers to the tip of their thumb is an additional workout.
- Medication: The following might be recommended by the healthcare provider to help relieve the pain.
- Topical medications: this medication will be applied directly to the skin, over the joint to relieve the pain. Example of this medicine is capsaicin or diclofenac.
- Over-the-counter: Some medication could be taken orally and could be purchased directly at the pharmacy such as acetaminophen (Tylenol, others), ibuprofen or naproxen sodium.
- Prescribed medication: Some medicine can only be purchased if there is a prescription from the healthcare specialist. Example of prescribed pain relievers are celecoxib or tramadol.
These drugs may have negative side effects when taken in excessive amounts, including:
- Tinnitus (ringing in the ear)
- Cardiovascular problems
- Kidney and liver problems
- Gastrointestinal bleeding
While taking these medications, patient might need to have some bloodwork done.
- Splint: The joint can be supported by a splint, which can also restrict thumb and wrist movement. Wearing a splint can be done both during the day and at night. Splint can also help reducing the pain, could properly position the joint, and could assist in resting the joint.
- Injections: A long-acting corticosteroid injection into the thumb joint may be advised by the healthcare provider if painkillers and a splint are ineffective. Injections of corticosteroids can lessen inflammation and provide momentary pain relief.
- Surgery: Healthcare provider might advise surgery if the patient do not react to alternative therapies or if they can hardly bend and twist their thumb.
Surgical options consist of:
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- Arthrodesis (joint fusion): The damaged joint’s bones are permanently fused together. The fused joint lacks flexibility yet can support weight without experiencing pain. This increases stability and lessens discomfort. However, the joint is no longer flexible, and you will not be able to undergo out specific tasks.
- Trapeziectomy: The wrist bone that supports the thumb joint (trapezium) has been removed.
- Osteotomy: This procedure will help repair abnormalities, the bones in the affected joint are realigned correctly. To get rid of extra growth, they can be properly trimmed.
- Arthroplasty (joint replacement): One of your tendons is used as a graft to replace all or part of the damaged joint.
Patient can anticipate wearing a cast or splint over their thumb and wrist for up to six weeks following surgery. Then they might undergo physical therapy once the cast is taken off to aid in their recovery of hand strength and motion.
