Basal joint arthritis

Basal joint is present at the base of the thumb and allows you to pinch, pivot, swivel, and to perform various other activities. It is called as thumb carpometacarpal joint. You may get thumb arthritis if the cartilage wears away from the ends of the bones that form your thumb joint. It causes severe pain (especially while pinching and gripping), swelling, decreased strength making it difficult to perform daily activities.

This condition is commonly observed in people with osteoarthritis (wear-and-tear arthritis). The prevalence of thumb arthritis increases with age and is often observed after menopause. Do not worry if you are suffering from this condition, as there are several treatment options such as medications and splints. In severe cases, surgery would be helpful.

Signs and symptoms

Pain is the most common symptom and the first sign of thumb arthritis. Your thumb base may feel stiff and tender, especially while trying to grip or catch something. Other signs and symptoms include:

  • Decreased strength while pinching or grasping objects

  • Decreased range of motion

  • Bony protuberance or bump at the base of your thumb

Causes

Thumb arthritis commonly occurs with aging.

Ends of bone are covered with the cartilage, which acts as a cushion and allows the bones to glide smoothly against each other. However, with thumb arthritis, the cartilage deteriorates and roughens the smooth surface. The roughened bones rub against each other, resulting in friction and joint damage.

If you have had an injury or trauma to the joint, the inflammation at the site results in osteoarthritis. If you have osteoarthritis in other joints such as knees, hips or elbows, there are chances that you may get thumb arthritis as well.

Risk factors

Several factors may increase your risk of thumb arthritis.

  • Gender – Females are at increased risk. -However, the reason is unknown

  • Old age- above 40 years

  • Obesity

  • Hereditary conditions like joint ligament laxity and malformed joints

  • Thumb fractures and sprains

  • Rheumatoid arthritis

  • Osteoarthritis

Your doctor may question you about the symptoms, previous injury pain patterns or activities that increase the pain. The doctor may hold the joint while moving your thumb and puts pressure on it to determine the severity of pain. If the movement has a grinding sound, and if you have pain or gritty feeling, the doctor may conclude that the cartilage has worn down, and the bones are rubbing against each other.

After that, he or she would suggest you to go for further tests such as X-ray to check the symptoms of thumb arthritis such as deterioration of the joint, bone spurs or calcium deposits, and joint spaces that have developed.

There are chances that you may develop carpel tunnel syndrome, and hence your doctor may suggest you to go for that test also.

Your doctor may recommend non-surgical treatment if the condition is diagnosed in the early stages which include:

  • Apply ice for five to fifteen minutes on most swollen and tender area

  • Wear a supportive splint to limit your thumb movement, to reduce pain and allow the joint to rest and heal. You can wear the splint just at night or for the whole day.

Medications

Your doctor prescribes OTC drugs such as acetaminophen, ibuprofen or naproxen. Celecoxib and tramadol are prescribed to manage severe pain.

If the pain relievers are ineffective, the doctor may give a long-lasting corticosteroid injection to your thumb joint. The injection gives you temporary but immediate pain relief and reduces inflammation.

Surgery

If you do not respond to non-surgical treatment, surgery would be an option. There are several different surgical procedures which are usually performed on an outpatient basis.

    Joint fusion- The bones of the affected joint are permanently fused together. The fused joint can bear weight, but the movement is limited.

    Osteotomy- The bones of affected joint are repositioned to correct deformities.

    Trapeziectomy- one of the bones of your thumb joint (trapezium) is removed.

    Joint replacement or arthroplasty- The affected part of the joint is removed and replaced with a graft taken from one of the tendons.

There are special exercises for the joint pains that improve range of motion and other symptoms of arthritis. The doctors usually recommend doing these exercises that give best results:

  • Thumb stretch, in which you should touch the tip of your thumb with the last finger.

  • Try to hold your thumb stable with other hand and bend only the upper part of your thumb.

  • Simply touch the tips of your fingers with the tip of your thumb.

Do not forget to apply ice to your joint for five to 15 minutes if you have severe swelling and pain.