Arthritis is a condition that irritates or destroys a joint. Although there are several types of arthritis, the one that most often affects the joint at the base of the thumb (the basal joint) is osteoarthritis (degenerative or “wear-and-tear” arthritis).
Smooth cartilage covers the ends of the bones. It enables the bones to glide easily in the joint. Without it, bones rub against each other, causing friction and damage to the bones and the joint. Osteoarthritis occurs when the cartilage begins to wear away.
The joint at the base of the thumb, near the wrist and at the fleshy part of the thumb, enables the thumb to swivel, pivot, and pinch so that you can grip things in your hand.
Arthritis of the base of the thumb is more common in women than in men, and usually occurs after 40 years of age. Prior fractures or other injuries to the joint may increase the likelihood of developing this condition.
Your doctor will ask you about your symptoms, any prior injury, pain patterns, or activities that aggravate the condition.
One of the tests used during the examination involves holding the joint firmly while moving the thumb. If pain or a gritty feeling results, or if a grinding sound (crepitus) can be heard, the bones are rubbing directly against each other.
An x-ray may show deterioration of the joint as well as any bone spurs or calcium deposits that have developed.
Many people with arthritis at the base of the thumb also have symptoms of carpal tunnel syndrome, so your doctor may check for that, as well.
In its early stages, arthritis at the base of the thumb will respond to nonsurgical treatment.
Because arthritis is a progressive, degenerative disease, the condition may worsen over time. The next phase in treatment involves injecting a steroid solution injection directly into the joint. This will usually provide relief for several months. However, these injections cannot be repeated indefinitely.
When nonsurgical treatment is no longer effective, surgery is an option. The operation can be performed on an outpatient basis, and several different procedures can be used.
One option involves fusing the bones of the joint together. This, however, will limit movement.
Another option is to remove part of the joint and reconstruct it using either a tendon graft or an artificial substance.
You and your physician will discuss the options and select the one that is best for you.
After surgery, you will have to wear a cast for 4 to 8 weeks, depending on which procedure is used. A rehabilitation program, often involving a physical therapist, helps you regain movement and strength in the hand. You may feel some discomfort during the initial stages of the rehabilitation program, but this will diminish over time. Full recovery from surgery takes several months. Most patients are able to resume normal activities.