Signs and Symptoms
- Pain at the base of the thumb worsened by activities such as pinching
- Swelling and occasionally redness around the thumb base at the level of the wrist
- May feel grinding at the thumb base
- Usually diagnosed by history and physical exam
- X-rays can confirm the diagnosis. While x-rays can help determine how advanced the arthritis is, they do not always correlate with the degree of pain one experiences. For example there may be advanced disease on the x-ray but the patient may not be experiencing a lot of pain. The converse is also true.
Osteoarthritis describes the wear and tear that occurs in joints over time, especially with repetitive use. Supportive cartilage and soft tissue between two bones tends to wear down with time, and the bones moving against one another can damage each other, create bone spurs, and slowly erode. A common place this can occur is the base of the thumb.
This guideline refers to conservative therapeutic management of base-of-thumb osteoarthritis. Your hand therapist can walk you through these different options, and short-term therapy will be helpful; however, many of these things can ultimately be done independently as part of a home program.
- Discomfort is typically the most common and troublesome symptom of thumb arthritis, so pain management strategies are a mainstay of therapeutic treatment. This can include:
- Moist heat packs and paraffin wax dipping, for deep heating
- Compression gloves or compressive wraps, for support and comfort
- Custom splinting, for support, stabilization, and comfort
- Therapeutic ultrasound, for deep heating and inflammation management
- Avoid mechanical stresses on the joint such as repetitive pinching and twisting, pinching and pulling, or forceful squeezing.
- Avoid carrying heavy objects with your fingers/thumbs (use both hands together in a “palm-up” position to carry things)
- Use adaptive equipment that helps take pressure off your hands (equipment is available for activities such as opening jars, starting your car, opening doors, cutting food, pulling weeds, cooking, computer work, etc)
- This is indicated when the above conservative measures are no longer providing consistent relief of pain. When the pain interferes with your activities of daily living it may be time to consider surgery.
- The goal of surgery is to remove and replace the painful arthritic joint.