Base of Thumb Arthritis2024-06-10T15:33:19+00:00

Base of Thumb Arthritis

Base of Thumb Arthritis

Recognise What it Looks Like and What I Can Do About it.

I am a Base of Thumb Arthritis Specialist.

Base of Thumb Arthritis – OUCH, but I can help!

Dealing with base of thumb joint arthritis (the wear-and-tear kind at the base of your thumb) often goes beyond just pain. The weakness, stiffness, and awkward instability can significantly hinder your daily activities and quality of life. If conservative treatments aren’t cutting it anymore, modern joint replacement surgery might be the key to getting your strong, stable thumb back. I am a thumb arthritis specialist so let’s explore these options, including how new designs are leaving traditional approaches in the dust.

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Understanding Base of Thumb Arthritis

Arthritis at the base of your thumb can stand out as a big lump or cause the thumb to be painful with the slightest movement, and forget about gripping anything! That hurts! Here’s what you need to know:

  • Symptoms: Pain and a lump at the base of the thumb. Pain on gripping. Sometimes the next joint in the thuumb starts to bend backwards (hyper-extension) to compensate for the thumb not being able to move away from the palm.

  • Causes: Often a combination of factors, including overuse, health conditions, and joint anatomy. Most often we never find out why arthritis happens!

  • Treatment: Lots! Ranges from chilli cream (capcaicin), to soft splints to steroid injections. At the end of the road is surgery and I have an excelelnt operation to take all our pain away! A full joint replacement, just like a new hip and just as effective.

I understand how frustrating base of thumb arthritis can be. I have some excellent fixes for you so let’s work together to relieve your symptoms and get you back to doing what you love.

Base of thumb FAQs

Base of thumb arthritis, or CMC joint arthritis, is a type of osteoarthritis that affects the joint where the thumb’s metacarpal bone meets the trapezium (a small wrist bone). This results in pain, stiffness, and loss of function BUT it interferes with life disproportionately as your thumb is SO important for almost everything that we do with our hands.

Common symptoms include a lump and pain at the base of the thumb (worsening with gripping, pinching), stiffness, decreased range of motion, swelling, and a grinding or crackling sensation.

Like other forms of osteoarthritis, the exact cause is often unknown. Factors include wear and tear over time, previous injury to the joint, genetics, and certain medical conditions.

Diagnosis starts with a physical examination and your medical history. X-rays are the main imaging used to confirm osteoarthritis and the amount of damage within the joint. It’s usually quite obvious just looking at the thumb.

Activity Modification:
Changing how you do tasks can lessen stress on the joint. Analyse what you do that hurts and try and change the way you do it.
Hand Therapy:
Hand therapists teach exercises, offer custom splints for support and pain relief, and provide training with adaptive equipment.
Medication:
Over-the-counter pain relievers (paracetamol, nonsteroidal anti-inflammatory drugs like ibuprofen, if you’re safe to take them) or prescription options.
Steroid Injections:
Cortisone injections directly into the joint can offer temporary pain relief.
Newer injections:
PRP (Platelet rich Plasma) injections are very successful in the knee and other joints but as yet the literature has not extended to the base of the full stop it does hold great promise though. Arthrosamid is an even newer type of injection that turns off the lining of the joint (synovium) and therefore you experience less pain. These injections would have to be self-funded and are expensive. I can give you more details on request

When non-surgical options fail to adequately control pain and limit daily life, surgery might be recommended. I usually say that “if the pain is causing you to lose JOY in your life” then come and see me so I can see what I can do.

Trapeziectomy:
This involves removing the trapezium bone at the base of the thumb. Modifications (with tendon reconstruction) offer more stability.
Joint Replacement (Arthroplasty – like a hip):
The latest implants that I use are as good as a hip replacement! These are so amazing, I would choose never to do a trapeziectomy again!

ELiS represents the latest generation of CMC joint replacements. There are three Dual Mobility options on the market at the moment and there is no evidence of one over the other. They are all fantastic at maximising pain relief while enhancing mobility.

Potential benefits include a reduction in pain, better hand function and much faster return to work, increased preservation of range of motion, and quicker recovery due to a less invasive procedure.

ELiS could be an option if you have severe base of thumb arthritis and non-operative measures have failed. We can discuss if this advanced treatment is right for you.

Overall success rates vary but newer joint replacements are promising, And the latest evidence is that they are as good as a hip replacement. After all, we did simply miniaturise the hip replacement to use in the thumb! Factors like surgical technique, severity of your arthritis, and your rehabilitation commitment all play a role.

Any surgery carries risks:

  • infection,
  • implant loosening,
  • changes in feeling around the thumb,
  • dislocation,
  • continued pain.

Risks should be thoroughly discussed with me and I have evidence-based consent informaion leaflets for you.

Recovery timelines differ, but often require one or two weeks of immobilisation, followed by hand therapy. Full restoration of strength can take months.
Equally, you will essentially be the same at four weeks after a joint replacement as a trapeziectomy is after four months!

Currently, no cure exists for osteoarthritis. However, treatments like the joint replacements I do, can improve pain and function significantly.

No specific diet reverses osteoarthritis, but maintaining a healthy weight and eating anti-inflammatory foods might positively impact overall joint health. A low carb diet may improve symtoms but the jury is out on this one.

While you can’t entirely prevent it, protecting your joints, and managing risk factors like obesity might lessen the development and progression of arthritis.

There’s no evidence thumb cracking is linked to osteoarthritis.

Some people report their symptoms fluctuate with weather changes, but there’s no definitive scientific proof.

Evidence for using supplements is limited. Talk to your GP before self-treating.

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