STT Arthritis
Recognising the Symptoms and Signs
Ali Phillips | Hand & Wrist Specialist
Pain at the base of your thumb?
I'm Ali Phillips. If you're experiencing a deep pain in your wrist, especially when moving it side-to-side, you might be dealing with STT arthritis. Let's explore what this means and how I can help you find relief.
Book a ConsultationWhat is STT Arthritis?
The Scapho-Trapezio-Trapezoid (STT) joint is a small but important joint in your wrist, located at the base of your thumb and index finger. It's crucial for the side-to-side motion of your wrist.
STT arthritis is a "wear-and-tear" condition where the smooth cartilage in this joint wears down. This causes the bones to rub against each other, leading to a deep pain within the wrist, stiffness, and weakness.
What are the symptoms of STT Arthritis?
Pain with Side-to-Side Motion
A deep ache near the base of your thumb that gets worse when you move your wrist towards your thumb or little finger (like waving).
Weakness in Grip
You might find it difficult to grip or pinch objects firmly, and notice a general weakness in your hand.
Swelling and Tenderness
You may notice some swelling on the back of your wrist near the thumb, and the area may be tender to touch.
Is This Your Wrist Pain?
If these symptoms sound familiar, getting an accurate diagnosis is the first step towards relief. Let's talk about your options and find a solution that works for you.
Get a Clear DiagnosisHow will I diagnose your wrist pain?
Diagnosis is usually straightforward, involving a conversation, a physical examination, and an X-ray. A very sensitive test for STT arthritis involves checking your side-to-side wrist movement. You can try this gently at home, but please stop if it causes pain.
1️⃣
Rest your forearm on a table, hand hanging off the edge.
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Slowly bend your wrist towards your thumb.
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Then, slowly bend it towards your little finger.
Pain during this side-to-side motion is a strong indicator of STT arthritis. It can be tricky to distinguish this from pain at the base of the thumb (CMC arthritis), so I often use a diagnostic injection of local anaesthetic to pinpoint exactly which joint is causing the problem.
How can I help you get better?
We'll create a personalised treatment plan together, starting with the simplest options first.
Splinting & Rest Supporting the wrist with a splint and avoiding activities that trigger pain can help reduce discomfort.
Anti-inflammatories Over-the-counter medications like ibuprofen can help to manage pain and reduce inflammation.
Steroid Injections These are very useful for both confirming the diagnosis and providing short-term pain relief by reducing inflammation directly in the joint.
Surgery: Pyrocardan Implant If other treatments fail, I specialise in an advanced joint replacement called the Pyrocardan implant. It has an excellent success rate in restoring pain-free motion and wrist stability.
Frequently Asked Questions
Like other forms of osteoarthritis, it's often due to "wear and tear" over time. It can also occur alongside arthritis at the base of the thumb (CMC arthritis). Factors like previous injury, genetics, and repetitive stress can also contribute.
Surgery is always my last resort. We would only consider it if conservative treatments like splinting and injections fail to provide enough relief, and the arthritis is significantly impacting your quality of life.
The Pyrocardan implant is an advanced joint replacement for the STT joint. It's made of a very durable material called pyrocarbon and is designed to preserve natural wrist movement, unlike fusion surgery which stops movement. It has an excellent track record for relieving pain and restoring function.
I will create a personalised rehabilitation plan for you. Recovery can vary, but many patients experience a smooth process. It will likely involve wearing a splint or cast for several weeks, followed by hand therapy to regain strength and motion. Full recovery can take several months.
They are very close neighbours! The CMC joint is at the very base of the thumb metacarpal bone, while the STT joint is slightly further into the wrist. Pain from both can feel very similar, which is why a diagnostic injection is so helpful to tell us exactly which joint is causing the problem before we consider surgery.
Currently, no cure exists for the underlying osteoarthritis. However, treatments like the Pyrocardan implant can significantly improve pain and function, effectively giving you back your quality of life.
Yes, hand therapy is a crucial part of your recovery. A specialist therapist will guide you through a personalised programme of exercises to help you regain strength, mobility, and get the very best result from your new joint.
The Pyrocardan implant has an excellent success rate. Studies show a survival rate of 95% (meaning 19 out of 20 implants are still working well) at 5 years. It is very effective at reducing pain, increasing grip strength, and maintaining wrist mobility.
While you can't entirely prevent wear-and-tear arthritis, you can take steps to protect your joints. This includes managing your weight, eating a healthy diet, and avoiding activities that put excessive or repetitive strain on your wrists.
If you are struggling with wrist pain, it is best to see a specialist hand surgeon like me. I have the expertise to accurately diagnose the specific cause of your pain and offer the full range of modern treatment options, including advanced procedures like the Pyrocardan implant.
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