What is arthritis of the base of the thumb?
Having difficulty using keys and gripping with associated pain in your thumb? This could mean that you have arthritis in one of the joints at the base of your thumb.
This is usually a type of osteoarthritis (‘wear and tear’ arthritis) where the smooth gliding cartilage covering the bones of the joint is lost, which causes the bones to grind against each other. The joint affected is between the thumb metacarpal and one of the small bones of the wrist (trapezium). The joint is very specialised allowing a large range of thumb motion causing arthritis here is very disabling.
What are the symptoms of arthritis of the base of the thumb?
The condition is ten times more common in women than men, and symptoms are more likely to begin in the mid-forties. The condition generally begins with intermittent pain which is noted after gripping or pinching. Over time this may become more constant, with associated loss of movement and strength. Eventually it becomes hard to turn keys, open jars or turn on taps. In severe cases a bump at the base of the thumb appears and the thumb becomes stiff making it hard to pick up larger objects.
How is the diagnosis of thumb base arthritis made?
The Horder centre will examine patients and suggest the diagnosis, and then X-rays are used to confirm the diagnosis. The severity of the x-ray does not always parallel the severity of the symptoms, but it can help to exclude other similar conditions.
What treatments are available for thumb base arthritis?
Most patients with this condition do not need surgery but manage with painkillers, splints and slight changes in lifestyle. Local anaesthetic and steroid injections into the joint can dramatically relieve symptoms, sometimes for prolonged periods.
In persistent or severe cases surgery may be considered. The Horder Centre can carry out many surgical procedures which may help relieve symptoms, some of the most commonly seen procedures include removing the trapezium alone, removing the trapezium and reconstructing one of the thumb ligaments, replacing the joint or fusing the joint. Each method of treatment has positives and negatives and must be carefully tailored to the individual patients’ requirements. All the operations are associated with a significant period of immobilisation of the thumb, generally six weeks, and further rehabilitation thereafter, but are good at relieving pain and improving function.
Information provided courtesy of our Consultant Orthopaedic Hand Surgeon, Mrs Lisa Leonard.
