Thumb arthritis: What to know
According to the American Academy of Orthopedic Surgeons, thumb arthritis usually occurs after 40 years of age and is more common in women than in men.
While arthritis of the thumb can be painful, a doctor can recommend treatments to reduce symptoms and improve a person's range of motion and quality of life.
What is thumb arthritis?
Arthritis can cause the bones in the thumb to rub together.
Thumb arthritis is arthritis that occurs in the joint at the base of the thumb, known as the basal joint. Thumb arthritis is usually a type of osteoarthritis, which is due to wear and tear.
In a healthy thumb joint, a rubbery tissue known as cartilage covers the knobby ends of the bones that come together in the joint. The cartilage cushions the two bones.
In people with thumb arthritis, the cartilage wears away. The two bones no longer have cushioning between them and rub together.
As the bones rub together, they create friction and damage the joint, causing pain and other symptoms.
The first symptom of thumb arthritis is usually pain at the base of the thumb when a person grips or pinches an object. A person with thumb arthritis may also notice pain whenever they use their thumb to apply force.
Other symptoms of thumb arthritis include:
- swelling at the base of the thumb
- aching, discomfort, or tenderness at the base of the thumb
- limited range of motion in the joint
- enlarged, bony-looking joint at the base of the thumb
- loss of strength in the thumb joint
Symptoms may vary in severity. Symptoms can be mild at first then get worse over time, especially if a person does not seek treatment.
Causes and risk factors
Most thumb arthritis is a type of osteoarthritis, which means it is due to degeneration or normal wear and tear.
Since thumb arthritis most commonly occurs as part of the normal aging process, it is more common in adults over 40 years of age. People who have had previous fractures or injury to the thumb joint are also more likely to develop thumb arthritis.
Other factors that may make a person more likely to develop thumb arthritis include:
- hobbies or jobs that stress the thumb joint
- computer work for extended periods of time
- diseases affecting the cartilage, such as rheumatoid arthritis
An X-ray showing arthritis in the thumb.
Image credit: Mikael Häggström, 2017.
Before diagnosing thumb arthritis, a doctor will typically examine the person's thumb and ask questions about:
- movements that make the pain worse
- the level of pain
- whether there has been a prior injury
- any other symptoms
The doctor will also likely perform simple tests, such as holding the joint while the person moves the thumb around.
They will listen or feel for grinding or clicking sounds or sensation that may indicate that the bones are rubbing together.
The doctor will feel to see if the joint is warmer than the surrounding tissue and if it is tender or enlarged. They will also test its range of motion.
If the doctor suspects arthritis, they may order an X-ray to examine the thumb and reveal any calcium deposits or bone spurs. Also, an X-ray can show deterioration or loss of space between the bones.
If a person has pain towards the base of the thumb, a doctor may also check for symptoms of carpal tunnel syndrome.
The severity of a person's thumb arthritis will help a doctor determine which treatment is best. Arthritis is a progressive disease, meaning it may get worse over time.
According to the American Society for Surgery of the Hand, there is no medication available that can slow the progression of arthritis in the thumb.
But some treatments may help alleviate the symptoms. Potential treatments include:
- bracing the thumb
- exercises to strengthen the muscles around the thumb
- anti-inflammatory medications
- steroid injections
- occupational or physical therapies
- applying heat or ice to the joint
- ergonomic adjustments
- avoiding activities that put pressure on the thumb
If these treatment options fail, a person may require surgery. Typically, a doctor will recommend surgery if other treatment options do not work and the symptoms are severe.
Surgical options include:
- Removing a small bone in the joint called the trapezium to help the surgeon cushion or suspend the joint, alleviating pain.
- Fusing the joint together that will reduce the thumb's mobility but alleviate pain and other symptoms.
It can take anywhere from 8 weeks to 1 year to recover from thumb surgery. During this time, a person may receive rehabilitation services from occupational or physical therapists.
With treatment, many people may be able to manage their thumb arthritis and reduce bothersome symptoms.
Arthritis does tend to worsen over time. If thumb arthritis is making daily activities difficult or painful, it is essential to see a doctor for treatment.