Hancock Regional Hospital Orthopedic Surgeon Anjan Kaushik, MD, who has completed a Hand and Upper Extremity Fellowship at the University of Rochester, explains the nature and causes of thumb basal joint arthritis and what you can do about it. What is thumb basal joint arthritis, and what is the cause? Thumb basal joint arthritis, also called carpometacarpal (CMC) joint osteoarthritis, is usually caused by degenerative wear & tear and instability at the base of the thumb. This joint, which serves as a junction between the thumb metacarpal bone and the remaining wrist bones, endures a large number of forces from multiple directions. As a result, the ligaments that stabilize the thumb CMC joint can become lax or rupture over time, leading to instability and eventually arthritis. Sometimes an injury to the thumb basal joint (such as a fracture or dislocation) can also lead to post-traumatic CMC arthritis.
Is there a predisposition for the condition?
Females are 6 to 12 times more likely to have symptoms of basal joint arthritis, and this may be associated with hormone changes around the time of pregnancy and menopause. There is also some evidence for a genetic predisposition for arthritis in this joint, so it is common to see it affect family members across multiple generations.
How is thumb basal joint arthritis diagnosed?
Symptoms of thumb CMC arthritis include pain with pinching and gripping and weakness with daily activities such as handshaking or jar opening. Carpal tunnel syndrome, marked by hand tingling and numbness, also commonly coexists with thumb CMC arthritis. X-ray is the best method to evaluate the severity of arthritis. However, a patient’s clinical symptoms may not always correlate with the degree of arthritis on X-rays, so treatment should be directed toward painful or unstable arthritic joints.
What are the treatment options for thumb basal joint arthritis?
Non-surgical treatments include thumb braces, anti-inflammatory medications, physical/occupational therapy for ergonomic adaptive devices and strengthening of muscles around the thumb, and steroid injections in the thumb CMC joint. However, these treatments are oriented toward symptom relief and do not remove the arthritis from the basal joint. These options often provide significant relief but are temporary in effect.
There are many surgical techniques for treatment of thumb basal joint arthritis. The most common procedures involve removal of the trapezium (the bone most severely affected) and some form of reconstruction of the ligaments around the thumb base to stabilize the metacarpal bone.
Please contact Dr. Kaushik’s office at (317) 477.6683 if you are experiencing symptoms of basal joint arthritis or other hand & upper extremity conditions.