Thumb Arthritis

Thumb Arthritis

It's easy to take use of your thumbs for granted, but not so for those living with arthritis of the thumb.

One of the most common forms of arthritis, people with it experience pain even in the simple pinching and gripping tasks of daily living, such as opening doors, wringing out a wash cloth, turning a key, or holding a newspaper.

The culprit in such cases is arthritis of the joint at the base of the thumb, called carpometacarpal (CMC) joint arthritis. According to current research, the condition is more common among women than men and usually occurs in people over the age of 40.

"The thumb accounts for about 50 percent of functionality with your hands," explains Jennifer Chisar, MS, PT, CHT, hand therapy supervisor for John Muir Health.

"If you don't have use of your thumbs, every aspect of life is impaired — your job, recreational activities, meal preparation, housework — the list goes on."

Worse still, some patients attempt to avoid discomfort by pinching items between the fingers and avoiding the thumb. But these stop-gap measures are not effective and without treatment can lead to loss of muscle strength.

Pain

Pain is often the first indicator that something may be wrong. For most, pain usually occurs when related to a particular activity.

Later, as the condition worsens, pain may be present even at rest. The most noticeable problem is that it becomes difficult to grip or pinch anything, causing a sharp pain at the base of the thumb in the heel of the hand.

"Studies have shown that the joint structure of women is less congruent than that of men, meaning the joints may not fit together as well," notes Chisar.

"Also, the articular cartilage, the elastic tissue that covers the ends of bones in joints and enables the bones to move smoothly over one another, typically is thinner in women than in men, so there's greater risk of painful bone-on-bone contact.”

“And hormonal changes, including pregnancy and menstrual cycles, make women more prone to joint laxity, which allows bones to slide a little more and decreases stability of the joint," explains Chisar.

"Such laxity can occur at any age, depending on activities," says Chisar. "Joint changes following trauma may also set you up for that type of arthritis, or if you just have lax ligaments in general."

Treatment

Effective therapy by certified hand therapists with specialized training and credentialing is available for people with thumb arthritis at John Muir Health. Once your physician refers you then you may undergo one or several therapeutic treatments, including:

  • Paraffin baths: The therapist immerses your hand in wax melted by an electric heating device. The effect is soothing and penetrates to the joint.
  • Contrast baths: Alternate dips in cold and hot water increase hand circulation and decrease inflammation. Heat or ice alone may be used as well.
  • Splinting: Splints help position and stabilize the thumb, decreasing detrimental forces on the joint. Splints also help the joints rest, decreasing inflammation.
  • Exercises: Exercise improves motion and strength. Learning to protect the joint, by teaching patients to use their hands in ways that don't overstress it, is also an important component.
  • Use of assistive devices: Patients employ built-up grips for writing instruments and kitchen utensils, jar openers, and more.

The course of treatment varies, depending on the intensity of pain and duration of the condition. Typically, therapy sessions occur once or twice a week for three to four weeks — often in combination with prescription or over-the-counter anti-inflammatory medications.

"Often, we can make a noticeable change in just a few visits if the patient follows the treatment plan," emphasizes Chisar.

If all these remedies fail, cortisone injections or surgery may be an option.

"If you are having thumb pain, address it sooner rather than later,” urges Chisar. “There are a lot of things you can be taught that will help you get rid of the pain faster and avoid a chronic problem that has fewer options for treatment."