Osteoarthritis (OA) at the base of the thumb can be a complex problem to treat because of the great mobility of the thumb that we have in our use of the hand. Arthritic changes often develop in this joint over the years. It can become disabling because of the degree of pain that it causes and also the fact that it severely limits strength in the hand, particularly pinching or grasping with the thumb. OA at the base of the thumb is more commonly seen in women over the age of 40.
What causes OA of base of thumb?
The exact cause is unknown, but genetics, previous injuries such as fractures or dislocations, and generalized joint laxity may predispose towards development of this type of arthritis.
What are the symptoms and signs?
The most common symptom is pain at the base of the thumb. The pain can be aggravated by activities that require pinching, such as opening jars, turning door knobs or keys, and writing. Severity can also progress to pain at rest and pain at night. In more severe cases, progressive destruction and mal-alignment of the joint occurs, and a bump develops at the base of the thumb as the metacarpal moves out of the saddle joint. This shift in the joint can cause limited motion and weakness, making pinch difficult.
How is the diagnosis made?
The diagnosis is made by history and physical evaluation. Pressure and movement such as twisting will produce pain at the joint. A grinding sensation may also be present at the joint. X-rays are used to confirm the diagnosis, although symptom severity often does not correlate with x-ray findings.
What are the treatment options?
Traditional / conventional treatment
Less severe thumb arthritis will usually respond to non-surgical care. Arthritis medication, splinting and limited cortisone injections may help alleviate pain. A hand therapist might provide a variety of rigid and non-rigid splints which can be used while sleeping or during activities.
Taking safe herbal supplements such as Provailen has been found to be of great help for providing symptom relief (e.g. pain) and reducing joint inflammation present in the OA of the base of the thumb. Also, unlike medical drug therapy, Provailen is free from side effects, can be used for long term and is very affordable for everyone.
Patients with advanced disease or who fail non-surgical treatment may be candidates for surgical reconstruction. A variety of surgical techniques are available that can successfully reduce or eliminate pain. Surgical procedures include removal of arthritic bone and joint reconstruction (arthroplasty), joint fusion, bone realignment, and even arthroscopy in select cases. A consultation with your hand surgeon can help decide the best option for you.