Thumb Arthritis

Arthritis in your thumb happens when the protective cartilage that cushions your thumb joints starts to wear out and deteriorate (osteoarthritis).

Osteoarthritis in your thumb usually develops in the carpometacarpal (CMC or basal) joint. This is the joint near your wrist at the fleshy part of your thumb. It helps your thumb move around in different directions so you can grip things in your hand. Healthcare providers may use the term CMC arthritis for arthritis in your thumb.

Thumb arthritis is the second-most common kind of arthritis that affects your hand, after arthritis in the last joint in your fingers.

Symptoms of thumb arthritis

CMC arthritis symptoms may include:

• Aching or discomfort after using your hand for a long time
• Bone spur at the base of your thumb
• Enlarged thumb joint
• Loss of strength and motion in your thumb
• Pain in your thumb when grasping, gripping or pinching
• Swelling, stiffness or tenderness at the base of your thumb

Thumb arthritis causes

Arthritis in your thumb happens when the cartilage that cushions your thumb joints breaks down (degenerate). Cartilage helps your bones to glide easily in your joints. Age and use can make cartilage break down. That can cause your bones to rub against each other, which causes friction and damage.

Arthritis in thumb risk factors

Thumb arthritis risk factors include:

• Being female
• Being age 40 and older
• Having a genetic predisposition for osteoarthritis
• Injuring or breaking your thumb
• Having health conditions like lupus and rheumatoid arthritis

How doctors diagnose thumb arthritis

A healthcare provider will ask about your symptoms. They may ask if your thumb hurts all the time or if certain activities cause pain. They’ll ask if you’ve ever injured your thumb.

They’ll examine your hand and thumb. They may see what happens when you move your thumb. They do that by holding your thumb joint while moving your thumb. They may suspect thumb arthritis if:

• It hurts when they move your thumb
• You experience a “gritty” feeling
• They hear a grinding noise (crepitus)

Your provider may also request an X-ray to confirm the diagnosis.

Thumb arthritis treatment

Thumb arthritis treatment varies based on the severity of your symptoms. If you have mild symptoms, a healthcare provider may recommend at-home treatments like:

• Applying ice and/or placing a heating pad on your thumb joint for five to 15 minutes a few times a day (try both options to see what works best for you)
• Taking pain medication like nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®) or aspirin or acetaminophen (Tylenol®) — you might alternate between the two different pain medications
• Wearing a splint to protect your thumb joint and let it rest (you can wear a splint from time to time during the day or overnight)

Your provider may recommend steroid injections if your symptoms are severe or get worse. They’ll inject a steroid solution into your thumb joint. This typically provides pain relief for several months. But injections become less effective over time. At that point, your provider may recommend surgery.

Thumb arthritis surgery

Options for surgery include:

• Arthroplasty (joint replacement). Arthroplasty involves removing all or part of your thumb joint and replacing it with an artificial implant.
• Denervation. This procedure doesn’t directly change the joint. It removes pain signals coming from the nerve ending, which relays back to your brain.
• Fusion (arthrodesis). Arthrodesis fuses the bones of your thumb joint together. This procedure could reduce pain and increase strength, but it may limit movement.
• Ligament reconstruction and tendon interposition (LRTI). LRTI involves removing all or part of your thumb joint and suspending the rest of your thumb using a tendon from your wrist. This procedure may reduce pain while allowing continued movement.
• Trapeziectomy with suspensionplasty. This procedure removes part of your thumb joint and suspends your thumb using nearby tendons or sutures. It may reduce pain while allowing motion.

What can I expect if I have arthritis in my thumb?

Thumb arthritis is a very treatable condition. Nonsurgical treatments often ease symptoms. But surgery is an option when other treatments don’t relieve symptoms. Your healthcare provider may recommend physical therapy or occupational therapy. For example, a certified hand therapist can help you regain strength and movement in your hand and thumb.