Thumb (Basal Joint) Arthritis

Thumb arthritis is arthritis that affects the joints in your thumb. It’s most common in the joint at the base of your thumb, closest to your palm. This is the basal joint. It’s also known as the carpometacarpal (CMC) joint. Your healthcare provider may call it basal joint arthritis or CMC arthritis. These are all different names for the same condition.

Osteoarthritis is the most common type of thumb arthritis. It happens when the cartilage in your thumb joint breaks down from a lifetime of normal wear and tear.

Arthritis in your hands is extremely common. It often develops in your thumbs because you use them so much to do so many movements and motions. A healthcare provider will help you understand which type of arthritis you have and how you can manage symptoms.

Symptoms of thumb arthritis

The most common thumb arthritis symptoms include:

• Pain
• Swelling
• Stiffness or losing some ability to move your thumb
• A bone spur you can feel or see at the base of your thumb
• Feeling or hearing grinding in your CMC joint

Thumb arthritis pain often feels like a constant dull ache. But it can also feel sharp, pinching or stabbing. The pain might change or get worse when you use your thumb to grip or move something. It may be worse when you squeeze your hand to open a jar, or when you do a precise motion, like putting a key in a lock and turning it.

Basal arthritis causes

Osteoarthritis happens when the cartilage lining in the joint of your thumb breaks down with time. Cartilage is a tough, slippery cushion that helps bones in joints move past each other smoothly. But over time, it can start to wear away. This is called degeneration. Eventually, the cartilage can wear down so much that your bones rub against each other. That’s what causes pain, swelling and other symptoms.

Some health conditions cause other types of arthritis. For example, rheumatoid arthritis happens when your immune system damages your cartilage by mistake.

Risk factors

Anyone can develop thumb arthritis. But you may be more likely to if you:

• Are female
• Are over 40
• Have a history of thumb injuries or have broken your thumb
• Have a health condition that causes inflammation in your body, like lupus or psoriasis

How doctors diagnose this condition

A healthcare provider can usually diagnose thumb arthritis with a physical exam.

Your provider will ask about any symptoms you’ve experienced and when you first noticed them. Tell them if the symptoms ever come and go, or if any activities or times of day seem to make them worse. Your provider might feel your carpometacarpal joint and have you move it.

You may not need any tests. But your provider might suggest X-rays to take pictures of your hand. This will show arthritis and any damage in your joints.

Thumb arthritis treatments

Your healthcare provider will suggest ways to help you manage the symptoms and reduce how much they affect your daily routine. There’s no cure for arthritis, but treatments can help you feel better. Some of the most common thumb arthritis treatment options include:

• Over-the-counter pain relievers: NSAIDs, ibuprofen, aspirin or acetaminophen can all help manage pain and stiffness. Your provider will tell you which medicines are best for you and how often it’s OK to take them.
• Ice and/or heat: Icing can relieve pain and swelling. Heat can help reduce stiffness. You can apply an ice pack, cold compress or heating pad on your thumb for 15 minutes at a time, a few times a day.
• A splint or brace: Wearing one of these will hold your thumb in a stable, supported position. They’ll take pressure off your joint. You might need to wear a brace or splint during certain activities.
• Corticosteroids: These are prescription anti-inflammatory medications. Your provider may give you a cortisone shot in your thumb joint.
• Occupational therapy (OT): OT can help you strengthen muscles in and around your hands. This can take extra pressure off your joint. OT can also help manage pain and stiffness.
• Surgery: Your provider will usually only suggest surgery if you have severe symptoms and other treatments haven’t worked. A surgeon may replace your joint, perform a joint fusion or do a ligament reconstruction. You might also need a denervation to reduce pain signals.

When should I see my healthcare provider?

Visit a healthcare provider if symptoms like pain, stiffness or swelling make it hard or impossible to use your thumb or hand. Everyone has occasional aches and pains. But don’t ignore symptoms that make you avoid or change your usual activities.

Talk to your provider if you feel your arthritis symptoms are changing or worsening. They might be able to recommend different treatments.

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

Thumb arthritis is very treatable. It might take some time to find the right combination of treatments, but your healthcare provider will help you find the right options. They’ll also tell you if or when surgery may be a good idea.

Your provider might suggest meeting with an occupational therapist if you have severe symptoms. Your therapist will help you find safe, effective ways to do all the motions and movements you need to in your daily routine.