At Hand to Shoulder Center of Wisconsin, our orthopedic doctors and staff have extensive experience diagnosing and treating thumb arthritis. When you’re seeking treatment from caring and experienced orthopedic specialists to treat your basal joint arthritis, contact Hand to Shoulder Center of Wisconsin in Appleton or Green Bay, WI.
What is Thumb Arthritis?
Basal joint arthritis, more commonly known as arthritis of the thumb, thumb arthritis or CMC arthritis occurs when the base of the thumb develops arthritis. Arthritis can develop from normal wear and tear, however, injuries or fractures, age and gender, and daily overuse and repetitive motions can excel your risk factors. Arthritis of the thumb affects the CMC joint and typically will cause the thumb to become inflamed and painful.
Arthritis comes in many forms, however, the most common forms of thumb arthritis are osteoarthritis (OA) (also known as degenerative joint disease – DJD) and rheumatoid arthritis (RA). Degenerative arthritis attacks and wears down the cartilage surrounding the base of the thumb joint, causing significant thumb pain and hindering functionality. Arthritis of the thumb is the most common site for arthritis in the hand.
The thumb consists of three joints, the CMC joint (base), MP joint (middle), and the IP joint (end knuckle). The base of the thumb referred to as the CMC joint is the area affected by thumb arthritis. The CMC joint is formed at the base of the thumb; it includes the trapezium, one of the small carpal bones in the wrist, and the long bone of the thumb. It provides stability and mobility to the thumb.
Symptoms of Thumb Arthritis
Cartilage is a protective covering at the end of the bones that permits gliding and range of motion movements to the joint. When the cartilage starts to break down, the body cannot replace it. Instead the body tries to repair itself by laying down bone. This new bone is not smooth, but rough. The osteophytes, or uneven bone, results in arthritic changes within the joint. As the disease progresses over time, functionality may decrease causing difficulty to normal everyday activities, such as turning a key or opening a door. Patients often report an inability to pinch and grasp objects or find that they frequently drop objects because of the sharp pain.
Thumb Arthritis symptoms may include:
- Swelling and aching pain of the thumb, especially at the base of the thumb
- Occasional warmth in the thumb region
- Loss of functionality and strength of the thumb during daily activities
- A deformed or enlarged appearance of the thumb
- Thumb pain during pinching or gripping activities
- Tenderness to the touch
Diagnosis and Treatment of Thumb Arthritis
The orthopedic physicians at Hand to Shoulder Center of Wisconsin are highly experienced in hand and upper extremity injuries and conditions. A thorough examination is conducted and all prior hand, wrist, and arm injuries and conditions are explored (Fig. 1). Old thumb injuries and conditions are reviewed. X-rays typically are ordered to view the damage of the joint and how the degenerative arthritis has affected the cartilage in the CMC joint.
Utilizing the X-ray findings in combination with the physician’s examination, thumb arthritis is classified in stages of I, II, III, or IV. Stage I will display limited damage to the CMC joint; as the levels increase, the damage to the cartilage becomes more widespread. Bone spurs, narrowing of the joint space and even joint dislocation may be seen in Stage IV.
In early stages, basal joint arthritis treatment options are typically conservative depending on the severity of symptoms. Mild anti-inflammatories, reduced activities, and splinting most often will deter early symptoms; however, since it is a degenerative disease, symptoms do worsen over time.
A cortisone injection is another option for temporary pain relief.
Basal Joint Arthritis Surgery
When conservative measures no longer ease the pain and discomfort, basal joint arthritis surgery is recommended. Surgery options are available and include:
- Osteotomy – bone is trimmed (cut) to allow re-positioning of bones to correct deformity
- Trapeziectomy and ligament reconstruction – trapezium bone is removed from the CMC joint and tendon material is used to suspend and stabilize the reconstructed thumb
Depending on the type of surgery performed, your recovery time and therapy sessions will vary. Nonetheless, you can expect to wear a short-arm splint over your thumb and wrist after surgery. At the first postoperative visit the splint will be removed and replaced with a short arm thumb spica cast. At 3-4 weeks post-op, the cast is removed and a removable splint is fabricated. Active range-of-motion exercises begin as well as regular therapy sessions focusing on regaining hand strength and movement. Most normal activities typically can be resumed by 3 – 6 months after surgery.
Surgery is conducted under regional anesthetic and is performed as an outpatient surgery. Surgery locations include Woodland Surgery Center and one of the three Fox Valley hospital locations.