Arthritis - Base of the Thumb
DESCRIPTION

A joint is where bones connect and move.  Arthritis is thinning of the cartilage, which is the smooth covering of the joint.  The body reacts to loss of the joint surface by forming bone spurs (osteophytes) (see Figure 1).

Arthritis at the base of the thumb is a genetic predisposition: like graying and thinning of the hair, it comes with age and it shows up earlier in some families.  Unlike thinning of the hair, women tend to get thumb arthritis sooner than men do.
CAUSES
SIGNS AND SYMPTOMS

Patients with arthritis of the base of the thumb report pain and weakness with pinching and grasping.  For in-stance, opening jars, turning doorknobs or keys, and writing are often painful.

Diagnosis

The diagnosis is made by talking with you and examining you.  The appearance of the thumb can change with the development of bone spurs and stretching of soft tissues (ligaments) (see Figure 2).  A grinding sensation may also be present at the joint (see Figure 3).  X-rays are not necessary to make the diagnosis, but they can help you understand the disease and they can help when surgery is being considered.

TREATMENT
As with other aspects of aging, we adapt to thumb arthritis and treatment is often unnecessary.  Options for treatment include non-surgical methods and surgery.  Treatments without surgery range from ice/heat, pain med-icines, splinting, and injections.  

Surgery consists of removing the joint either by removing a bone or connecting the bones together.  There are options for moving one of your tendons to secure or cushion the bone, and each hand surgeon has a different opinion on whether this is helpful (see Figure 4). After surgery, a splint or cast is worn for several weeks.

(c)  2013 American Society for Surgery of the Hand

Developed by the ASSH Public Education Committee
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Copyright 2014 by American Society for Surgery of the Hand