Chapter 6

Medical Highlight: Thumb Arthritis

Thumb Arthritis is a daily and annoying problem. Simple activities, like turning the key in a car’s ignition,picking up a cup of tea or coffee, or buttoning a shirt, cause a sharp pain in the thumb.

Thumb pain that occurs when a person attempts to pinch or grasp something is a result of arthritis in the thumb(known as the carpometal joint). This condition typically occurs after age 40, and is more common in women than men.

The carpometal joint is made up of the trapezium bone ofthe hand and the first metacarpal of the thumb. Because of constant wear and tear, the cartilage covering the end of the bones gradually deteriorates, and arthritis develops.

Symptoms - Symptomsinclude pain when gripping or pinching, swelling at the base of the thumb, and the skin may feel warm or tender to the touch. As the condition worsens, the pain becomes more severe, and there is loss of strength in the joint making it difficult to hold onto things. A bony deformity may develop at the base of the thumb, or a person may feel or hear a catch, click, or crack when moving the thumb.

Treatment- Aphysical or occupational therapist can teach a personhow to prevent further damage to the joint. This may include:

  • Rest - Avoid painful activities whenever possible.
  • Cold and heat- Apply ice or heat to the joint for 15-20 minutes to help reduce the pain.
  • Analgesic pain medication-Aspirin, nonsteroid anti-inflammatory, or prescription-strength drugs may alleviate the pain.
  • Splint- A splint that limits range of motion may decrease pain and allow the joint to heal.
  • Assistive devices- Household devices, such as kitchen gadgets with thick, rubber handles, can minimize how forceful the grip must be. Other devices include large foam handles,which ease the grip while brushing the teeth or hair, or while writing.
  • Corticosteroids-Some doctors recommend cortisone injections to reduce pain and inflammation. Generally, up to three injections may be given over a period of six to twelve months.
  • Restructuring the joint- If conservative measures are no longer effective, surgery may be required. Several procedures may be used; a common procedure is to remove part of the joint and reconstruct it, using a tendon from the forearm.
  • Joint replacement- A new type of implant made from pyrocarbon material has received approval for treatment of thumb arthritis. Early results look promising, but it will be several years until the treatment is available.

Ref. Thumb Arthritis-Mayo Clinic Health, Letter, June 2006, Mayo Clinic Health, Rochester,MN