Losing Your Grip?

Treating arthritis of the thumb

Shorter and thicker than its counterparts, the base of the thumb has a unique saddle-like joint structure. It provides a wide range of motion and allows us to hold and grip things. Even the most idle person uses their thumbs countless times a day every day of their life. It’s no wonder that arthritis of the thumb is one of the most common types of arthritis of the hand.

Basal joint arthritis: Causes and Symptoms
Arthritis that occurs at the base of the thumb is called basal joint arthritis. The unique structure that gives the thumb such great mobility is prone to wear and tear. Over time, the cartilage in the joint wears away leading to osteoarthritis (OA). Symptoms of osteoarthritis include:

• pain, stiffness, or swelling of the thumb joint
• red or tender skin near the thumb joint
• limited range of motion in the thumb
• reduced strength in the thumb
• symptoms that worsen when moving the thumb

According to Dr. David Veltre of SVMC Orthopedics and Northern Berkshire Orthopedics, “Patients most often experience the pain of OA when doing simple motions like gripping and pinching. Tasks such as opening a jar, turning a door knob, and even using a key can cause discomfort. Some patients also experience pain when resting or even at night.”

Treating arthritis of the thumb
Like all types of osteoarthritis, osteoarthritis of the thumb is a progressive disease, which means it gets worse over time.

Veltre says, “While we can’t cure osteoarthritis, treatment can slow its progression and help patients manage symptoms. Getting an early diagnosis and starting a treatment plan is extremely important as it can help prevent ongoing irreversible damage.”

The most common initial treatment for osteoarthritis of the thumb is an over-the-counter (OTC) pain medication. “OTC medication and topical gels and creams are often a first step in dealing with the pain of osteoarthritis,” says Veltre, “If there’s a particular activity or repeated motion that contributes to pain, I also recommend a soft splint to help support the joint and relieve pain when engaging in that activity.”

As the condition progresses, Veltre often recommends occupational therapy. “There are a number of exercises a therapist can teach that will help with both strength and range of motion.”

He notes that often patients ask about injections.

“Unfortunately, corticosteroid injections are not a long-term solution for osteoarthritis. They might work for a few months or even a few years, but the relief typically diminishes with each injection.”

For patients who have exhausted all other treatment options, Veltre often offers surgery.

“Surgery for thumb basal joint arthritis typically involves removing one of the painful bones in your wrist and stabilizing your thumb. We have been doing the same surgery for decades with some recent variations to the techniques used to suspend the thumbs.  These newer techniques often shorten the recovery period and get patients back to work and their activities earlier.  However, the common feature with all techniques is that they are all very effective at relieving pain.  But even the most modern techniques necessitate a recovery of a few months that involves splinting and occupational therapy to ensure a good outcome.” 

To learn more about treatments options offered through SVMC Orthopedics, visit svhealthcare.org/ortho or call 802-442-6314.

David Veltre, MD, is a hand surgeon with SVMC Orthopedics, which has offices in Bennington, VT, and Williamstown, MA. The practice is part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care.