Base of Thumb Arthritis and Pain

As we age, we may develop thumb arthritis. This happens when cartilage wears away from the joint at the base of the thumb. Without cartilage the bones rub against each other, causing pain and joint damage.

Symptoms

Symptoms of thumb arthritis include pain (sometimes severe), swelling, and diminished strength or range of motion in the thumb. The base of your thumb might appear larger and bony, and it may feel stiff or tender.

Causes

Risk for thumb arthritis is higher in females and people over the age of 40. Other risk factors include:

• Diseases that affect the cartilage such as rheumatoid arthritis
• Hereditary conditions such as malformed joints
• Injuries to the thumb joint
• Obesity
• Repetitive motion and activities that put stress on the thumb joint

Treatment

Thumb arthritis in its early stages is often treated with non-surgical therapies, such as topical medications, over-the-counter pain relievers, or prescription pain relievers. A splint can help to support the joint and contain the movement of the thumb and wrist. This reduces pain, holds the joint in proper position, and rests the joint.

If pain relievers or splints do not work, your doctor may recommend corticosteroid injections. These long-acting injections relieve pain and reduce inflammation.

Finally, if the arthritis doesn’t respond to any of these treatments your doctor may recommend surgery. Most surgical options can be done in an outpatient setting. Following surgery, you would wear a cast or splint for a few weeks. After the cast or splint is removed, physical therapy may be recommended to rebuild strength and range of motion.

Tendon Injuries

De Quervain Tenosynovitis is a painful condition in which the tendons on the thumb side of the wrist become irritated and inflamed. It is also known as “mother’s thumb” or “gamer’s thumb.”

Symptoms

The most common symptom is pain and swelling near the base of the thumb. People suffering from this condition often feel pain when they pinch or grasp things, turn or twist their wrist, or when they make a fist.

Causes

De Quervain Tenosynovitis is most often caused by repetitive use of the hand and wrist.

Treatment

For mild cases of de Quervain tenosynovitis, an anti-inflammatory medication may be prescribed or injected around the affected tendons. Simply resting the thumb and wrist for a few weeks in a splint may also help.

If non-surgical treatment options do not relieve the pain, surgery is an option. Surgery releases the sheath that surrounds the inflamed tendons, allowing the tendons to move more easily. The surgery is performed using a local anesthetic and is completed in a short amount of time.

Thumb Sprains

Thumb sprains are a common injury that damages or tears the thumb’s connective tissues. Most thumb sprains involve the main ligament at the base of the thumb on the inside of the hand.

Symptoms

A thumb sprain makes it difficult to hold objects between the thumb and index finger. Other symptoms may include pain, swelling, bruising, and weakness. The thumb may also feel unstable.

Causes

Sometimes called “skier’s thumb,” this injury can occur when a skier falls on their hand while holding a ski pole, for example. Other causes are repetitive overstretching of the thumb joint or if the thumb gets jammed backward on a hard surface.

Treatment

Most sprains can be treated with a thumb splint to immobilize the joint. You would wear a splint for several weeks to give the ligament time to heal. After the splint is off, your doctor or physical therapist will give you strengthening exercises.

If the injury is more serious or complex, your doctor may recommend surgery. Surgery would also involve a cast or splint afterward, followed by strengthening exercises.