Osteoarthritis happens when the joint space between two bones decreases or worse, disappears entirely. This leads to a lot of pain, and yes, even disability.

One of the most common spots for osteoarthritis is the base of the thumb (located at the bottom hence base of the thumb) because of the thumb’s

• use in literally everything we use and do
• size of the thumb relative to work and load (small joints vs heavy loads are not a good combination)

that’s why it wears and tears out very fast.

Arthritis at the base of the thumb is also known as CMC arthritis or basal joint arthritis.

Stuff that makes it more likely to happen

The cause of arthritis at the base of the thumb is thought to be the result of a combination of factors including

• family history, DNA and genetics
• occupation / habit / hobby related where there is a lot of pinching such as administrative works, manual labour etc
• sports that include thumb loading and twisting
• general overuse
• trauma such as thumb dislocations, sprains, fractures or direct force

Thumb arthritis affects ladies over the age of 50.

What are the common signs and symptoms?

The most common symptoms of base of thumb joint arthritis are pain or dislocation with

• pinching
• gripping
• general thumb use

Examples of activities include

• using a key to unlock a door
• opening a tight jar (twist)
• using a computer mouse or phone (yeah)
• stapling paper together
• turning door knobs
• etc

Sometimes, patients also may experience ache, pain or discomfort at the base of the thumb at night.

We think that it’s possibly that is does hurt the whole day, but because they’re distracted and busy, they dont realize it (especially for milder cases); and it’s more apparent at night.

What treatments is done for base of thumb arthritis?

This depends on how severe and painful it is. If it’s mild, then it’s likely conservative (non surgical).

Conservative treatment’s motto typically revolves around rest and modification of daily activities. If the symptoms are mild, the patient’s doctor may prescribe

• an anti-inflammatory medicine
• a referral to hand therapist
• and/or suggest a cortisone injection to help decrease the pain

Only when the symptoms worsen, such as

• pain getting worse
• pain getting in the way of you being able to use your thumb to do things

then they may recommend corrective thumb surgery.

What can a hand therapist do for me?

Initially, patient education including

• incorporating more rest into schedules and activities
• modifying activities to be less straining or painful for the painful thumb
• use of adaptive equipment
• special exercises to help reduce pain

Sometimes you may be prescribed with a custom-fabricated brace or orthosis that will allow the thumb joint to rest and will provide support while performing daily activities.

Hand therapy following thumb arthritis surgery improves range of motion, and teaches the patient how to regain the function of the hand.

Patients may also receive the following hand therapy treatment:

• cold therapy
• heat therapy
• moist heat paraffin wax therapy
• manual therapy
• joint mobilization
• ultrasound therapy

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