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  • Home
  • About Dr. Izadi
    • About Dr. Izadi
    • What's a Hand Surgeon?
    • Which Hand Surgeon is Right For Me?
    • Blog
  • Hand
    • Hand
    • Hand Anatomy
    • Hand Arthritis >
      • Hand Arthritis
      • Knuckle Arthritis
      • Thumb Arthritis
    • Dupuytren's Contracture
    • Fingers & Thumb >
      • Fingers & Thumb
      • Baseball (Mallet) Finger
      • Basketball Finger Injuries
      • Fingertip Injuries
      • Jammed Finger
      • Jersey Finger
      • Trigger Finger
      • Gamekeeper's Thumb
      • Skier's Thumb
      • Thumb Sprain
    • Ganglion Cysts
    • Hand Fractures
    • Nail Bed Injuries
    • Hand Numbness & Tingling
    • Hand Pain
    • Tendon Injuries >
      • Tendon Injuries
      • Extensor Tendon Injuries
      • Flexor Tendon Injuries
  • Wrist
    • Wrist
    • Wrist Anatomy
    • Wrist Arthritis
    • Wrist Arthroscopy
    • Carpal Tunnel Syndrome
    • Cyclist's Palsy
    • de Quervain's Tendonitis
    • Wrist Fractures >
      • Wrist Fracture
      • Scaphoid Fracture
      • Scaphoid Non-Union
    • Ganglion Cysts
    • Golf Injuries
    • Kienbock Disease
    • Wrist Pain
    • Snowboarding Injuries
  • Elbow
    • Elbow
    • Elbow Anatomy
    • Elbow Arthritis
    • Cubital Tunnel Syndrome
    • Distal Biceps Tendon Rupture
    • Elbow Fractures
    • Golfer's Elbow (Medial Epicondylitis)
    • Olecranon Bursitis
    • Elbow Pain
    • Tennis Elbow (Lateral Epicondylitis)
  • Arthritis
    • Arthritis
    • Inflammatory Arthritis
    • Juvenile Arthritis
    • Osteoarthritis
    • Post-Traumatic Arthritis
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
  • Work Comp
    • Common Work Comp Claims >
      • Repetitive Motion Injuries
      • Slips, Trips and Falls
      • Fall to Lower Level
      • Machinery Accidents
      • Overexertion
      • Struck by an Object
      • Struck Against an Object
      • Bodily Reaction
      • Highway Incident
      • Workplace Violence
    • Work Comp >
      • Work Comp Second Opinion
      • Work Comp Appointment
      • Work Comp Injuries >
        • Acute Work Comp Injuries >
          • Fractures and Falls
          • Amputations
          • Agricultural Accidents
        • Chronic Work Comp Injuries >
          • Carpal Tunnel Syndrome
          • Cubital Tunnel Syndrome
          • Hand-Arm Vibration Syndrome
        • Hand Injuries
        • Wrist Injuries
        • Elbow Injuries
      • For Case Workers
    • Can you Choose Your Work Comp Doctor?
    • What is Workers' Compensation?
  • Second Opinion
  • PATIENTS
    • New Patients
    • Virtual Care
    • COVID-19
    • Surgery >
      • Wide Awake Hand Surgery
      • Anesthesia
      • Before Surgery
      • Day of Surgery
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      • Smoking & Wound Healing
    • Steroid Injections
    • Patient Stories >
      • Scheduling Test
      • Embedded Schedule
  • Contact

Thumb Arthritis

Healthy joints have smooth cartilage, which acts as a shock absorber allowing pain-free movement. The thumb basal joint (CMC or carpometacarpal joint) is a saddle-shaped joint that is formed by the wrist bone (carpal trapezium bone) and the first metacarpal thumb bone. The thumb basal joint is responsible for the thumb's extensive range of motion, which allows firm grasping and pinching (see Figure 1).
 
The most common type of arthritis that affects the thumb joint is osteoarthritis. Less common causes of basal joint arthritis are post-traumatic arthritis, reactive joint arthritis due to infection, rheumatoid arthritis, gout arthritis, and psoriatic arthritis.
 
In osteoarthritis, the cartilage wears out, resulting in direct contact of joint bones and producing pain and deformity. Thumb basal joint is one of the most common places in the hand where degenerative arthritis occurs.
 
Basal thumb arthritis is more commonly seen in women over 40. Previous thumb injuries and joint laxity may predispose towards the development of basal thumb arthritis.

Symptoms of Thumb Arthritis

The most common symptom of thumb arthritis is pain at the base of the thumb joint. The pain can be aggravated by daily activities such as opening jars, turning doorknobs or keys, and writing. Patients with advanced basal thumb arthritis have pain at rest and night. In severe cases of thumb basal joint arthritis, a bony bump develops over the joint space at the base of the thumb as the joint subluxation forces its collapses into the palm, causing a zig-zag deformity.

Thumb Arthritis Diagnosis

The diagnosis of thumb arthritis is made by history and physical evaluation. Frequently, people with thumb arthritis have decreased grip strength, loss of strength, limited motion, pain with activity such as twisting, all of which cause joint pain in the carpometacarpal joint. A grinding sensation and grinding sound may also be present at the carpometacarpal joint (see Figure 3). X-rays are used to confirm the diagnosis, but symptom severity often does not correlate with x-ray findings.

Treatment For Thumb Arthritis

Less severe thumb arthritis will usually respond to conservative management and nonsurgical treatment such as anti-inflammatory medication. Arthritis medication, splinting, and limited corticosteroid injections are treatment options that may provide pain relief. A physical therapist or an occupational therapist may recommend activity modifications and provide a variety of rigid and non-rigid splints which can be used while sleeping or during activities. 
 
Patients with advanced disease, severe pain, or who fail conservative measures and conservative treatment have surgical options. Various surgical options and surgical techniques can successfully reduce or eliminate pain, including surgical reconstruction and joint replacement. Surgical procedures include removing arthritic bone and joint reconstruction (arthroplasty), joint fusion, bone realignment, and even arthroscopy. Your hand surgeon can help you decide the best option for you. 
Figure 1. Thumb Basal Joint
Figure 2. Zig-Zag Deformity
Figure 3. Grind Test
Reproduced with permission from the American Society for Surgery of the Hand     www.handcare.org
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