Thumb Arthritis (Osteoarthritis) is a common condition involving instability and degeneration of the thumb carpometacarpal joint. This can cause significant pain. At Action Rehab our Hand Therapists and Hand Physiotherapists are experts in the non-surgical treatment of this painful and common condition.
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Thumb arthritis is a very common condition that involves the carpometacarpal joint of the thumb. This joint is made up of the Metacarpal and the Trapezium bone. The joint is really important in thumb function and the thumb is 60% of all hand function. This makes the carpometacarpal joint very commonly damaged.
Thumb arthritis is wear and tear of the joint. As we use our thumbs we put a large amount of stress through the joint and this damages the ligaments that stabilise the joint and then rubs away the cartilage in the joint. Women are more likely to suffer thumb arthritis than men and interestingly it is more common to have pain in your non-dominant hand than your dominant one.
View the video below to learn more about what causes ‘Facebook thumb’ more predominantly in women and how Action Rehab treats the thumb joint with a custom-made splint to reduce the inflammation and cure the pain. As explained by Action Rehab founder Ben Cunningham.
When people have thumb arthritis they describe a “ring” of pain around the base of the thumb near the wrist. Initially the pain is occasional and it is often when you have been doing heavy gripping or activities like pinching or pruning. Gardening often sets off the pain. Typing can also cause thumb arthritis pain.
The injury initially presents as an instability in younger women and then as we get older more of the cartilage wears away and in over 50-year-olds it is more of a joint degeneration. Diagnosis is best done by physical examination, strength testing and X-rays. The Hand Therapists and Hand Physiotherapists at Action Rehab can refer you for X-rays if required and our experienced Hand Therapists and Hand Physiotherapists can assess the severity of the arthritis or instability.
Thumb arthritis and thumb instability is best treated initially with a custom thumb brace. Hand Therapists at Action Rehab are experts in the fabrication of these orthoses, and they can advise you on when and how to wear them. The goal of the splint is to hold the carpometacarpal joint in the most comfortable position and take stress and pressure off the joint.
Once the brace has relieved the pain and reduced the swelling in the joint then the Hand Therapists and Hand Physiotherapists at Action Rehab will instruct you in exercises that help to stabilise the joint and reduce the pain. All treatment is designed to stabilise the joint, firstly in the brace and then by using the muscles around the thumb that hold the carpometacarpal joint in position.
Surgery should never be the first treatment for thumb arthritis. Generally thumb arthritis, pain and instability can be treated without surgery. In most cases treated with Hand Therapy patients can achieve a satisfactory outcome with stabilisation of the joint and not have to continue on to have surgery.
Surgery for thumb arthritis is considered a last resort if the stabilisation program fails.
Fig 1 (below): Incorrect Treatment: A brace being incorrectly used to treat thumb arthritis pain. It does not support the thumb joint, and does not allow for motion of movement for exercising the hand.
Fig 2 (below): Correct Treatment: A custom splint to alleviate the stress and pressure on the thumb joint. It is lightweight, waterproof and comfortable to wear, supporting hand stability exercises.
It is important when you have thumb arthritis that you choose Action Rehab for your treatment. Therapists at Action Rehab are experts in the assessment and treatment of thumb arthritis.
Your Action Rehab therapist will only suggest surgery as a last option, after a thorough treatment program that includes thumb joint stabilisation with stability accesses that restore the function of the hand.
This is why it is important to see a Hand Therapist at Action Rehab for your thumb pain.
Known for providing treatment for thumb arthritis and other hand, wrist, elbow and shoulder injuries Action Rehab are the hand therapists that Melbourne trusts.
How common is thumb arthritis?
A. Base of thumb joint pain and instability is very common in women. Many women mistake it as Carpal Tunnel syndrome or just think they need to put up with or have surgery. This instability leads to joint degeneration and arthritis if left untreated for a period of time. The sooner you seek treatment from a Hand Therapist or Hand Physiotherapist then the less degeneration there is in the joint and the better your treatment outcomes.
How is thumb arthritis caused?
A. Thumb arthritis is caused by instability of the ligaments of the base of the thumb, load of the muscles of the thumb, overuse of the thumb joint and then degeneration of the cartilage of the joint. Generally it happens in the non-dominant hand because it is our “holding hand” and will often hold the load while our dominant hand does the fine motor tasks. It may also be more common in the non-dominant hand because our core stabilisers are weaker in our non-dominant side.
How long does it take to recover from thumb arthritis?
A. Thumb instability is the initial symptom of thumb degeneration and then this can lead to thumb arthritis. Younger active women may be experiencing thumb pain while going to the gym, doing yoga, gardening or typing. The sooner you seek treatment from a Hand Therapist for this pain then the better the likelihood of a good recovery. Generally recovery from thumb arthritis takes about 3 months and it requires bracing and stabilisation in a small splint followed by stability exercises to restore function of the hand.
Will it require surgery?
A. Surgery should never be the first treatment for thumb arthritis. Generally thumb arthritis, pain and instability can be treated without surgery. Surgery for thumb arthritis is considered a last resort if the stabilisation program fails. In most cases treated with Hand Therapy patients can achieve a satisfactory outcome with stabilisation of the joint and not have to continue on to have surgery.
Will a steroid injection help my thumb arthritis?
A. No generally an injection into the joint does not help with thumb arthritis. The short term benefits of the injection are countered by the harmful degenerative effects of the steroid injection. At Action rehab we would not suggest that a patient has an injection to help thumb arthritis. A stabilisation program will not have any adverse side effects and so injections should be avoided if possible.
Is it a serious condition?
A. The thumb makes up 60% of hand function so injury, pain, swelling and instability of the thumb can mean that a person might lose 60% of their function. This is a very serious and debilitating injury. The sooner thumb instability is treated then the better the result and the less degeneration there will be in the joint.
Will it go away if left untreated?
A. Unfortunately thumb arthritis will only get worse if you leave it untreated. Thumb degeneration leads to cartilage loss and then if it continues this can lead to subluxation of the joint and eventual dislocation. This is called a “step deformity”. A step deformity is where the Trapezium bone and the thumb Metacarpal bone dissociate themselves from each other, dislocating and causing a step in the base of the thumb at the wrist.
This information has been verified by Action Rehab director Ben Cunningham.
Ben Cunningham is currently the Hand Therapist at Melbourne Football Club (AFL) and the director of Action Rehab. Ben has over 20 years’ experience providing hand and upper limb therapy, including working in the United Kingdom at the Queen Victoria Hospital and as the senior clinician at the Alfred Hospital in Melbourne.