Thumb pain
The joint at the thumb base, also called the carpometacarpal (CMC) joint, is formed by one of eight small bones of the wrist and the first bone of the thumb (metacarpal).
Thumb pain usually occurs due to cartilage degeneration, which is related to age, wear and tear. In a normal joint, cartilage covers the end of the bones and serves as a shock absorber to allow smooth, pain-free movement.
When the cartilage layer wears out, it results in direct contact between the bones, causing thumb pain and inflammation. If left untreated, the swelling and inflammation may cause the ligaments stabilising the base of thumb joint to stretch out, causing instability, subluxation and deformity of the thumb.
Causes
Since deformity or degeneration most commonly occur as part of the normal aging process, it is more common in adults over 40 years of age.
Factors that may cause a person to develop base of thumb arthritis include:
- Previous fracture or injury to the thumb joint
- Hobbies, sports or jobs that require repetitive use of the thumb joint for a prolonged period of time
- Genetic predisposition
Base of thumb arthritis symptoms
- Swelling and inflammation at the base of the thumb
- Aching, discomfort or tenderness at the base of the thumb
- Limited movement in the joint
- Enlarged, bony-looking joint at the base of the thumb.
- Weakness of the thumb
Symptoms may vary in severity and may be mild at first, and worsen over time if a person doesn’t seek treatment.
Treatment options
Conservative treatment may be indicated when there is only mild pain or functional impairment. Once the symptoms cause functional limitations and excessive pain, surgery may be required.
Conservative treatment
Splinting
Hand-based splint to rest the base of the thumb and reduce the pain and inflammation. Splints may be made from a soft neoprene material or a more rigid material, depending on the amount of support and immobilisation needed to reduce the pain.
Strengthening exercises
Strengthening of the muscles surrounding the joint at the base of the thumb to improve joint stability and reduce the strain on the joint.
Surgical management
SURGICAL TECHNIQUES
May vary according to the choice of the surgeon, the severity of the condition, and the integrity of the bone and soft tissues surrounding the CMC joint.
THE GOAL OF SURGERY
Post-operative management
You will be immobilised in a post-operative cast for 8 – 14 days after surgery. Your stitches may either dissolvable or the doctor will remove them after 10 – 14 days.
Aims of hand therapy
- Management of swelling & wound care
- Management of pain
- Scar management
- Splinting the wrist and thumb to allow the new joint to heal
- Gradual exercise program to prevent stiffness and improve strength in the thumb
Symptoms may vary in severity and may be mild at first, and worsen over time if a person doesn’t seek treatment.
*The above text is for information purposes only and should not be seen as health advice. Please consult with your medical practitioner should you require health advice or medical treatment.