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The joint at the base of the thumb, just below the wrist often becomes arthritic as people get older. In arthritis the joint starts to lose the smooth covering of cartilage over the ends of the bones. The cartilage becomes thin and rough, and the bone ends can rub together. Osteoarthritis can develop at any age, but usually appears after the age of 45 and it may run in families.
Arthritis of the basal joint of the thumb is common in women and rather less common in men. X-rays show it is present in about 25% of women over the age of 55, but many people with arthritis of this joint have no significant pain.
Patients usually complain of:
1. Pain at the base of the thumb, aggravated by thumb use.
2. Tenderness if you press on the base of the thumb.
3. Difficulty with tasks such as opening jars, turning a key in the lock etc.
4. Stiffness of the thumb and some loss of ability to open the thumb away from the hand.
5. In advanced cases, there is a bump at the base of the thumb.
Examination by a hand specialist and X-rays will reveal the cause of the pain. Treatment consists of:
1. Avoiding activities that cause pain, if possible.
2. Analgesic and/or anti-inflammatory medication. A pharmacist or your family doctor can advise.
3. Using a splint to support the thumb and wrist. Rigid splints (metal or plastic) are effective but make thumb use difficult. A flexible neoprene rubber support is more practicable.
4. Steroid injection improves pain in many cases, though the effect may wear off over time. The risks of injection are small, but it very occasionally causes some thinning or colour change in the skin at the site of injection. Improvement may occur within a few days of injection, but often takes several weeks to be effective. The injection can be repeated if needed.
5. Surgery can be performed if the symptoms do not stabilise by the non-surgical treatments above. There are various operations that can be performed to treat this condition. Removal of the bone at the base of the thumb (trapezectomy) is the most commonly performed operation. Following surgery the patient is placed in a plaster cast for 1 to 2 weeks and then requires specialist splints and exercises to encourage a good recovery. Most patient achieve a good result within 3 to 4 months.
Your Hand Surgeon will advise you on the best options for your thumb.
Appointments can be made at the Orthoderm Clinic to see a hand specialist and have X-rays or scan performed. Injections can take place on the same visit or surgical options discussed if required.