Thumb Basilar Joint Arthritis
Thumb basilar joint arthritis, otherwise known as thumb carpometacarpal (CMC) arthritis, is the most common painful arthritic condition of the hand. Patients often complain of an aching pain in the base of the thumb and are unable to pinch, twist off bottle tops, or use their thumbs. Insomnia may even result, as people have a hard time getting to sleep at night due to the pulsating discomfort.
While thumb CMC arthritis typically afflicts women in their 40s and 50s, particularly if there is a family history of similar arthritis, both genders can be affected.
At the base of the thumb, for reasons of mechanical amplification, pinching activities are magnified by a factor of 10 at the CMC joint. There is gradual wear of the articular cartilaginous surfaces of the joint. As the cartilage wears away, the resultant bone-on-bone contact leads to inflammation and pain. Usually, grip and pinch strength diminish as pain increases. With time, the joint surfaces and surrounding joint capsule may be so disrupted that the CMC joint starts to slide out of place (sublux), which can lead to a bony bump deformity at the base of the thumb by the wrist. Essentially, the arthritic joint is collapsing.
Initial treatment of thumb basilar joint arthritis centers around rest, splinting, and oral anti-inflammatory medications. For mild cases, this is often sufficient to avoid more invasive treatment. Anti-inflammatory steroid injections may also help relieve the pain. Unfortunately, none of these modalities can actually cause the worn out cartilage to regenerate. In severe cases, where pain becomes a daily obstacle to work, hobby, or routine living activities, surgery may be indicated. Either joint replacement (arthroplasty) or joint fusion (arthrodesis) can be performed. The staff at California Hand Center can help you determine which is right for you. The important thing to remember is that treatment centers around your degree of symptoms, and not just your x-ray images.