Base of thumb arthritis

What is it?

Osteoarthritis is a process where the joint becomes more reactive, and over time and develops supportive growths around the joint. Initially there is a low lying inflammatory reaction, with occasional ache, or sharp catching sensation. With time the inflammatory reaction continues and causes swelling of the joint and eventual lumpy nodules.

Pain at the base of the thumb during gripping or pinching activities is the most common complaint for those with basal thumb OA. There may be some associated aching after activity, or some muscle spasm and tenderness in the fleshy muscles on the palm side of the thumb. As the arthritis becomes more severe, these muscles may waste and become weak.

Who gets and how?

OA is primarily caused by time, so it is more common as people age, typically starting around the age of 40-50. The other significant risk factor is your genetics, meaning it is much more likely that you will develop OA if your parents or grandparents had the condition.

Other factors has a smaller relationship with developing OA. High physical work load has shown to be associated with the development of OA, while trauma to a joint may increase the risk of later OA (eg dislocations or fractures involving the joint). Being very flexible (double jointed) or uncoordinated also seems to be a risk of developing this condition.

What can I do about it?

Efforts to manage OA should target two key areas – settle down the pain and inflammation, continue to keep the thumb fit and healthy.

1. Education: People who understand what pain is, and what is causing it, are better equipped to manage their pain and to live well with it.
2. Avoid ongoing aggravation: Calm down the area, preventing pain for 2-6 weeks. You can do this with activity modification, splinting, ice and anti-inflammatory medication. At Flex Physiotherapy we fabricate custom made splints which can help to protect the joint during aggravating activities. Many varieties of ‘off the shelf’ braces are also available, but it can be difficult to find one that is comfortable and effective. We will also show you how to change the way you approach an activity to reduce the load on the thumb.
3. Graduated exercises:  Slowly increase the activity you do with the splint off. To prevent flare-ups of your pain, regularly perform some strengthening exercises, starting with gentle gripping exercise and progress the resistance.