Ask a Doctor: Thumb Arthritis

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I have been having pain at the base of my thumb near the wrist, and am having increased difficulty opening jars and turning doorknobs. Is there such a thing as thumb arthritis?

Thumb arthritis is a very common problem. It affects up to 10% of middle-aged women. In people over 75 years old, it affects 40% of women and 25% of men. Thumb arthritis is the number one cause of arthritis surgery in the upper extremity. Often patients have arthritis in many parts of the body, including the hip and knee joints. In the thumb, the pain is located where the thumb attaches to the wrist (at what is called the carpometacarpal joint). The normal cartilage surfaces get worn away and bone starts rubbing on bone causing pain. Over time daily activities become increasingly uncomfortable. Pain occurs with pinching and twisting motions such as opening a jar, turning a doorknob, and even writing or brushing teeth. Lifting objects is often difficult due to the pain.

The diagnosis of thumb arthritis is made with a history and physical exam as well as plain x-rays. Expensive tests are rarely, if ever, needed. The arthritis can range from mild to very severe. X-ray findings do not always correlate with the amount of pain.

Often the pain of arthritis is very debilitating due to having to use our thumbs for a lot of activities. The good news is that treatment is very effective. Treatment of thumb arthritis often starts with nonoperative measures. Splints, anti-inflammatory medications, and cortisone injections can be helpful. The goal of a splint is to limit the bone-on-bone motion that causes pain in the joint. Anti-inflammatory medications and cortisone injections aim to control the pain of arthritis.

When these treatments are no longer working or the pain is severe, surgery is very helpful. Surgery involves removing a small bone in the wrist where the bones are rubbing and causing pain. A tendon is used to suspend the thumb and prevent further bone-on-bone pain. After surgery, the thumb is immobilized for a short time, and then therapy is started to regain motion and strength of the thumb. My patients are extremely happy after this procedure. Their pain is gone and the thumb still moves and functions like normal. This is the most gratifying procedure I perform because patients have tremendous pain relief.

As a hand specialist, I see more patients with thumb arthritis than any other physician in the area. I have extensive experience with both operative and nonoperative treatment. If you are having pain at the base of your thumb, or any other hand or wrist problems, I’d be happy to see you at the Hand and Wrist Clinic at HFM Lakeshore Orthopaedics.

David Mikolyzk. M.D., is a fellowship trained hand and wrist surgeon at HFM Lakeshore Orthopaedics. To make an appointment, call HFM Lakeshore Orthopaedics at (920) 320-5241.