Base of Thumb Arthritis

What is it : A common area of arthritis is at the base of the thumb. The pain you would experience is located between your thumb and wrist joint. The bones affected are usually the trapezium and the first metacarpal, but can affect the scaphoid and trapezoid as well.

As with most arthritis, the cause is unknown. It can occur due to overuse, or if previously injured. You may have arthritis elsewhere in your hands and other joints in the body.

Management : A decent trial of non-operative management is worthwhile for base of thumb arthritis. Using a thumb splint can help with day-to-day activities. The use of simple pain relief and anti-inflammatory drugs and creams can help. A hand therapist can help with increasing strength and movement of the joint. Occasionally the pain can be partly due to inflammation and a steroid injection can be done to settle it down. If the pain is still an issue, then an operation to remove one of the small bones (trapezium) near the thumb and transfer a tendon, can be done with generally good results. We call this a trapeziectomy and suspensionplasty.

Post-operative : You will be placed in a thumb splint after the operation which can come off for gentle range of motion. The hand therapist will work with you to regain pinch and grip strength. This can take several months to improve. A trapeziectomy and suspensionplasty is very good at removing the constant arthritis pain you would have had before the surgery.