Thumb arthritis
Pain at the base of the thumb (basal joint arthritis). Treatment options to improve function and relieve pain.
Basal joint arthritis (also known as trapeziometacarpal osteoarthritis or rhizarthrosis) is the progressive wearing of cartilage at the base of the thumb. It is one of the most common forms of hand arthritis and predominantly affects women over the age of 50.
Symptoms of basal joint arthritis
- Pain at the base of the thumb during pinching tasks (opening a jar, turning a key)
- Progressive loss of grip and pinch strength
- Visible deformity at the base of the thumb in advanced stages
- Morning stiffness and reduced range of motion
- Pain that worsens with activity and improves with rest
Causes and risk factors
Basal joint arthritis results from progressive cartilage degeneration. Risk factors include: female sex, age over 50, menopause, genetic predisposition, repetitive manual activities and ligamentous laxity.
Diagnosis
Clinical examination (grind test, palpation tenderness over the trapeziometacarpal joint) together with plain radiographs allows the degree of arthritis to be classified and guides the most suitable treatment approach.
Non-surgical treatment
In the early stages, non-surgical measures can control symptoms effectively: a thumb splint for activities that provoke pain, anti-inflammatory medication, hyaluronic acid or corticosteroid injections, and muscle-strengthening exercises. These measures do not halt the progression of arthritis but significantly improve quality of life.
Surgical treatment
When pain significantly limits hand function, several surgical options are available: trapeziometacarpal arthroplasty (joint replacement with a prosthesis), trapeziectomy (removal of the trapezium with or without tendon interposition) or arthrodesis (joint fusion). Trapeziometacarpal arthroplasty is the most widely performed technique owing to its excellent functional results.
Recovery
Following surgery, a splint is worn for four to six weeks, followed by a structured rehabilitation programme. Full recovery may take three to four months, but patients experience significant pain relief and a good functional outcome.
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Frequently asked questions
- How can I relieve thumb arthritis pain?
- In the early stages, a thumb splint, anti-inflammatory medication and hyaluronic acid or corticosteroid injections can provide significant pain relief. Strengthening exercises also help. When these measures are insufficient, surgery offers excellent results.
- At what age does thumb arthritis appear?
- Basal joint arthritis is most common after the age of 50, particularly in women following menopause. However, it can appear earlier in individuals with repetitive manual activities or genetic predisposition.
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