This thumb joint is very important for function of your hand. It allows the thumb to come into position to work with the other fingers for pinch and grasp.
This condition typically effects those that are over 40 and more likely female. It can easily affect both hands, but often unequally. No specific activities typically produce this problem, but many can aggravate it.
The symptoms typically are dull and sharp pains at the base of the thumb near the wrist, and weakness. There is frequently stiffness, and a visible deformity as the deterioration progresses.
When we examine patients, they have localizing pain, some instability/slip to the joint, and frequently a crackling/grating sound as the joint is loaded or they pinch.
The diagnosis made with history and physical exam can be confirmed with simple xrays. Notice the difference between a healthy joint, and an arthritic one.
As is the case with most arthritis, the wear is progressive and tends to worsen with time. Some lucky patients may have symptoms fade, but for most, it will increase. The younger you are (or act!) when symptoms present, the more difficulty you will likely have.
There is a variety of treatment options available. Treatment always depends more on the severity of the symptoms than the severity of the appearance.
Medications, supplements, heat, activity modifications can help one cope and control symptoms, but are not curative.
Some over the counter braces can be helpful, but often do not fit well. A custom fabricated brace can give relief, and can be worn intermittently or as needed for symptom control.
For those with unrelenting symptoms despite attempts at conservative treatment, an injection is an option. A "cortisone" shot, or potent anti-inflammatory corticosteroid injection can be administered into the degenerated joint. While it does little to heal the problem, it can be quite effective for symptom relief, typically for months at a time. The procedure can be repeated. The joint lubricants often injected into knees have not been proven effective for this problem.
For those whose symptoms are severe and persistent, a "cure" exists. However it does involve a surgical reconstruction of the thumb joint. The most common procedure involves removing the worn and damaged joint surfaces and replacing them with a soft tissue interposition. In this way, no synthetic material is used. The benefit of such an operation is that the surgery tends to be very durable, and very reliable, with typically 95%+ satisfaction rates. However, it is a significant procedure, and a period of recovery is to be expected. Therapy can be helpful after surgery to speed recovery.
The take away messages are that degenerative arthritis of the thumb base joint is a common problem, and that there are effective treatment options. At Cascade Orthopaedics, we have 2 specially trained hand surgeons, Dr. Roger Blauvelt and Dr. Donna Smith. Our goal is always to diagnose and inform, providing treatment options for every individual. On site XRAY, hand therapy and surgical services are available for patient convenience and assurance of quality.
Even the best pamphlet or website is no substitute for a thorough patient interview and exam, so if you have questions, please call for a consultation. We are here to answer questions and give options, with the ultimate goal being an increase in quality of life.
If you have questions or wish to schedule an evaluation, please call us at (253) 833-7750, and ask to be scheduled with one of our hand specialists.
