Thumb arthritis: Symptoms, causes, and treatment (2022)

Arthritis occurs when cartilage in a joint wears away and the bones rub together. This can result in swelling, pain, and stiffness in the affected joint, such as at the base of the thumb.

Arthritis is the medical term for joint inflammation and joint pain.

Thumb arthritis usually occurs after 50 years of age and is more common in males than females. A doctor may refer to the condition as “basal thumb arthritis” or “thumb basal joint arthritis.”

Arthritis of the thumb can be painful, and various treatments and techniques can reduce symptoms and improve the function of the joint.

This article outlines what thumb arthritis is and explains the symptoms, risk factors, diagnosis, and treatment options.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Thumb arthritis occurs in the joint at the base of the thumb.

The thumb joint is the second most common site of arthritis in the hand. According to a 2017 review, up to 15% of people over 30 experience thumb arthritis.

Thumb arthritis is usually a type of osteoarthritis (OA), which results from gradual wear in the joint.

In a typical joint, rubbery cartilage covers the ends of opposing bones. The cartilage cushions the two bones, preventing any friction during movement.

In people with thumb arthritis, the cartilage wears away. Without this barrier between them, the two bones rub together.

As the bones rub together, they create friction and damage the joint, causing pain, inflammation, and other symptoms.

The first symptom of thumb arthritis is usually pain at the base of the thumb. It may occur when a person grips or pinches an object or uses the thumb to apply force.

Other symptoms of thumb arthritis include:

  • swelling at the base
  • aching, discomfort, or tenderness at the base
  • a limited range of motion in the joint
  • the base seeming enlarged or bony-looking
  • a loss of strength in the thumb joint

The symptoms can vary in severity. They may be mild initially and worsen over time, especially without treatment.

Read more about arthritis from our dedicated hub.

OA is responsible for most arthritis cases in the thumb. This means that the issue stems from gradual cartilage degeneration.

The symptoms of thumb arthritis commonly occur due to the gradual breakdown of cartilage over time. This is often due to general wear and tear associated with aging. Thumb arthritis is more common in people over 50 years old.

The Arthritis Foundation states that around half of all females and one-quarter of all males will experience symptoms of OA in their hands by the time they are 85 years old.

The Arthritis Foundation also suggests an injury may cause a person to develop thumb arthritis. Even if a person receives effective treatment, injured joints are more likely to develop OA over time. The most common injuries that lead to OA are fractures and dislocations.

Joint infections may also cause a person to develop thumb arthritis.

Several factors can increase a person’s chances of developing OA, which may affect the thumb. These include:

  • Age: As a person ages, their risk of developing OA increases.
  • Sex: Females are more likely to develop OA than males.
  • Weight: Maintaining a lower body weight lessens a person’s risk of developing OA.
  • Genetics: A family history of arthritis can increase a person’s risk of developing the condition.
  • Joint laxity: Loose joints may increase the risk of developing thumb arthritis.
  • Hormones: The menopause can increase a person’s risk of developing thumb arthritis.
  • Injuries: A joint injury can increase a person’s chance of developing OA.
  • Occupation: Jobs, such as computer work, may cause stress to the joints.

Before diagnosing thumb arthritis, a doctor typically examines the joint and assesses the following:

  • the current level of pain
  • which movements make the pain worse
  • whether there has been a prior injury

A doctor may also ask the person about their medical history. This may include asking the following:

  • which symptoms they are experiencing, frequency, and severity
  • if their joints are:
    • swollen
    • red
    • tender
    • warm to touch
  • if the symptoms began suddenly or came on gradually
  • if the symptoms become worse after activity or rest
  • at what time of the day the person experiences their symptoms
  • what, if anything, provides relief from the pain

If a person has pain at or around the base of a thumb, the doctor may also check for symptoms of carpal tunnel syndrome to rule out other possible diagnoses.

Diagnostic tools

If the doctor suspects arthritis, they may order an X-ray. If a person has thumb arthritis, the X-ray may show joint space, indicating cartilage loss.

The X-ray images can also show the formation of bone spurs, which is another symptom of arthritis. Doctors can determine what stage a person’s arthritis is at.

Read more about tests for thumb arthritis here.

The severity of thumb arthritis symptoms helps guide the approach to treatment.

Arthritis is a progressive disease that may get worse over time. No medication can slow the progression of arthritis in the thumb, but it can help relieve pain and other related symptoms.

Nonsurgical measures

Common medications for treating OA include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications can treat inflammation and pain. Common NSAIDs include:
    • aspirin
    • ibuprofen
    • naproxen
    • celecoxib
  • Counterirritants: These medications contain ingredients that irritate a person’s nerve endings, which can cause painful areas to feel cold, warm, or itchy. This can take a person’s focus away from their actual pain. Examples include:
    • capsaicin
    • menthol
    • lidocaine
  • Corticosteroids: These anti-inflammatory medications can help reduce inflammation around the thumb joint to reduce symptoms of thumb arthritis. A person may also receive steroid injections in the affected joint.
  • Analgesics: These medications help relieve pain. They include acetaminophen and opioids. A person can purchase acetaminophen over the counter; however, a doctor must prescribe opioids.

Doctors can also prescribe steroid injections to help reduce inflammation and other thumb arthritis symptoms. This treatment may only be effective in people who have mild symptoms.

Home remedies

Treatments and care techniques may help alleviate pain and improve thumb function. Options include:

  • doing exercises to strengthen the muscles around the thumb
  • wearing thumb and wrist supports and braces
  • avoiding activities that put pressure on the thumb

People may also wish to use assistive devices to help support their thumb joints. These devices can improve a person’s quality of life and ability to perform daily activities. They include key assists and jar openers.

Learn more about braces for thumb arthritis here.

Surgical measures

If these conservative approaches do not work, a person may need surgery.

Below are some possible surgical options for people with thumb arthritis:

  • Total joint replacement (arthroplasty): During this procedure, the surgeon removes all or part of the damaged thumb joint. They then replace it with an artificial implant.
  • Fusion surgery (arthrodesis): A surgeon will fuse the bones in the thumb joint together to eliminate pain. They hollow out the thumb’s metacarpal bone, then shape it into a cone and fit it inside the socket. They then use a metal pin to hold the bones together until they fuse.
  • Ligament reconstruction: During this procedure, the surgeon removes a portion of the damaged ligament and replaces it with a piece of the patient’s wrist flexor tendon. This tendon stabilizes the joint, preventing the bones from slipping out of place.
  • Ligament reconstruction and tendon interposition (LRTI): A surgeon removes the damaged joints and replaces them with a cushion of tissue that prevents the bones from rubbing together. They also remove all or part of the bone in the wrist at the base of the thumb, replacing it with a nearby tendon.

LRTI is the most common surgery for thumb arthritis. However, it often has a relatively long recovery period, and some people experience pain during recovery.

It can take 8 weeks to 1 year to recover from thumb surgery. During this time, a person benefits from working with an occupational or physical therapist.

Learn more about thumb arthritis surgery here.

Thumb arthritis occurs when the cartilage in the thumb joint wears away, causing the bones in the joint to rub together. This causes friction, inflammation, damage, and pain.

People can treat their thumb arthritis with medications, bracing, and certain lifestyle modifications. In more severe cases, a person may require surgery such as joint replacement.

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