Thumb Ip Joint Arthritis/Inflammation – Hand To Elbow (2022)

What is the thumb IP joint and what problems occur?

The Inter-phalangeal joint (IP joint) is the end joint of the thumb. It is shaped as a double dome side by side on the hand side of the joint and two side by side matching shallow curves on the nail side. This allows mobility in bending and straightening but stability in sideways and twisting movements. The IP joint is therefore very stable but this makes it more prone to stiffness and other problems.

The common problems are related to wear and tear arthritis.(osteoarthritis) (Problems in rheumatoid arthritis are described in the section on inflammatory arthropathy/rheumatoid arthritis) and tendon/ligament imbalance. The later is often associated with some arthritis. Arthritis itself is either primary i.e. occurring for no obvious reason or secondary i.e. occurring due to an underlying cause. The most common cause of secondary arthritis is previous injury particularly a fracture (break) into the joint (intra-articular).

Patients typically present in late middle age and later (50yo and onwards) with gradually increasing stiffness/pain. The pain and stiffness may run together or one or other may predominate. Sometime the symptoms will come on quite quickly following a sudden injury which may be quite mild but then tips the elbow over from being potentially symptomatic to being symptomatic. The symptoms may increase giving marked disability due to restricted movement and pain both at night and in the day.

(Video) Common Conditions Of The Thumb - Everything You Need To Know - Dr. Nabil Ebraheim

Why does it occur?

Normal joints are lined with articular cartilage and lubricated with a little bit of fluid that is continually renewed. Either due to general wear and tear, an inherited tendency or a structural abnormality in a joint such as a previous fracture (break) or operation the lining of the joint thins and may wear away leading to bone rubbing on bone. This is not necessarily painful but may be. The joint tries to protect itself by forming a little more new bone at the edges and producing more joint fluid. These lead to stiffness and swelling.

What happens if nothing is done?

(This is referred to as the natural history i.e. what happens if Nature runs its own course.)

Some people’s symptoms resolve particularly their pain especially if the activities that cause pain are avoided. Many people are left with some long-term stiffness particularly a lack of full straightening (extension). Some patients develop more pain and stiffness with time. They may develop marked pain and increasing disability in their hand affecting both dexterity and grip strength.

Making the diagnosis

The Hand specialist who sees the patient will ask questions about their symptoms, when they started, how they progressed, what treatment (if any) they have had and other questions relevant to the problems. They will then examine the patient looking at the wrists and hands. Stressing i.e. pushing on the affected joint is usually painful. It is necessary to demonstrate some tenderness to confirm the site of the symptoms but this should not be too painful.

What test(s) might be performed?

Tests (also known medically as Investigations) include X-rays, scans, blood tests and particularly in the hand electrical tests (known as EMGs or Neurophysiology). These may be used to help make or confirm a diagnosis after a patient has described their symptoms and been examined.

The diagnosis is usually obvious after listening to and examining a patient. Typically an X-ray is requested on the same day to delineate the extent of joint damage, although the X-ray findings do not correlate well with the symptoms with some patients having few X-ray changes but marked symptoms and vice versa.

(Video) Treating Basal Thumb Joint Arthritis - Mayo Clinic

X-ray thumb base arthritis

Thumb Ip Joint Arthritis/Inflammation – Hand To Elbow (2)

(Video) Arthritis Of The Fingers - Everything You Need To Know - Dr. Nabil Ebraheim

Treatment:

What are the non-operative treatments?

Treatment should start with non-operative options. The first step is activity modification which the patient may well already have tried. Pain killers (analgesics) particularly anti-inflammatory analgesics, such as Ibuprofen (Nurofen) and Diclofenac (Voltarol) can be very helpful for the pain. These can be applied as a gel, massaging the area, or taken orally, assuming there is no history of indigestion. A splint for certain activities can also be of value. A splint on the end of the thumb may prevent it being knocked during certain activities and can rest the joint. If these measures are insufficient then a steroid injection would usually be recommended. An injection is given of a long-acting steroid, such as Depomedrone or Triamcinolone, with some local anaesthetic into the joint at the bottom of the thumb. The body naturally produces steroids to help dampen down inflammation. This appears to be one of the actions at this site. Success cannot be guaranteed but in 70-80% of patients there is some significant benefit. How long this lasts is unpredictable. Some people only have a few weeks or months of benefit. Others may have years or even life-long benefit such that they do not require further treatment, although may still have some mild on-going symptoms. If one injection provides only short term benefit then it may well be repeated. Patients often ask how many injections can be given. There is no set rule about this. Typically, however, a second injection will work a little less well than the first (although this is not inevitable). By the time three injections have been given, if this is over a shortish period, i.e. less than 1 year, then it is unlikely further injections will be successful and most surgeons would recommend an alternative approach. There are risks. The biggest risk is of failure. There are risks of some pain for a few days, although that is usually minimised by taking pain-killers, starting while the area is still numb from the local anaesthetic. In theory there is a risk of infection, but this seems very rare and has not occurred in our Practice in over 10 years. The main other risk is some thinning of the skin. This can present with some pallor and a little less bulk at the site and occasionally an increased tendency to bleeding if the area is knocked. This is not common with this injection but is common with some other injections. If it does occur then that is a relative contra-indication to further injections, i.e. the patient’s surgeon would probably decide not to go ahead with further injections because of the risks of further local damage.

What does the operation involve?

The main operations for thumb IP joint arthritis are called: IP joint debridement or with more severe disease: IP joint fusion (arthrodesis):

(Video) Osteoarthritis of carpometacarpal Thumb joint

IP joint debridement: Debridement means cleaning out of the area in this case of abnormal bone and inflammatory tissue. It can typically be performed under local anaesthetic. It is also the first step in a fusion operation

IP joint fusion: Fusion obliterates the joint creating a solid bony link between the bones. This is stable, usually painless and reasonably functional.

In both operations the surgeon makes a cut over the back of the joint. The joint is opened up and cleaned out. If the decision is made to fuse the joint (usually based upon the degree of joint destruction) the thickened bone ends are trimmed to bone tissue with better healing tendencies. The bones are fixed together with a screw or wire construct. At the end of the operation the deep tissues are closed and the skin is then stitched up usually with absorbable stitches. A supportive dressing/plaster of Paris is applied and the patient’s arm elevated.

The total time in hospital is usually 2-4 hours.

What happens in the next few weeks?

The care of the hand in the post-operative period is very important in helping to ensure a good result. Initially the aims are comfort and elevation. These are met by keeping the hand up (elevated) especially in the first few days and by use of a long acting local anaesthetic (Bupivicaine). The local anaesthetic lasts at least 12 hours and sometimes 48 hours. Patients should start taking painkillers before the pain starts i.e. on return home and for at least 24 hours from there. This way most of our patients report little or any pain.

The patient is reviewed in clinic within 2 weeks of the operation. Typically dissolvable stitches are used so they should not require to be removed. A splint may be provided. Careful follow up is required to ensure a successful result with good relief of pain and a good range of movement.

The hand can be used for gentle activity after the first few days out of the dressing/plaster. Most patients can drive after a 2-3 weeks. Most patients return to work in 5-6 weeks, but this varies with occupation; heavy manual work usually takes about 3 months if ever. The wound should be massaged by the patient 3 times a day with a bland soft cream for 3 months once the wound is well healed (typically after 2 weeks). This reduces the scar sensitivity which can be a nuisance. If this is marked a Physio may be organised to help reduce the scar tenderness but this is rarely required. Patients should avoid pressing heavy use of the hand for a good 3 months from surgery.

(Video) 7 Thumb Joint (CMC) Stretches & Exercises

What are the results of the operation?

At least 90% of patients in studies say they have a good or excellent result following this operation, with relief of the pain and a stable joint.

Are there any risks?

All interventions in medicine have risks. In general the larger the operation the greater the risks. For thumb IP joint debridement or fusion the risks include:

  • The scar may be tender, in about 20% of patients. This usually improves with scar massage, over 3 months.
  • Aching at the site may last for several months
  • Grip strength can also take some months to return to normal.
  • Stiffness may occur in particular in the fingers. This is usually short-term and only infrequently requires physiotherapy. But it is very important that it is resolved quickly to avoid permanent stiffness. This occurs rarely but can do associated with CRPS (see below)
  • Numbness can occur around the scar but this rarely causes any functional problems.
  • Wound infections occur in about 1% of cases. These usually quickly resolve with antibiotics.
  • For joint fusion there is a risk of failure to achieve bone to bone union of to gain union with some malalignment. Either may (but not of necessity) require reoperation.
  • Chronic Regional Pain Syndrome “CRPS”. This is a rare but serious complication, with no known cause or proven treatment. The nerves in the hand “over-react”, causing swelling, pain, discolouration and stiffness, which improve very slowly.
  • Any operation can have unforeseen consequences and leave a patient worse than before surgery.

FAQs

How do I reduce inflammation in my hands from arthritis? ›

Use a warm, moist compress (or towel or heating pad) on your fingers and hands for 15 minutes before you exercise. To reduce swelling, use ice packs. Put an ice pack on the painful joint for 10 to 15 minutes at a time. You may want to switch between moist heat and ice packs.

Why is arthritis in the thumb so painful? ›

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.

What causes inflammation in the thumb joint? ›

In most cases, it's osteoarthritis — the age-related breakdown of joint tissue — that causes a swollen thumb joint, especially at the lowest joint (called the basal joint). It can also be caused by reactive arthritis, which is triggered by an infection in the body.

What is Stage 4 thumb arthritis? ›

Stage IV: All the components of stage III along with destruction of the scaphotrapezial joint. At this stage the CMC joint is usually fixed and some patients may have little to no pain. Treatment: In early stages, stage I and sometimes stage II, con- servative treatment should be considered.

Is thumb arthritis serious? ›

Thumb arthritis can cause severe pain, swelling, and decreased strength and range of motion, making it difficult to do simple tasks, such as turning doorknobs and opening jars. Treatment generally involves a combination of medication and splints. Severe thumb arthritis might require surgery.

What's the best painkiller for arthritis? ›

Pain relief medicines
  • Paracetamol. If you have pain caused by osteoarthritis, a GP may suggest taking paracetamol to begin with. ...
  • Non-steroidal anti-inflammatory drugs (NSAIDs) ...
  • Opioids. ...
  • Capsaicin cream. ...
  • Steroid injections.

What is the best product to use for arthritis in your hands? ›

Oral pain medications most frequently recommended to treat hand arthritis include acetaminophen and/or non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen.

How can I stop arthritis getting worse in my hands? ›

Staying active, eating a healthy and balanced diet, and getting plenty of sleep are simple ways to manage your arthritis. Make sure to take breaks when doing strenuous or repetitive activities. Figure out the activities that cause your arthritis to flare up, and learn the best way to manage your pain.

Is thumb arthritis curable? ›

While there is no cure for arthritis in your thumb, there are various simple treatments that can help relieve symptoms for many people. Talk with a doctor or physical therapist about which treatments might work best for you.

What are the stages of thumb arthritis? ›

Classification
Table 1. Eaton classification of basilar thumb arthritis7
StageFeatures on plain radiographs
Stage IArticular contours normal. Slight widening of joint space on X-ray.
Stage IISlight narrowing of joint space. Osteophytes ≤2 mm. Scaphotrapezial joint normal on X-ray.
2 more rows

Does massage help thumb arthritis? ›

Studies have shown that having a professional hand massage just once a week, and doing self-massage once a day, may help reduce the pain associated with many conditions, including arthritis, carpal tunnel syndrome, and neuropathy.

Is hand arthritis a disability? ›

Can I Get Disability for Arthritis in My Hands? You are able to get disability for arthritis in your hands if you can show the SSA that you meet the medical and work requirements necessary in order to qualify for Social Security disability benefits.

How successful is thumb surgery for arthritis? ›

Pros: Removing the entire trapezium eliminates the possibility of arthritis returning and, according to Dr. Ruch, LRTI has a 96 percent success rate. “Most patients achieve complete pain relief and mobility equal to that of a healthy thumb, with results lasting at least 15 to 20 years,” he says.

Where does thumb arthritis hurt? ›

The most common symptom of thumb basal joint arthritis is a deep, aching pain at the base of the thumb. The pain is often worsened with activities that involve any pinching movements such as opening jars, turning door knobs, and handwriting. As the disease progresses, patients may experience pain at rest and at night.

Does a cortisone shot help thumb arthritis? ›

Cortisone injections

Injection of a long-acting corticosteroid into the thumb basilar joint may provide pain relief for a few months. However, the relief is temporary and the arthritis in the joint will continue to progress.

How painful are cortisone shots in the thumb? ›

Once the anaesthetic wears off, it is common for the thumb to ache for 1-2 days after the injection due to stretching of the joint capsule. Take some Panadeine after the injection. At times one may experience pain from both the Basal Thumb joint and also the nearby STT joint.

What doctor do I see for thumb pain? ›

If you're experiencing discomfort in your hand or thumb, the first step is to talk to your primary care doctor. He or she can assess your pain and adjust any medication you may be on if needed. From there, your doctor may place your hand in a splint, or prescribe anti-inflammatory medication or physical therapy.

How do I stop my thumb from hurting? ›

How you can ease thumb pain yourself
  1. rest your thumb when you can.
  2. put an ice pack (or a bag of frozen peas) in a towel and place it on your thumb for up to 20 minutes every 2 to 3 hours.
  3. take paracetamol.
  4. take off any jewellery if your thumb looks swollen.

Can thumb arthritis come on suddenly? ›

Depending on the type of arthritis, symptoms can develop suddenly or gradually over time. Symptoms may come and go, or persist over time.

How do they test for arthritis in hands? ›

Your healthcare provider can make the diagnosis of arthritis of the hand by examining your hand and with X-rays. X-rays show loss of bone cartilage and formation of bone spurs. A blood test for rheumatoid factor and other markers can help determine if the cause is rheumatoid arthritis.

What is the strongest anti-inflammatory drug? ›

What is the strongest anti-inflammatory medication? Research shows diclofenac is the strongest and most effective non-steroidal anti-inflammatory medicine available.

What is the new cure for arthritis? ›

New Treatments for Rheumatoid Arthritis - Latest FDA Approvals
DrugDrug Class
rituximab (Rituxan)CD20-directed cytolytic antibody
abatacept (Orencia)selective T cell costimulation modulator
adalimumab (Humira)tumor necrosis factor (TNF) blocker
anakinra (Kineret)interleukin-1 receptor antagonist
12 more rows
11 May 2022

What is better for arthritis heat or cold? ›

For an acute injury, such as a pulled muscle or injured tendon, the usual recommendation is to start by applying ice to reduce inflammation and dull pain. Once inflammation has gone down, heat can be used to ease stiffness. For a chronic pain condition, such as osteoarthritis, heat seems to work best.

What do most doctors prescribe for arthritis? ›

Commonly used arthritis medications include:
  • NSAIDs . Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. ...
  • Counterirritants. ...
  • Steroids. ...
  • Disease-modifying antirheumatic drugs (DMARDs).
15 Sept 2021

What is the best painkiller for hand pain? ›

Simple analgesic medications such as acetaminophen (paracetamol) or aspirin are often useful in the relief of hand pain. Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, ketoprofen or naproxen can also be useful.

Is there any medication for arthritis in hands? ›

Analgesics, which include acetaminophen (Tylenol) and opioids, are commonly used for arthritis in the hands and other joints. They also may be used to relieve pain from other hand and wrist conditions or surgery. Unlike NSAIDs, which target both pain and inflammation, analgesics are designed purely for pain relief.

Is there a vitamin that helps with arthritis? ›

Several nutritional supplements have shown promise for relieving pain, stiffness and other arthritis symptoms. Glucosamine and chondroitin, omega-3 fatty acids, SAM-e and curcumin are just some of the natural products researchers have studied for osteoarthritis (OA) and rheumatoid arthritis (RA).

Is drinking more water good for arthritis? ›

Staying hydrated is vital when you live with arthritis. Hydration is key for flushing toxins out of your body, which can help fight inflammation, and well-hydrated cartilage reduces the rate of friction between bones, meaning you can move more easily.

How do I stop my fingers from deforming with arthritis? ›

Ring splints can be worn on any finger to help these problems and other deformities, such as joints that become “stuck” in a hyperextended position or instability at the knuckles from conditions like Ehlers-Danlos syndrome, where fingers may cross under or over each other.

Is thumb arthritis common? ›

Thumb arthritis is the second most common type of arthritis in the hand; the most prevalent hand arthritis involves the last joint in each finger. Thumb arthritis is also known as basal joint arthritis. It is more common in women, though certainly men can develop this type of problem.

How can I stop arthritis getting worse? ›

Slowing Osteoarthritis Progression
  1. Maintain a Healthy Weight. Excess weight puts additional pressure on weight-bearing joints, such as the hips and knees. ...
  2. Control Blood Sugar. ...
  3. Get Physical. ...
  4. Protect Joints. ...
  5. Choose a Healthy Lifestyle.

How often can you get a cortisone shot in your thumb? ›

There's concern that repeated cortisone shots might damage the cartilage within a joint. So doctors typically limit the number of cortisone shots into a joint. In general, you shouldn't get cortisone injections more often than every six weeks and usually not more than three or four times a year.

What is the test for arthritis? ›

X-rays may show joint changes and bone damage found in some types of arthritis. Other imaging tests may also be done. Ultrasound. Ultrasound uses sound waves (not radiation) to see the quality of synovial tissue, tendons, ligaments, and bones.

What does arthritis in the thumbs feel like? ›

Pain at the base of the thumb on the palm side may be the most obvious sign, but it is far from the only one. Look out for these additional signs if you think you may have thumb arthritis: Pain or weakness with a grasping, twisting or pinching motion. Swelling and tenderness at the base of the thumb.

What triggers hand arthritis? ›

Injuries: Even when properly treated, an injured joint is more likely to develop OA over time. Fractures and dislocations are among the most common injuries that lead to arthritis. Joint issues: Joint infections, overuse, loose ligaments, and poorly aligned joints can also lead to hand or wrist arthritis.

How do you stretch a thumb joint? ›

Start with your hand in a neutral, relaxed position with your fingers and thumb straightened. Next, bend your thumb across your palm, touching the tip of your thumb to the bottom of your small finger. If you can't make your thumb touch, just stretch as far as you can. Return your thumb to the starting position.

How do I massage my arthritic thumb joint? ›

Bodywork For Arthritis: The Hand - YouTube

How do you massage a thumb joint? ›

Massage therapist self-care: Thumb pain - YouTube

How successful is thumb surgery for arthritis? ›

Pros: Removing the entire trapezium eliminates the possibility of arthritis returning and, according to Dr. Ruch, LRTI has a 96 percent success rate. “Most patients achieve complete pain relief and mobility equal to that of a healthy thumb, with results lasting at least 15 to 20 years,” he says.

Is thumb arthritis curable? ›

While there is no cure for arthritis in your thumb, there are various simple treatments that can help relieve symptoms for many people. Talk with a doctor or physical therapist about which treatments might work best for you.

Can arthritic thumb joints be replaced? ›

There are a few different types of thumb joint surgery available, but the Arthritis Foundation reports that a procedure called ligament reconstruction and tendon interposition arthroplasty has been around for more than 40 years and “is the most commonly performed surgery for thumb arthritis.”

How long does it take to recover from thumb arthritis surgery? ›

Your body takes time to rebuild the structures around the base of the thumb and to learn to move in a different way. Recovering the early movement takes six to eight weeks, but increasing the strength of the thumb pinch can take six months. After surgery, your hand will be painful.

Do you wear a cast after thumb surgery? ›

After surgery, you will be in a bulky dressing (bandage) with a plaster splint that covers your thumb, wrist and forearm. The splint is similar to a cast. The splint can not be removed and must be kept dry.

What is thumb arthritis surgery called? ›

Trapeziectomy is a surgical procedure to treat a medical condition called “thumb base arthritis”. The procedure involves removal of a small, cube-shaped bone known as the “trapezium” at the base of the thumb joint which joins your thumb to your wrist.

Is thumb joint replacement painful? ›

Following surgery, the thumb is padded and a splint is applied to promote healing. You may experience some discomfort and swelling. Your doctor will recommend some pain medication to help. Keeping the hand elevated above your heart can also help relieve the symptoms.

What are the stages of thumb arthritis? ›

Classification
Table 1. Eaton classification of basilar thumb arthritis7
StageFeatures on plain radiographs
Stage IArticular contours normal. Slight widening of joint space on X-ray.
Stage IISlight narrowing of joint space. Osteophytes ≤2 mm. Scaphotrapezial joint normal on X-ray.
2 more rows

Is thumb arthritis common? ›

Thumb arthritis is the second most common type of arthritis in the hand; the most prevalent hand arthritis involves the last joint in each finger. Thumb arthritis is also known as basal joint arthritis. It is more common in women, though certainly men can develop this type of problem.

Does massage help thumb arthritis? ›

Studies have shown that having a professional hand massage just once a week, and doing self-massage once a day, may help reduce the pain associated with many conditions, including arthritis, carpal tunnel syndrome, and neuropathy.

Is hand arthritis a disability? ›

Can I Get Disability for Arthritis in My Hands? You are able to get disability for arthritis in your hands if you can show the SSA that you meet the medical and work requirements necessary in order to qualify for Social Security disability benefits.

What doctor do I see for thumb pain? ›

If you're experiencing discomfort in your hand or thumb, the first step is to talk to your primary care doctor. He or she can assess your pain and adjust any medication you may be on if needed. From there, your doctor may place your hand in a splint, or prescribe anti-inflammatory medication or physical therapy.

How do I stop my thumb from hurting? ›

How you can ease thumb pain yourself
  1. rest your thumb when you can.
  2. put an ice pack (or a bag of frozen peas) in a towel and place it on your thumb for up to 20 minutes every 2 to 3 hours.
  3. take paracetamol.
  4. take off any jewellery if your thumb looks swollen.

How do you wrap a thumb with arthritis? ›

Arthritic thumb (OA) - try this superb Kinesio taping technique - YouTube

What can you not do after thumb surgery? ›

For 1 to 2 weeks after surgery, avoid using your hand. This includes lifting things heavier than 0.5 to 1 kilogram (1 to 2 pounds) or doing repeated finger or hand movements, such as typing, using a computer mouse, washing windows, vacuuming, or chopping food.

What is the most common complication with thumb arthroplasty? ›

There are always risks with any surgery. The most common complications after a thumb arthroplasty include infection, temporary numbness along the top of the thumb, and stiffness.

Videos

1. STOP Thumb Joint Pain with Simple Self Exercises
(Bob & Brad)
2. Diet changes in patients who have inflammation and their hands | Dr. Brutus, Hand Surgeon
(Dr Jean-Paul Brutus)
3. Thumb Arthritis
(OACMorthopedics)
4. Hand Pain ,Fingers pain - Everything You Need To Know - Dr. Nabil Ebraheim
(nabil ebraheim)
5. What is Osteoarthritis (OA) of the Thumb & Fingers?
(John Gibbons)
6. 5 Natural Pain Relieving Remedies for Thumb Arthritis
(Regenexx)

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