The basal joint at the base of the thumb near the wrist, also called the thumb CMC (carpometacarpal) joint, allows the thumb a wide range of motion. Basal joint arthritis is a relatively common condition, even if a person does not suffer from arthritis in any other joint.
Causes:
Normal use of the thumb throughout life wears out the cushioning cartilaginous surfaces that protect the bone ends that move against each other within the joint. As the cartilage gets worn away, friction between the bone surfaces causes inflammation and pain, the condition known as osteoarthritis.
Trauma, such as a fracture or sprain, can increase the risk of developing basal joint arthritis, as can performing certain activities that place extra stress on the joint.
Symptoms:
Pain felt at the base of the thumb, near the wrist, when gripping or pinching objects
Swelling, tenderness, and stiffness at the base of the thumb
Decreased strength when pinching
Decreased ability to do simple tasks such as open a jar or turn a doorknob
Basal joint appears enlarged, bony or out-of-position
Diagnosis:
Your doctor will physically examine your thumb, and move the joint in various directions to determine what causes pain, a gritty feeling, or even a grinding sound. You may be asked to grasp or pinch objects to assess hand function.
X-rays may be taken to confirm the diagnosis.
Treatment:
A mild case of basal joint arthritis can be treated with conventional (non-surgical) methods.
Heat or cold treatment can help to reduce swelling and pain. Sometimes it is helpful to alternate between the two.
Acetaminophen (Tylenol) or NSAIDs such as ibuprofen (Advil) or naproxen (Aleve) can be taken to relieve pain and reduce swelling. Your doctor might prescribe stronger pain medication if needed.
Your doctor may suggest that you wear a splint that supports the wrist and thumb. This will allow the joint to rest while keeping it in its proper position. The splint can be worn just at night or during the day as well, if needed.
If using a splint and taking pain medication does not relieve your symptoms, you may be given a corticosteroid injection directly into the joint. These are very effective and can be administered up to three times a year.
For persistent and debilitating pain and loss of hand function, surgery may be the best option. Your doctor would help you choose the most suitable procedure for your case.
Range of motion exercises can help to maintain and improve the mobility of your thumb joint.
Exercises: Thumb Slide:
Lift your hand with your palm facing inward. Slide your thumb against your palm, toward your little finger, and bend your thumb at the base to maximize the stretch. Then lift your thumb straight up toward the ceiling as high as it will go. Now bring it to rest against your index finger and then move it sideways, as though trying to make an 'L' shape. Rest and repeat. Thumb Walk:
Lift your hand with the palm up. Keeping the wrist straight, touch your thumb to the tip of each finger in turn. Rest and repeat.
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