Is thumb arthritis possible? Most of us don’t consider how much we rely on our hands to accomplish daily tasks, particularly our thumbs. From turning a key to writing a note, stirring coffee, or opening a door, our thumbs are a fundamental part of what makes us human.When thumb pain begins, it can be potentially debilitating. Whether you’re working with a keyboard or a screwdriver – or playing with a tennis racket – it’s important to seek out a physician who can help determine the cause of your pain and begin treatment.Thumb Arthritis Is PossibleOnce you’ve ruled out potential injuries, one remaining possible cause of thumb pain may be a form of osteoarthritis called basilar joint arthritis, or thumb arthritis. An orthopedic surgeon who specializes in the small bones and joints of the hand, wrist, and elbow can help with diagnosing your condition as well as treating it.What Causes Thumb ArthritisThumb arthritis is prompted by the same joint conditions that cause arthritis in any other joint in the body: joint instability. This instability may be caused by an injury that’s healed improperly or repeated injury to the joint. Cartilage deterioration and general wear and tear to the joint are also factors.Patients over 40 and those suffering from rheumatoid arthritis are also more susceptible to osteoarthritis, and though it’s not known why, arthritis of the thumb affects women more commonly than men.How Basilar Joint Arthritis HappensThe unique shapes of its small bones allow the thumb to move in and out of the plane of the palm to oppose the other fingers. The stability of the carpometacarpal joint of the thumb depends on several small ligaments, which allow movement but remain close to the joint surfaces. If those ligaments loosen and permit too much sliding of the joint surfaces, the joint cartilage will suffer increased wear, leading to arthritis. A fracture or injury can also lead to joint dysfunction and deterioration, ultimately leading to arthritis as well.What Are the Symptoms of Thumb Arthritis?Basilar joint arthritis will produce pain that progresses gradually over time. Symptoms may include:• Pain and tenderness at the base of the thumb that worsens when snapping, turning a key or doorknob.• An overall enlarged appearance of the thumb.• Improper alignment of the joint. Eventually, the pain makes it increasingly difficult to use the thumb, which can lead to joint weakness and muscle loss. How Is It Diagnosed?After assessing your history and examining your thumb, an X-ray may help show the degree of joint damage. A series of X-rays can help determine the rate of progression. What Does Treatment Look Like? Treatment is determined based on the effect that the arthritis has had on your joint at the time of diagnosis. Possible treatment options include:MedicationTo relieve pain, your doctor might recommend:• Topical medications, such as capsaicin or diclofenac, which are applied to the skin over the joint• Over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others), or naproxen sodium (Aleve)• Prescription pain relievers, such as celecoxib (Celebrex) or tramadol (Conzip, Ultram)SplintA splint can support your joint and limit the movement of your thumb and wrist. You might wear a splint just at night or throughout the day and night.Splints can help:• Decrease pain• Encourage proper positioning of your joint while you complete tasks• Rest your joint Injections If pain relievers and a splint aren’t effective, your doctor might recommend injecting a long-acting corticosteroid into your thumb joint. Corticosteroid injections can offer temporary pain relief and reduce inflammation.SurgeryIf you don’t respond to other treatments or if you’re barely able to bend and twist your thumb, your doctor might recommend surgery. Options include:• Joint fusion (arthrodesis). The bones in the affected joint are permanently fused. The fused joint can bear weight without pain but has no flexibility.• Osteotomy. The bones in the affected joint are repositioned to help correct deformities.• Trapeziectomy. One of the bones in your thumb joint (trapezium) is removed.• Joint replacement (arthroplasty). All or part of the affected joint is removed and replaced with a graft from one of your tendons.These surgeries can all be done on an outpatient basis. After surgery, you can expect to wear a cast or splint over your thumb and wrist for up to six weeks. Once the cast is removed, you might have physical therapy to help you regain hand strength and movement. If you’re experiencing constant thumb pain and think you may have thumb arthritis, you may want to visit the hand specialists at DOC Orthopaedics. Dr. Randy Riehl of DOC Orthopaedics and Sports Medicine specializes in providing both surgical and non-surgical treatments for hand conditions and injuries. In addition to Xiaflex injections to treat Dupuytren’s Contracture, Dr. Riehl also performs an endoscopic carpal tunnel surgery, which offers a less invasive alternative to traditional surgery with shorter recovery time. He also specializes in sports medicine, hip, knee and shoulder pain, and joint replacement.Dr. Riehl is a native of North Alabama raised in Huntsville, Alabama and began his education at Birmingham Southern College. He attended The University of Alabama at Birmingham School of Medicine on an academic scholarship and completed his orthopaedic residency at the internationally renowned Campbell Clinic in Memphis, TN. He has served as president of the National Clinical Orthopaedic Society and past Medical Staff President at Decatur Morgan Hospital. He has board certifications in both orthopaedic surgery and sports medicine. He specializes in delivering state of the art sports medicine and upper/lower extremity musculoskeletal care utilizing advanced arthroscopic surgery, minimally invasive joint replacement, hand surgery, and complex fracture fixation. Dr. Riehl serves as the team physician for many of our area schools including Decatur High School and has been involved in many community projects in the Decatur Parks and Recreation Department as well as international medical mission trips.Dr. Riehl continues to refine his skills by keeping abreast of the latest advances in surgical and nonsurgical techniques for musculoskeletal care. This commitment to excellence combined with over 20 years of experience ensures you will receive the best skilled orthopaedic care possible.To schedule an appointment with DOC Orthopaedics’ skilled team of orthopaedic and sports medicine specialists, call 256-350-0362.
