Monday Medical: Thumb arthritis — things to know
For Steamboat Pilot & Today
If everyday actions, such as opening a jar, have become painful, you just might be dealing with thumb arthritis.
“Thumb arthritis affects one in every three women,” said Dr. Patrick Johnston, an orthopedic surgeon in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “It also affects men, but not as frequently. Overall, it’s one of the most common conditions that brings patients into the office.”
Below, Johnston outlines what you need to know about thumb arthritis.
What causes thumb arthritis?
The base of the thumb and wrist meet at the basal or CMC joint, commonly called the saddle joint.
“When you pinch with your fingertips, the force in that joint is 13 times what it is at the fingertips,” Johnston said. “Over years of pinching, you stretch out the ligament that holds the thumb in the saddle joint, so the thumb no longer sits in the middle of the saddle.”
That causes an extra load on the joint’s cartilage — the strong, flexible tissue that provides padding at the joints. Eventually, that cartilage can wear out.
“Arthritis is the progressive loss of cartilage, and it’s irreversible,” Johnston said. “Like tread on the tires, once it wears off, you can’t put it back on.”
Thumb arthritis can’t be prevented, but genetics play a role: if one of your parents had thumb arthritis, you are more likely to suffer from the condition.
What does it feel like?
The most common complaint is pain at the base of the thumb when pinching things, especially when trying to open a jar. The pain may also be felt in the palm of the hand.
Thumb arthritis can begin as early as age 40. Eventually, the pain may go away on its own.
“Over time, the pain from thumb arthritis tends to improve,” Johnston said. “It may take several years, but that pain can kind of burn out. But not everybody makes it to that point.”
How is it treated?
When dealing with arthritis, the goal is to alleviate pain.
“I don’t treat the X-ray, I treat the patient,” Johnston said. “If a patient has arthritis on an X-ray but isn’t experiencing pain, we’re happy. I’m concerned with their pain level and how it’s affecting their life. I want patients to be able to live the lifestyle they want, and I’ll do whatever I can to help get them to that point.”
To ease pain, Johnston recommends running the hand under warm water, taking anti-inflammatory medications if tolerated and trying natural supplements, such as tart cherry juice and turmeric, both of which have anti-inflammatory properties.
Another option is using a thumb splint, which is designed to support the thumb during aggravating activities, such as gardening and pulling weeds.
If those steps aren’t enough, a steroid injection may help. And finally, there’s surgery.
“Surgery is a good option for patients who are experiencing pain that’s severe enough to affect their daily activities and quality of life and who are not improving with conservative treatment options,” Johnston said.
While there are many surgical techniques for thumb arthritis, Johnston prefers one that’s been around since the 1940s.
“It’s a tried and true technique with great long-term results,” Johnston said. “It has a very high success rate and a low complication rate.”
In the 45-minute procedure, Johnston makes a little incision in the wrist to remove the small wrist bone that causes the pain, then uses a tendon from the forearm to reconstruct the ligament that’s been stretched out. The patient wears a removable splint for six weeks, then can resume activities as tolerated.
If my thumb hurts, does that mean I have thumb arthritis?
Not necessarily. Other issues can cause similar pain, but thumb arthritis is the most common culprit.
“If you’re having pain in the base of your thumb, it’s probably worth having an evaluation,” Johnston said. “We can get an X-ray and help determine what’s going on.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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