Diagnosis

During a physical exam, your doctor will ask about your symptoms and look for noticeable swelling or lumps on your joints.

Your doctor might hold your joint while moving your thumb, with pressure, against your wrist bone. If this movement produces a grinding sound, or causes pain or a gritty feeling, the cartilage has likely worn down, and the bones are rubbing against each other.

Imaging techniques, usually X-rays, can reveal signs of thumb arthritis, including:

  • Bone spurs
  • Worn-down cartilage
  • Loss of joint space

Treatment

In the early stages of thumb arthritis, treatment usually involves a combination of non-surgical therapies. If your thumb arthritis is severe, surgery might be necessary.

Medication

To 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)

Splint

A 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.

Surgery

If 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.

Lifestyle and home remedies

To ease pain and improve joint mobility, try to:

  • Modify hand tools. Consider purchasing adaptive equipment — such as jar openers, key turners and large zipper pulls — designed for people with limited hand strength. Replace traditional door handles, which you must grasp with your thumb, with levers.
  • Apply cold. Icing the joint for five to 15 minutes several times a day can help relieve swelling and pain.
  • Apply heat. For some, heat may be more effective than cold in relieving pain.

Preparing for your appointment

You might be referred to a doctor who specializes in disorders of the joints (rheumatologist).

What you can do

  • Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
  • Write down your key medical information, including other conditions and any history of injury to the painful joint.
  • Write down key personal information, including any major changes or stressors in your life.
  • Make a list of all your medications, vitamins or supplements.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.
  • Write down questions to ask your doctor.

Questions to ask your doctor

  • What's the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What treatments are available?
  • Are there any restrictions I should follow?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to discuss in depth. You might be asked:

  • When did your pain begin?
  • How severe are your symptoms? Are they continuous or occasional?
  • What, if anything, seems to improve or worsen your symptoms?
  • Have you ever injured that hand?
June 09, 2018
References
  1. Bray J, et al. Evaluation of the patient with thumb pain. https://www.uptodate.com/contents/search. Accessed April 30, 2018.
  2. Arthritis of the base of the thumb. American Society for Surgery of the Hand. http://www.assh.org/LinkClick.aspx?fileticket=AsKorJBUZsw%3d&portalid=1. Accessed April 30, 2018.
  3. Thumb arthritis. American Society for Surgery of the Hand. http://www.assh.org/handcare/hand-arm-conditions/thumb-arthritis. Accessed April 30, 2018.
  4. Arthritis of the thumb. American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-thumb/. Accessed April 30, 2018.
  5. Rath L. Surgery for thumb arthritis. Arthritis Foundation. https://www.arthritis.org/living-with-arthritis/treatments/joint-surgery/types/other/new-thumb-surgery-options.php. Accessed April 30, 2018.
  6. Fox P, et al. Osteoarthritis in the hand and wrist. In: Plastic Surgery: Volume 6: Hand and Upper Extremity. 4th ed. London, England: Elsevier Saunders; 2018. https://www.clinicalkey.com. Accessed April 30, 2018.
  7. Kloppenburg M, et al. Management of hand osteoarthritis. https://www.uptodate.com/contents/search. Accessed April 30, 2018.
  8. Baker R, et al. Evidence-based medicine: Thumb basal joint arthritis. Plastic and Reconstructive Surgery. 2017;139:256.