Thumb Arthritis

Diagnosis

During a physical exam, your healthcare professional will ask about your symptoms and check for swelling or lumps on your thumb joints.

Your doctor may hold your thumb joint while pressing it against your wrist bone. If this causes a grinding sound, pain, or a gritty feeling, it may indicate that cartilage has worn away and the bones are rubbing against each other.

Imaging techniques, most commonly X-rays, can confirm a diagnosis of thumb arthritis.

Treatment

Treatment for thumb arthritis depends on the severity of symptoms. Early stages often respond to non-surgical approaches, but surgery may be needed for more advanced cases.

Medication:
• Topical NSAIDs applied to the skin over the joint, such as diclofenac (Voltaren Arthritis Pain).
• Over-the-counter pain relievers, including acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB), or naproxen sodium (Aleve).
• Prescription pain relievers, such as celecoxib (Celebrex) or tramadol (Conzip).

Splint:
A splint can support your joint and limit movement of your thumb and wrist. You might wear it at night or throughout the day. Splints help:
• Ease pain.
• Keep the joint stable while performing tasks.
• Rest the joint.

Injections:
If medications and splints are not enough, a long-acting corticosteroid may be injected into the thumb joint to reduce pain, swelling, and inflammation.

Surgery or other procedures:
If conservative treatments fail or thumb movement is severely limited, surgical options may include:
• Joint fusion (arthrodesis) to fuse the bones, allowing weight-bearing without pain but limited movement.
• Osteotomy to reposition bones in the joint for better alignment.
• Trapeziectomy to remove all or part of the trapezium bone, sometimes with a tendon graft.
• Joint replacement (arthroplasty) to remove all or part of the affected joint and replace it with a prosthetic joint.

Most surgeries do not require an overnight hospital stay. After surgery, a cast or splint is worn over the thumb and wrist for up to eight weeks. Physical or occupational therapy may follow to restore hand strength and mobility.