thumb arthritis / Arthritis of the thumb, arthritis bones.

Arthritis of the thumb, arthritis bones.


What is arthritis thumb?

Thumb arthritis is more common in the carpometacarpal thumb, between the base of the metacarpus thumb and a wrist bone (trapezium). arthritis thumb is sometimes referred to as basal joint arthritis. Because of stresses with daily activities, basal joint arthritis is very common.

The thumb is the single most important figures in the hand, representing 40% of the hand's function. The thumb base joint is subjected to an enormous amount of force with pinching and grasping activity.
Symptoms of arthritis Thumb

The initial symptoms of thumb arthritis include pain and swelling around the wrist and the base of the thumb and progressive weakness. Patients find it becomes increasingly difficult to twist open jars or even turn a handle. In severe cases, even a pen or tool can be very painful in your hand. The base of the thumb can appear enlarged and out of place. Stiffness and reduction of thumb movement can be minimal or significant, depending on the severity of the disease.
Causes of thumb arthritis and risk factors

Joint basal arthritis of the thumb is more common in women over the age of 40. The exact cause of thumb arthritis is unknown, but the researchers hypothesized that it is a combination of factors, including joint ligament laxity, deformed joints, early fracture or injury to the thumb, and repetitive loading to the joint.

In the normal joint, the cartilage covers the ends of the bones to allow smooth sliding with the movement of the thumb and act as a shock absorber. The basal joint of the thumb is a specialized joint that is shaped like a saddle and allows the significant amount of movement for daily activities that involve pinching and grasping.

With progressive wear and tear (degenerative arthritis or osteoarthritis), the cartilage becomes thinner and there is no direct contact between the bone surfaces (bone-on-bone).

In the advanced stages, bone spurs, or osteophytes, can form in the joints, causing the metacarpus thumb to slip out of the saddle. Hyperextension instability can also occur in the adjacent joint (metacarpophalangeal joint).
Treatment of arthritis Thumb
Initial treatment

A number of conservative measures are useful for decreasing pain and maintaining thumb function.

Heat and ice
Heat can be helpful in loosening joints and relaxing rigid muscles. As the thumb joint is often stiff in the morning, you could try showers in the morning or take your hand in warm water first thing in the morning. Ice is generally effective for flare-ups or swelling at the end of the day, especially after overdoing activities.

Activity change
A number of simple changes at home can be useful.

    Change door handles to latches
    Using larger writing grip pens
    Using tools and garden tools with larger handles
    Using bottles and vase open

Over the counter medications
Tylenol and non-steroidal anti-inflammatory drugs (NSAIDs) can be taken to relieve pain. NSAIDs have the advantage of decreasing inflammation and swelling. In an acute flare-up, it may be helpful to take scheduled NSAID doses for 5-7 days. NSAIDs include ibuprofen (Motrin, Advil), naproxen (Aleve), and many others that are the prescription strength. NSAIDs should always be taken with food. long-term use in high doses can lead to serious side effects, including gastric ulcers, gastrointestinal bleeding, and kidney damage.
Splints and braces

There are a number of different staples and splints that support the thumb, which places the joint in the rest position and provides significant pain relief. The braces can be soft and made of neoprene or rigid with plastic frames. Depending on the work and needs, the braces can be worn as a splint resting at night or used with activities. Your doctor or hand therapist can tell about the different options and help you decide which one is best for you. Many patients are interested in having the hand therapist make a custom thermoplastic thumb splint (plastic), which provides a better fit and support.


cortisone injections

If testing reinforces, modifies activity, and the use of NSAIDs is no longer effective and the pain becomes disabling, the doctor may recommend a cortisone injection. Injecting a long-acting corticosteroid into the basic joint thumb can provide pain relief for a couple of months. However, relief is temporary and arthritis in the joint will continue to progress.
Surgery

If conservative management is no longer effective and you have persistent pain and weakness, there are a number of surgical options that would provide pain relief and improved function. Consult your hand surgeon to discuss the best surgical options for you. Surgical treatment options for thumb arthritis can include:
Thumb osteotomy
Thumb artrodesi (fusion)

In this procedure, the surgeon removes the diseased cartilage and fuses the bones in the affected joint. This provides stability and decreases pain. Even if you can have better resistance with the grip and the thumb lift without pain, do not lose flexibility.
Thumb arthroplasty (joint prosthesis)
Recovery after surgery

In all 3 surgical procedures, you will be in a thumb or guard splint for the first 6 weeks. After the 6 weeks of immobilization, you will have to work with a hand therapist on the range of movement and flexibility of the thumb. At the 3-month time point, most patients have little or no pain. Reinforcement exercises are initiated at this time, both with hand therapy and in a home exercise program. Most patients regain their strength and return to normal activities at the 6-month time point.