Thumb Arthritis

Osteoarthritis of the thumb is a degenerative disease that generally affects the base of the thumb, where the carpo-metacarpal or CMC joint is situated. This very important joint is responsible for the functional ability to be able to grip, pinch, and hold things with one’s thumb. The wearing away of the cartilage inside the joint, with the progress of age and sometimes even without age factors through overuse, brings about pain, swelling, stiffness, and diminished hand functioning. Thumb OA is treated in our Sydney hand therapy clinic with various techniques with splinting and hand physiotherapy for the aim of helping to improve the pain and function.

Causes and Risk Factors of Thumb Osteoarthritis

The major cause of thumb OA is the wearing down of the CMC joint cartilage that occurs in stages. The thumb has a wide range of motion, which makes it highly susceptible to wear and tear throughout the years. Other important causes and risk factors include the following:

• Ageing: As people age, their cartilage thins out and naturally degenerates, leading to osteoarthritis.
• Repetitive stress: Activities or professions that often involve ‘working’ thumbs, like typing, vibrating tool use, and playing instruments, tend to accelerate deterioration. Genetics: A family history of osteoarthritis can raise the risk for developing thumb OA. Gender: The incidence of thumb OA is higher in women than in men, especially post-menopausal changes in their hormone levels.
• Previous injuries: previously fractured or injured thumb joint may also lead to early arthritis. Sear and tear of CMC joint of the thumb results in pain, swelling, stiffness and poor grip that can further irritate the thumb and make various routine activities like opening jars, turning keys and writing quite painful

Symptoms of Thumb Osteoarthritis

In the patients with thumb OA, there are usually following symptoms:

• Pain at the base of the thumb: Pain is usually the first symptom; it is often noticed when using the thumb for pinching or gripping something.
• Swelling and tenderness: The inflammation occurring at the joint can equally present itself as visible swelling, or it might show up as a spot that is tender to the touch.
• Limited mobility: Rigidity of the thumb joint could limit mobility, therefore making mundane activities such as buttoning a shirt or holding a cup a bit challenging.
• Poor grip: Patients may also complain of loss of hand strength, especially during efforts to hold or grip an object.
• Grinding sensation: A number of patients have reported a grinding or clicking feeling in the joint due to the rough contact of bones.
• Non-Surgical Treatment of Thumb Osteoarthritis

Several non-surgical thumb OA treatments are available in our Sydney hand therapy clinic to alleviate symptoms such as pain and hand dysfunction, and to prevent further progression of the disease. Such treatments are individualised, taking into consideration the specific condition and lifestyle to optimise results.

1. Splinting for Thumb OA

Splinting is a very important, nonsurgical approach in managing thumb OA. A thumb splint is one that will help support the CMC joint, limit excessive motion, and reduce the pressure on the affected area. In this case, the splint will act to immobilise the thumb, helping to alleviate pain and stabilise the joint further to decrease potential cartilage breakdown. Thumb splints include:

• Rigid splints: These provide complete immobilisation and, hence, are ideal for pain relief on days of inflammation.
• Soft splints: These are made from flexible materials and, hence, can be used during activity to offer some support yet allow movement.

A splint can be used throughout the day, at particular times when activity aggravates symptoms, or even at night to prevent stress on the joint in sleep.

2. Hand Physiotherapy for Thumb OA

Hand physiotherapy is very crucial for symptom management in thumb OA. Our skilled hand therapist can design an individualised exercise program with the aim of improving joint mobility, strengthening the muscles around the CMC joint, and reducing stiffness. Hand physiotherapy helps patients regain function and perform daily activities with less discomfort.

Some of the key hand therapy exercises for thumb OA include:

• Strengthening exercises: This would include strengthening the muscles around the thumb joint to provide additional stability to the joint and relieve pressure from the cartilage.
• Joint protection techniques: Our therapists teach patients ways to change their motion to minimise thumb joint stresses throughout daily activities. This might include using ergonomic tools, changing grip methods, or having more frequent rest periods during repetitive tasks.

3. Anti-Inflammatory Medications and Injections

Other measures that may be useful in addition to the splinting and hand physiotherapy are anti-inflammatory treatments. The pain and inflammation in the CMC joint can be subsided with the use of NSAIDs. Cortisone injections may be indicated in cases when longer pain and inflammation relief may be desirable. These injections will, therefore, be considered in those instances when patients are experiencing particularly bad pain that seriously limits their activities of living

Surgical Options for Thumb Osteoarthritis

Indications for thumb OA surgery include disease that has progressed beyond the point at which conservative treatments are helpful. Surgical procedures most commonly include trapeziectomy, which includes the removal of the small bone at the base of the thumb. The removal of the destroyed bone takes away the origin of pain and allows space between bones in the thumb joint.

After surgery, the patients will commence hand therapy rehabilitation guided by a specialist hand surgeon and a hand therapist focused on restoring thumb strength and mobility.

Long Term Management Of Thumb Osteoarthritis

Thumb OA is a chronic condition, thus needing symptom control and hand function maintenance in the long term. Besides splinting and hand physiotherapy, there is much that the patient can do themselves to protect the hands and avoid further joint damage. These steps include:

• Various tools and gadgets that may ease the strain in hands are considered as ergonomic adjustments to prevent flare-ups and allow the joints to function longer. The use of jar openers, pens with thickened grips, and other assistive devices is recommended.
• Activity modification can also be suggested to patients regarding modifications to be made in performance of certain activities in order to avoid undue stress on the thumb joint. Proper hand positioning and body mechanics can be learned by the client to minimise the chances of exacerbating the condition.
• Healthy lifestyle: A healthy diet and the continuation of physical activities go a long way in lessening the overall burden on the joints, including those of the hand.

Why Choose Our Hand Therapy Experts for Thumb OA?

We undertake expert treatment and advice for patients with thumb OA with an emphasis on non-surgical treatment, splinting, and hand physiotherapy to reduce pain and improve function. Whether conservative treatments or post-operative rehabilitation, we strive to get you back to health with the strength and range of motion that will help you in daily living.

If you are trying to overcome thumb OA or have already received a diagnosis of such, please contact our Sydney hand therapy clinic today for an appointment.