Thumb arthritis: causes, management and treatments

How do you know if you have thumb arthritis and what are the best treatment options available? Mr Alistair Jepson, consultant orthopaedic surgeon at Three Shires Hospital in Northamptonshire, shares his expertise on thumb arthritis and common treatment options.

Why does my thumb hurt?

If you have suffered an injury to your thumb, such as a fracture or sprain, you will naturally experience pain, stiffness and limited function for a while. Many fractures and sprains heal on their own in around six weeks so long as you give them plenty of rest and use anti-inflammatory medication. However, in some cases the pain persists.

If your pain doesn’t go away after six weeks following an injury, or if you develop unexplained pain in your thumb that becomes progressively worse with age, you may have arthritis.

What is arthritis?

A normal joint is made of two smooth, cartilage-covered bone surfaces that fit perfectly together, allowing your bones to glide smoothly against each other. Cartilage is a strong and flexible connective tissue that protects your joints and bones, acting as a shock absorber throughout your body. When this is damaged or worn away due to overuse or injury, it leads to joint problems, also known as arthritis. Arthritis can affect any joint. While your thumb is not the obvious joint people think of when considering arthritis, it is actually very common to develop arthritis in the joint at the base of your thumb.

Thumb arthritis is thought to affect around 10% of adults. It is more common in women, affecting up to one third of women over 55. Arthritis is more common as we get older, and most people with the condition are over 40 years of age.

You may be more likely to develop arthritis in your thumb if your job or hobbies put pressure and strain on your thumb joint, if you are obese, or if you have a hereditary condition that affects your joints. Hobbies like tennis and badminton (sports that require you to use repetitive hand and thumb movements) are some of the more likely to cause arthritis. Being obese puts more pressure on your joints, but this is more likely to cause problems with your hips and knees.

There are various types of arthritis that can affect your thumb. Osteoarthritis is the most common form, but rheumatoid arthritis can also affect your thumb. This is an autoimmune disease that happens when your body attacks its healthy cells by mistake. Rheumatoid arthritis often starts when you are younger, as it has nothing to do with overuse over time. If you have rheumatoid arthritis in your thumb you will usually have it in one or more other joints too.

How do I know if I have thumb arthritis?

The most common symptom of thumb arthritis is pain at the very base of your thumb (close to the wrist joint). This is often accompanied by stiffness, weakness and/or swelling. Your symptoms may be worse after activities that use your thumb.

You may find that even simple tasks, such as opening a jar or turning a key, become difficult. If this is the case, it’s time to seek medical advice.

Your doctor will likely give you a physical examination as well as asking for your medical history. They will consider your symptoms and may also run tests, such as X-Rays, before giving a diagnosis. These X-rays typically show bone spurs, which are a hallmark of arthritis, as well as narrowing of the joint.

What are the treatment options for thumb arthritis?

Most people with arthritis of the thumb will not require invasive treatment.

If your arthritis of the thumb is not very advanced, modifying your activities while you rest your joint can usually help. Other conservative treatments include splinting, or physiotherapy and hand therapy. Physiotherapy for joint pain comprises a specialist exercise programme designed to strengthen the muscles around your joints, improving mobility and – in taking the pressure of your joints – reducing your pain. It can be a highly effective treatment and many people see amazing results.

If these treatments are not effective, and you find that the pain and discomfort in your thumb is really affecting your quality of life, you might be offered joint injections. Also known as steroid injection therapy, this treatment involves injections of steroid medication (corticosteroid) into your painful thumb joint. This can effectively reduce pain and inflammation, and the effects can last anywhere from a few weeks to a few months. This form of pain relief may be recommended if you can't take oral anti-inflammatories for any reason.

Surgery is offered if these other treatment options have not been successful.

Can you have surgery for thumb arthritis?

Surgery for thumb arthritis is typically only offered if all other options have been exhausted.

Traditionally, the main options have been joint excision without replacement (also known as a apicectomy), or fusion of the joint (arthrodesis). While both these options are excellent at relieving pain, they do come with downsides. Risks include loss of range of motion or strength in your thumb.

You’ve probably heard of hip or knee replacement surgery, and it is possible to replace a thumb too. We use similar technology, just on a much smaller scale to replace thumb joints, as well as other arthritic joints in your fingers.

During joint replacement surgery, the damaged parts of your arthritic thumb are replaced by an implant (also known as a prosthesis), which is designed to match your original joint as closely as possible. The benefit of a thumb joint replacement is that you should retain much of your movement and strength.

The operation itself is done as a day case procedure and results in just a small scar.

Thumb replacement surgery: Jan’s story

Jan Zakary underwent a thumb joint replacement procedure at The Saxon Clinic, Milton Keynes. The following year, she had the same procedure on her other hand. Both of these surgeries were successfully performed by consultant hand and wrist surgeon, Mr Andy Hacker.

Jan says she has experienced no downsides to the surgeries and that they have transformed her mental health for the better. Before surgery, Jan was in constant pain that affected simple things like exercise, shopping, and even holding her husband’s hand. Now, she feels as fit as ever and back to her usual self.

Read Jan’s full story

Recovering from thumb joint replacement surgery

You will be encouraged to begin moving your joint and rebuilding its strength the very next day after surgery. You’ll have a lightweight splint in place to help protect your thumb.

Return to more demanding activities, including sports, can take two to three months.

Your consultant will explain how long it will take for you to recover based on your circumstances.

Get help with Circle Health Group

At Circle Health Group we offer tailored orthopaedic treatment, including surgery, for thumb arthritis. We also have bespoke aftercare programmes to help you recover from surgery as soon as possible.

If you want to know more about our treatment options, book your appointment online today or call a member of our team directly.