Thumb arthritis is a common condition that often presents as a generalised ache around the base of the thumb region. It is a progressive degenerative condition. The condition may start as some mild discomfort that is felt on performing gripping or heavy loading tasks. Over time as the problem advances, the function may become more and more limited.
Initial treatment options include simple remedies such as regular painkillers and anti-inflammatory medication. Some patients will benefit from wearing a supportive splint that helps to hold the base of the thumb in position and provide some stability. On occasions patients may have some benefit with a steroid injection to settle acute inflammation.
In cases where patients are not able to manage with non operative measures, there are surgical options available.
Base of thumb arthritis usually starts off with arthritic changes in the joint between the trapezium bone and the metacarpal bone. In cases where the surrounding joints are in good condition, some patients are suited to having a prosthetic implant inserted between the trapezium and the metacarpal.
This prevents the pain associated with the bone surfaces rubbing against each other. Some people may be suited to have a fusion of the joint.
In cases where there is more advanced arthritis, a more aggressive operation is usually recommended.
The trapezium may be removed to take away the arthritic pain caused by the bone surfaces rubbing against each other. The space that is left is filled with a strip of tendon that is harvested from the forearm. This tendon is also used to reconstruct ligaments to help support the base of the thumb.
This operation is a reliable way of providing good pain relief for patients with arthritic degeneration.
Recovery after the surgery does take quite some time. Patients are usually immobilised in a splint for the first six weeks.
Most patients report good improvement in their pain management and function.