Degenerative arthritis (aka osteoarthritis) of the thumb carpo-metacarpal joint (CMC) is a common problem,
which usually affects women beginning around the fifth decade of life. Arthritis is a condition where the
articular cartilage or gliding surface of a joint becomes worn and degraded. This may ultimately result in
a painful and stiff joint.
Q: What causes Thumb Carpo-Metacarpal Arthritis?
A: The actual degenerative process of osteoarthritis is not completely understood.
While it is primarily a "wear and tear" process, there are other factors that play a role in degenerative arthritis.
These include previous trauma or injury, repetitive stress over long periods of time, laxity or looseness of the joint
secondary to hormones or just the aging process.
Q: What are the symptoms of Thumb Carpo-Metacarpal Arthritis?
A: People with arthritis of the thumb typically complain of pain or an aching feeling at the base
of the thumb. These symptoms may be aggravated by the weather, grasping, pinching or when severe may be present
at rest or at night. Other symptoms include weakness, clumsiness or deformity of the thumb.
Q: What can be done?
A: The initial treatment for carpo-metacarpal arthritis is usually conservative or non-surgical.
Splint treatment usually at night is often quite effective at decreasing the pain associated with thumb arthritis.
While oral non-steroidal anti-inflammatory medications (NSAIDS) may be helpful, the most effective initial non-surgical
treatment is a cortisone injection into the arthritic joint. Once non-surgical treatment has been exhausted, excellent
surgical treatment exists for treatment of thumb arthritis. Fusion or arthrodesis is usually reserved for younger patients
who use their hands for heavy labor. More commonly, the procedure called 1st CMC arthroplasty is the best surgical option.
Unlike joint arthroplasty in the hip and knee, where the arthritic joint is replaced or resurfaced, thumb arthroplasty does
not implant a prosthesis or artificial joint. Thumb arthroplasty involves removing the small arthritic bone called the
trapezium and rerouting tendons to act as a spacer or cushion between the arthritic thumb bone and the rest of the wrist
bones. The result is excellent pain relief, as well as restoration of lost range of motion.
Surgical treatment consists of a short procedure done in the operating room on an out
patient basis (you go home the same day). After the operation, the thumb is placed in some type of
splint for approximately a month, followed by hand therapy.
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