What is Thumb Arthritis?
There are several types of Thumb Arthritis. The most common is Osteoarthritis, which occurs when the cartilage that cushions the bones in the joints wears out and breaks down. This could be as a result of wear and tear, or from injuries.
Another type of arthritis is Rheumatoid Arthritis, which occurs when the body’s immune system attacks the joints. This can cause damage to the cartilage and bones in the joint as a consequence of an inflammatory process. Psoriasis, a skin condition, could also be associated with Thumb Arthritis as part of an autoimmune process.
Diagnosis of Base of Thumb Osteoarthritis
Thumb arthritis can be diagnosed by a doctor following clinical and radiological assessment. Typically, Thumb Arthritis leads to pain, stiffness, and swelling in the thumb. X-rays are used to confirm the diagnosis. Ultrasound scan can also be useful in excluding other soft tissue problems that can cause pain around the thumb and to guide injections into the base of the thumb for accuracy.
How to treat Base of Thumb Osteoarthritis
There is no one-size-fits-all answer to the question of how to treat thumb arthritis, as the best course of treatment will vary depending on stage of disease and previous treatment. However, treatments for thumb arthritis include physical therapy, splinting or bracing, and medications like non-steroidal anti-inflammatory drugs (NSAIDs) and others that are available over the counter. In more severe cases, injections or surgery may be necessary. At ACTIVATE, we provide a full range of non-surgical treatments.
If you were diagnosed with base of thumb arthritis, it is important to talk to your doctor about the best treatment option for you. With the right treatment at the right time, your pain would improve, you could keep your thumb moving and return to your day-to-day activities.
Physiotherapy for Thumb Arthritis
Thumb physiotherapy aims to improve the function of the thumb and surrounding muscles. It is often used in patients who sustained thumb injury, or other conditions that affect the thumb. This could be delivered by a physiotherapist or digitally via a physiotherapy prescription.
The physiotherapist will work with you to assess the strength and range of motion of your thumb. They will then design a program of exercises and activities to help improve your function. It can also help reduce pain and swelling.
Splinting and Bracing
A thumb splint is a device that is worn on the thumb to help stabilize the joint and reduce movement. It is often used in the treatment of thumb joint pain, or to prevent the thumb from moving out of place after surgery. Thumb splints vary in design and can be custom-made or purchased off the shelf, your doctor or physiotherapist can advise you on the most suitable one for you for management of thumb arthritis. Depending on the reason for your splint, it may be worn all the time or only during activities that put stress on your thumb.
If you have a thumb splint, follow your doctor or therapist’s instructions on how to care for it. This will include when to wear it and how to clean it. It is important to keep your splint clean and dry to prevent skin irritation.
Injections for Base of Thumb Arthritis
Thumb injections are a type of medical procedure. They involve injecting medication into the joint space. Thumb injections are generally safe. However, there is a small risk of tissue damage and infection.
Thumb Steroid Injections
Steroid injections are a common treatment for thumb pain. The corticosteroid medication is injected into the joint to help reduce pain and swelling. The injections have temporary effect on pain so will be particularly useful to facilitate physiotherapy. They can be repeated but usually reserved for flare ups of arthritis pain rather than regular injections. Corticosteroid injections can be associated with pain in the initial 2-3 days after the injection.
Hyaluronic Acid Injection of the Thumb
Hyaluronic acid (HA) injections are used to treat base of thumb joint pain. The goal of the injection is to provide joint lubrication and reduce friction. HA is a naturally occurring substance in the body that cushions and lubricates joints. It is also a main component of the joint's synovial fluid, which is the fluid that surrounds and lubricates joints. Your body constantly produces and breaks down HA. However, over time, your body produces less HA, and the HA that is produced breaks down more quickly.
If you are considering hyaluronic acid injections for thumb arthritis, get in touch to see if it is the right treatment option for you.
Platelet Rich Plasma (PRP) for Thumb Arthritis
PRP injection is a therapy that uses a person’s own blood to treat their thumb arthritis. Platelets are the cells in our blood that help with clotting, and they also contain growth factors that can promote healing. When PRP is injected into the joint, it can help to reduce pain and inflammation, and promote healing of the joint.
PRP injection is a minimally invasive procedure that can be done in a doctor's clinic. A small amount of blood is drawn from the arm, and then the platelets are separated from the other blood cells in a special tube using a centrifuge machine. The concentrated platelets are then injected into the joint. The injection is usually done with a local anaesthetic, so there is little discomfort.
PRP injections have been shown to be effective in reducing pain and improving function in a variety of musculoskeletal conditions, and the evidence is beginning to accumulate for their use in thumb arthritis as well. There are some small studies that have shown promising results. In one study, 70% of people who received PRP injection had a significant decrease in pain after 6 months. PRP injections for thumb arthritis are typically done as a series of three injections, given about four weeks apart. There is usually no downtime after the injections, and patients can typically return to their normal activities immediately.
If you are considering PRP injections for your thumb arthritis, be sure to discuss this with your doctor to determine if it is the right option for you.
Surgery for Thumb Arthritis (Trapeziectomy)
Trapeziectomy is an operation to remove the Trapezium bone from the base of the thumb. The Trapezium is one of the small bones in the hand situated between the Scaphoid and the Thumb Metacarpal bones.
The operation is done through an incision (cut) on the side of the Thumb. The surgeon will remove the bone and some surrounding tissue. The surgeon will then close the incision with stitches. You will be able to go home the same day. The operation usually takes about 30-45 minutes.
You will have a dressing on your hand and you will be able to use your hand for light tasks such as holding a cup or brushing your teeth. This procedure is very successful in more than 90% of patients.
If you are experiencing thumb pain, get in touch with ACTIVATE or book online to get your diagnosis and treatment promptly
About the Author: Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent
Comments