Basilar Thumb (CMC) Arthritis

The basilar thumb joint, or thumb carpometacarpal (CMC) joint, has significant pressure across it with normal hand use. The joint can become unstable from ligament stretching or weakening with normal aging. Over time, the combination of instability and high pressure across the joint, leads to arthritis of the thumb CMC joint.

This common ailment can cause pain with grasping, pinching, or turning things, such as opening jars or turning keys to unlock a door. Statistically, this condition seems to affect women more than men. This could be due to the weakness in the ligaments around the thumb. This CMC joint of the thumb allows the thumb to more omnidirectional and so, therefore, is at risk of arthritis. Keep in mind that osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. Osteoarthritis symptoms can usually be managed, although the damage to joints cannot be reversed.

How do I typically treat arthritis of CMC Thumb Joint?

I am a bit conservative with treatment. Usually I start with cortisone injections and splinting the area and then some therapy. If that fails, then we consider surgery. The surgery itself is highly effective, with 90% of patients becoming pain-free. The issue is really the downtime involved. After we rebuild the joint by taking the little bone and some cartilage out, and take one of your tendons and roll it up like a little anchovy, there a period of about 3 months where you have no use of the thumb.

When do you know it is time to go see a hand specialist?

When the pain is chronic and every day. Surgery should never be the first option. If you are dealing with chronic pain in the thumb every day, go see a specialist for an x-ray to make sure it is arthritis and not a benign tumor or a lipoma. Next step would be to treat it with a cortisone shot to see if that reduces the inflammation and pain.

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