Thumb Arthritis

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Thumb Arthritis Diagnosis & Treatment

Women more than men suffer arthritis at the base of the thumb. The trapeziometacarpal joint is the carpometacarpal or CMC joint. CMC joint arthritis plagues women at about nine women per man compared to relatively infrequent involvement in men.

Photos show x-ray of arthritic thumb CMC and tendon joint reconstruction Most people will initially be offered oral arthritis medication known as NSAIDS or non steroidal anti-inflammatory drugs unless they have an ulcer history, allergy or unless they are ant-coagulated for a blood clotting problem. Since surgery works so well however, it should not be considered 2nd choice but an alternative. Cortisone injection may be offered as a short lived often painful temporizing measure to tide one over while awaiting surgery. It's benefit for this problem is mostly in very sedentary people who don't have to use their hand much. Many of the people who present with arthritic decay have substantial deformity at the base of the thumb as well as the middle joint or MCP of the thumb. Ultimately with procrastination the MCP joint becomes stretched out on it's palmar surface and the 1st web space becomes contracted resulting what has come to be known as a swan neck deformity.

CTS Associated with Basilar Thumb Arthritis

Interestingly, median nerve entrapment at the wrist occurs in over 50% of patients who present with CMC DJD. There is a controversy as to which of the patients need a carpal tunnel decompression versus a joint replacement removal of arthritic bone or both.

Further complicating the treatment options-if the MCP joint is stretched out due procrastination it's very important to tighten the palmar side of the joint with a capsulodesis. Thus, surgical care that we would all generally think of as definitive, avoiding a return to the operating room can very as to a 10 minute procedure under local anesthesia to an hour and fifteen minute procedure under general anesthesia or with the arm completely numb. Rate of recovery depends on how much is undertaken and personal attributes.

How does one determine if Carpal Tunnel Syndrome is Affecting Symptoms from CMC Arthritis?

Symptoms from median nerve entrapment at the wrist, carpal tunnel syndrome, often overlap the symptoms from arthritic joint decay. However, an arthritic joint usually hurts with joint motion not at rest. Night pain in the wrist, especially that which awakens a person is usually the sign of CTS. Clumsiness often accompanying CTS is not characteristic of CMC DJD. Weakness commonly complained of is related to arthritic pain and possibly disuse or even an associated cubital tunnel problem-not CTS. A nerve conduction study (NCS) is the best way to definitively answer the question. It's important to iron out all the abnormalities pre operatively so as to limit oneself to one visit to the operating room.