Basilar thumb arthritis typically occurs with aging or from a previous injury or trauma. The disease results when cartilage wears away from the ends of the bones that form the joint at the base of the thumb (called the carpometacarpal (CMC) joint).

More than 54 million people in the United States live with arthritis, and that number is expected to reach 67 million by 2030.

While exact data for patients suffering from hand or thumb arthritis is sparse, it is thought that the condition may be second only to knee arthritis. That inkling is confirmed by the experience of Alan R. Blackburn, II, M.D., a fellowship-trained orthopaedic surgeon and hand and upper extremity specialist at South Florida Orthopaedics & Sports Medicine.

“Basilar thumb arthritis is one of the most common conditions encountered in my clinic,” says Dr. Blackburn. “Fundamentally, arthritis is a condition that irritates or destroys a joint. And while there are many types of arthritis, osteoarthritis is the most common type of arthritis that affects the basilar thumb joint.”

Symptoms of Basilar Thumb Arthritis

According to Dr. Blackburn, thumb arthritis can cause severe discomfort, inflammation, and can seriously affect one’s ability to perform routine actions with the hand. The disease occurs about ten times more often in women than in men.

“When a patient comes to my clinic, they frequently complain of pain at the basilar thumb joint, swelling, an appearance of a swollen deformity at the base of the thumb, and difficulty with pinching and gripping objects,” says Dr. Blackburn. “Frequently this manifests as difficulty opening jars, turning a key, or opening doors.”

“In addition to the pain experienced at the base of the thumb, arthritis also often leads to limited motion. At some point in the course of this disease process, a patient will visit my clinic and they’ll state that the pain or the limitation in strength and functioning has become too severe for them to manage on their own.”

How to Treat Basilar Thumb Arthritis

When you first consult an orthopaedic hand specialist, they will obtain a history of the problem and perform a physical exam to identify the precise area where treatment is needed. This process is usually accompanied by the use of an X-ray, CT scan or an MRI.

“On a patient’s first visit, I’ll ask them what they’ve done so far to manage the pain,” says Dr. Blackburn. “Often the items patients have tried on their own include over-the-counter splinting or anti-inflammatories. After a thorough history has been obtained where I find out exactly how this problem is impacting your life, we’ll proceed to a physical examination of your hand and specifically the base of the thumb. X-ray imaging is often used for this condition; it allows us to evaluate for bone spurs and other bony deformities.”

Early on in the treatment process, and depending on the severity of the condition, patients may try a combination of non-surgical therapies including:

  • Heat or ice
  • A splint or brace (to reduce pain and encourage rest and proper bone alignment)
  • Topical medication applied to the skin around the joint
  • Over-the-counter pain medicine such as Tylenol or ibuprofen
  • Prescription pain medication
  • Physical therapy
  • Steroid injections (to provide pain relief and reduce swelling)

“If a diagnosis of basilar thumb arthritis has been made, several treatment options may be appropriate for you,” says Dr. Blackburn. “Initially, we try non-surgical management options which include icing, anti-inflammatory medications, splinting or mobilization at the base of the thumb, and occasionally corticosteroid injections.”

When conservative methods fail to provide relief of symptoms, and a patient’s quality of life continues to deteriorate, surgical intervention may be recommended.

“Should surgery be necessary, several surgical options are appropriate for this condition,” continues Dr. Blackburn. “And these options can be reviewed, and a patient-specific option can be chosen after our discussion.”

If you or someone you know have hand arthritis, are experiencing severe pain or swelling at the base of the thumb, or if you need any additional information, please feel free to contact us.