Treating Thumb Arthritis

Over-the-counter options can ease symptoms of common joint pain.

Written by Melissa Bean Sterzick

Arthritis often affects the joints of the hand and is typically caused by overuse. The thumb is the powerhouse of the hand, with a unique and wide range of motion that makes it possible to grasp and hold items. Heavy use makes the thumb susceptible to arthritis, which commonly occurs with aging and develops when cartilage wears away from the bones that form the carpometacarpal (CMC) joint.

Thumb arthritis can cause severe pain, swelling and decreased strength and range of motion making it difficult to do simple tasks, such as turning doorknobs and opening jars. Although CMC arthritis is a common condition overall, it affects women more than men.

“Research has shown 20% of women over 50 who are past menopause develop CMC arthritis,” says Andrew Lim, MD, a Torrance Memorial Physician Network orthopedic and hand surgery specialist. “Men are also susceptible, but for them it is usually associated with previous trauma.”

In a normal thumb joint, cartilage covers the ends of the bones—forming a cushion so the bones glide smoothly against each other. With thumb arthritis, the cartilage that covers the ends of the bones breaks down and its surface roughens. The bones then rub against each other, causing friction and joint damage.

Thumb arthritis causes pain when gripping or grasping an object, or using the thumb to apply pressure. It can be discouraging to find everyday tasks becoming more difficult, but there are many effective approaches for CMC arthritis. Much of the treatment involves adjusting activities and managing pain.

“Thumb arthritis is not necessarily preventable, because you must use your hands. This type of arthritis is related to everyday activities,” says Dr. Lim. “But it’s not hopeless. Multiple levels of treatments are available in the marketplace.”

Dr. Lim says people who develop CMC arthritis often first experience it when performing “pinch” activities—such as turning keys or knitting—that require a tight grasp of a small item. The pain can range from sharp to a dull ache. Other symptoms include swelling and stiffness, decreased strength, decreased mobility and enlargement of the joint.

According to Dr. Lim, it is important for individuals to know if they are experiencing thumb pain, X-rays are the best way to make the diagnosis and follow the progression of arthritis. “Expensive and invasive tests such as MRIs are not relevant or necessary,” he says.

Primary treatments for thumb arthritis are over-the-counter and topical anti-inflammatories. See your doctor if symptoms don’t improve with the use of anti-inflammatories. A clinical exam should confirm whether you have CMC arthritis or another condition, like tendonitis.

If diagnosed with CMC arthritis, it is recommended to wear a brace to support the hand and thumb. Your doctor might also refer you for occupational therapy or hand therapy. Steroid injections are an option if the arthritis worsens. And, if necessary, surgery is the final step.

“Once conservative treatment is exhausted, there are good surgical treatment options. In fact, CMC arthritis is probably the arthritis of the hand most often treated with surgery,” Dr. Lim says.

Management Approaches for Thumb Arthritis:

• Icing the joint for 5 to 15 minutes several times each day
• Anti-inflammatory medication, like aspirin or ibuprofen
• A supportive splint to reduce thumb movement
• A steroid injection, depending on how far along your arthritis has developed