Basal joint arthritis, which is also called thumb arthritis, occurs at the base of the thumb.
Arthritis is the condition of deterioration of joints due to injury or wear and tear. Basal joint arthritis is the most common type of arthritis to affect the hand, and it can be a very painful and limiting condition.
The pain is usually at the base of the thumb near the wrist, and the thumb begins to lose its ability to pinch or grip, and also loses its strength and range of motion.
Thumb arthritis is most commonly in the form of osteoarthritis, which is due to age-related wear and tear on the joints. However, basal joint arthritis appears to affect people earlier in life than other forms of degenerative arthritis.
This is typically a progressive condition which worsens with time.
Anatomy of Basal Joint Arthritis
The basal joint, also known as the thumb carpometacarpal (CMC) joint, is located at the base of the thumb, and connects the thumb to the wrist. This joint is responsible for the pivoting, pinching and swiveling movements of the thumb.
At the ends of the bones in the joint, there is thick, smooth articular cartilage that protects the bones, and prevents friction between the bones when they move against each other.
As a result, the rubbery cartilage layer in between the bones gets worn down and damaged over the years. Without the cushioning effect of the cartilage layer, the bones in the thumb joint rub against each other, leading to this painful inflammatory condition.
Causes of Basal Joint Arthritis
The major reason for basal joint arthritis is Osteoarthritis which causes deterioration of the joints’ articular cartilage. This condition is age-related to a large extent, and people over the age of 40 are at a higher risk of developing thumb arthritis.
People with osteoarthritis in other joints are also more likely to have thumb arthritis.Gender is another risk factor, and women are six times more likely than men to develop this form of arthritis.
Basal joint injuries are also likely to lead to thumb arthritis. Injuries such as torn ligaments, tendons or cartilages, or even bone fractures in the basal joint can lead to the development of this condition.
Carpal tunnel syndrome has also been linked to thumb arthritis.
Overuse of the thumb, or routine repetitive motions such as sewing, typing, gardening or playing certain sports or musical instruments, can increase the risk of developing basal joint arthritis earlier in life.
Symptoms of Basal Joint Arthritis
Some of the common symptoms of basal joint arthritis are:
- Pain in the thumb, especially at the base
- Decreased grip strength, decreased ability to pinch or hold things with the thumb
- Limited range of motion of the thumb
- Swelling and tenderness at the base of the thumb, and even in the entire hand
- An enlarged and deformed thumb may be seen in some cases
- Bony protuberances or bumps may form over the joint
Treatment of Basal Joint Arthritis
Similar to other forms of arthritis, treatment of basal joint arthritis is focused on pain management and easing the symptoms. Through early management of this condition, further deterioration of the joint will be slowed down a little.
Pain medications, anti-inflammatory corticosteroids, NSAIDs, icing and splinting, wrist and thumb braces, and rest from activity are the typical conventional treatment options.
When the symptoms of thumb arthritis are not eased by these traditional treatments, surgical options can be considered.
Total thumb joint reconstruction surgery is the common procedure. Joint fusion surgery, and tendon grafts are some other surgical options, depending on the progression of the basal joint arthritis.