Meet Margaret
Margaret, a 65-year-old retiree, has always found joy in her hobbies of knitting intricate patterns and tending to her flourishing garden.
However, over the past year, she has noticed increasing pain and stiffness at the base of her right thumb, making it difficult to grasp knitting needles or comfortably pull weeds. Tasks that once brought her relaxation now leave her hand aching and fatigued.
On cooler mornings, her thumb feels particularly stiff, and she struggles to open jars or carry her gardening tools. After seeing her doctor, Margaret was diagnosed with thumb osteoarthritis.
Although she’s frustrated by her limitations, she’s determined to find ways to manage the pain and maintain her independence, ensuring she can continue doing what she loves.
Understanding osteoarthritis of the thumb
Osteoarthritis of the thumb, also known as basal joint arthritis or thumb CMC (carpometacarpal) joint arthritis, is a common condition that affects the base of the thumb, where the thumb meets the wrist.
This form of arthritis can cause pain, stiffness, and weakness, making it difficult to perform everyday tasks like opening jars, turning keys, or gripping objects.
As hand therapists, we often see patients with thumb osteoarthritis and work with them to manage symptoms and improve function.
In this blog, we’ll explore the causes, anatomy, and treatment options for thumb osteoarthritis, as well as how hand therapy can help.
​
What causes osteoarthritis of the thumb?
​
There are several factors that can contribute to the development of thumb osteoarthritis:
​
-
Age: As we age, the cartilage in the thumb joint naturally wears down, making osteoarthritis more common in people over the age of 50.
​
-
Repetitive Use: Jobs or activities that involve repetitive thumb and hand movements, such as sewing, typing, or manual labor, can increase stress on the thumb joint.
​
-
Genetics: Some individuals may be more prone to developing osteoarthritis due to genetic factors or joint structure.
​
-
Previous Injury: A history of injury to the thumb joint, such as a fracture or sprain, can increase the likelihood of developing arthritis in that area.
Anatomy of thumb osteoarthritis
The thumb’s CMC joint allows a wide range of movement, enabling us to grasp, pinch, and hold objects. This joint is formed where the metacarpal bone of the thumb meets the trapezium bone of the wrist.
Over time, the cartilage that cushions the bones in this joint can wear down, leading to osteoarthritis. As the protective cartilage wears away, the bones begin to rub against each other, causing pain, inflammation, and sometimes the formation of bone spurs.
​
Osteoarthritis of the thumb often leads to:
-
Pain and tenderness at the base of the thumb, especially during gripping or pinching
​
-
Stiffness in the thumb joint, particularly in the morning or after periods of inactivity
​
-
Weakness in the hand and thumb, making it hard to perform tasks requiring fine motor skills
​
-
Swelling and sometimes the development of a bony lump at the base of the thumb
How hand therapists can help with osteoarthritis of the thumb
Hand therapy is a key component in managing thumb osteoarthritis. While osteoarthritis cannot be reversed, therapy focuses on reducing pain, improving joint function, and slowing the progression of the disease. Below are some common treatments you may encounter during your therapy sessions:
Splinting
​A thumb spica splint is often used to stabilise the thumb and reduce stress on the CMC joint.
By immobilising the thumb in a functional position, the splint allows the joint to rest and can reduce pain during daily activities.
Splints can be worn during flare-ups or while performing tasks that aggravate your symptoms.
Activity modification
We work with you to identify activities that put excessive strain on the thumb joint.
Simple changes, such as using larger handles on utensils, adjusting your grip when lifting objects, or using ergonomic tools, can make a significant difference in reducing pain.
Learning proper hand positions and modifying your daily routine can help prevent further damage to the joint.
Exercises to improve mobility and strength
While rest is important, it’s equally important to maintain mobility and strength in the hand. We’ll guide you through a series of stretching and strengthening exercises that can improve flexibility and support the thumb joint.
​
-
Range of motion exercises: These gentle movements help maintain the mobility of the thumb and reduce stiffness.
​
-
Strengthening exercises: Strengthening the muscles around the thumb joint can help stabilise the joint and reduce stress on the affected area.
Heat and cold therapy
​Heat therapy can be used to relax the muscles and reduce stiffness in the thumb joint, while cold therapy can help reduce inflammation and numb pain.
Your hand therapist may recommend alternating between heat and cold packs, depending on your symptoms.
Manual therapy
Manual therapy techniques, including soft tissue mobilization and gentle joint manipulation, can help improve circulation, reduce stiffness, and relieve pain.
Your hand therapist will use these techniques to promote healing in the surrounding tissues and help you regain function in your thumb.​
​
​
-
Range of motion exercises: These gentle movements help maintain the mobility of the thumb and reduce stiffness.
​
-
Strengthening exercises: Strengthening the muscles around the thumb joint can help stabilise the joint and reduce stress on the affected area.
Adaptive equipment and ergonomic tools
​We may suggest using adaptive tools or equipment to make daily tasks easier on your thumb joint.
Devices like jar openers, large-handled pens, or ergonomic kitchen tools can reduce the amount of strain on your thumb and allow you to continue performing daily activities without pain.
Frequently asked questions about finger & hand fractures
How do you treat osteoarthritis of the thumb?
Treatment for thumb osteoarthritis often involves a combination of non-surgical approaches, such as hand therapy, splinting, activity modification, and exercises to improve strength and mobility. In some cases, medications or corticosteroid injections may be recommended by your doctor. Surgery is typically considered only when conservative treatments are no longer
What movement should you avoid with osteoarthritis of the thumb?
Movements that put excessive pressure on the thumb joint, such as pinching, gripping, and twisting, should be minimized. Activities that involve repetitive thumb movements, like typing or using scissors, can aggravate symptoms. Your hand therapist can help you identify movements to avoid and suggest alternative ways to perform tasks that reduce stress on the thumb.
Can thumb osteoarthritis be reversed?
Unfortunately, osteoarthritis is a degenerative condition, meaning the cartilage damage cannot be reversed. However, with the right treatment plan, including hand therapy, splinting, and exercise, symptoms can be effectively managed, allowing you to maintain function and quality of life.