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Basal Joint Arthritis

Arthritis is a disease that causes inflammation and stiffness in the joints. It often affects the joint at the base of the thumb, called the basal joint. Basal joint arthritis is most common in women over 40, but anyone can get it. Often it happens in both thumbs.

Causes

Basal joint arthritis occurs as a result of wear and tear on the joint. It is more likely to occur, and at a younger age, if you have fractured or injured your thumb. Repeatedly gripping, twisting, or turning objects with the thumb and fingers may  make the arthritis worse.

Symptoms

The most common symptom is pain in the lower part of the thumb. You may feel pain when you lift something with the thumb and fingers, unscrew a jar lid, or turn a door handle or a key. You may find yourself dropping things. Weather may also make the thumb hurt. The joint may swell, and with time the thumb may become stiff or deformed.

Your doctor can usually diagnose basal joint arthris from the way your thumb looks and moves. He or she may also order x-rays to see how much of the joint is destroyed. Your treatment will depend on how severe the pain is and how worn the joint is.

Nonsurgical Treatment

If arthritis is diagnosed early, it often responds to treatment without surgery. Your doctor may put a splint on your thumb for 3-6 weeks. This limits movement and helps reduce the inflammation. You may also be given oral anti-inflammatory medication, such as aspirin. If your symptoms don't improve, your doctor may give you injections of an anti-inflammatory, such as cortisone.

Surgical Treatment

If nonsurgical treatment doesn't relieve the pain and stiffness, or if arthritis has destroyed the joint, your doctor may recommend surgery. The diseased joint is removed. Then the joint is rebuilt, usually with a piece of tendon (graft) taken from your arm or wrist. Your arm, or sometimes your entire body, is anesthetized so you don't feel anything dunng surgery. You can probably go home the day of surgery

Your Recovery

First your hand will be wrapped in a dressing. Then you'll have a cast or a splint on your thumb for 3-6 weeks. This keeps the thumb stable while it heals. Once you can move your thumb, your doctor will give you exercises, or refer you to a physical therapist, to help strengthen the muscles and make the joint more flexible, Regaining use of your thumb will take time.

Inside Your Thumb

The basal joint is formed by one of the wrist bones and the first of the three bones in the thumb. This joint allows the thumb to move and to pinch with the fingers. When arthritis occurs in the basal joint, it slowly destroys the joint.

Arthritis Destroys the Joint

The ends of the bones are covered with cartilage. This covering acts like a cushion, allowing the bones to move smoothly. Arthritis destroys the cartilage. Then the bones rub against each other when you move your thumb. This causes the joint to become inflamed and painful. With time, the small bone at the base of the thumb may collapse. Then you can no longer straighten your thumb.

Using Your Thumb Again

Once the joint heals, you should have little or no pain - as long as your don't overuse your thumb.  Be sure to do any excercises your doctor or physical therapist gives you to strengthen the joint.  The thumb may never be quiteas good as new, but you should be able to return to many of your normal activities.