Understanding Basal Joint Arthritis (And What You Can Do About It)

Arthritis Services

Osteoarthritis can cause debilitating pain and stiffness wherever it strikes. When you experience these symptoms in your thumb, it’s called basal joint arthritis. The condition, also called thumb arthritis, is just as common as knee arthritis and affects about 80% of women by age 80, according to the Arthritis Foundation.  

Basal joint arthritis affects your use of the carpometacarpal (CMC) joint at the base of your thumb. This joint, also known as the basal joint, forms where your thumb’s metacarpal bone and your wrist’s trapezium bone meet.

While basal joint arthritis affects a small area of your hand, it can make it difficult to perform everyday small motor tasks that involve the use of your thumb. These activities include writing, opening a jar, or turning a door handle. 

Your first step in treating basal joint arthritis involves getting an accurate diagnosis of your symptoms. The skilled team of orthopedic surgeons at Arizona Center for Hand and Shoulder Surgery in Phoenix and Mesa, Arizona, provides expert diagnosis and treatment for basal joint arthritis. Their expertise in both surgical and non-surgical arthritis treatments helps patients relieve pain and restore function.

How basal joint arthritis occurs

Basal joint arthritis is a form of degenerative arthritis called osteoarthritis. Osteoarthritis occurs when cartilage deteriorates from age or injury. 

Cartilage, which covers the ends of your bones, creates a smooth cushion between two bones at the point where they meet to form a joint. This allows the bones to smoothly glide against each other. When your cartilage wears away, the ends of two bones rub against each other and cause painful friction 

Women have a higher risk of developing basal joint arthritis because they often perform the type of tasks that use the basal joint. Other risk factors include being overweight, having a family history of arthritis, being over age 40, and having a previous trauma or injury to your thumb. You’re also more likely to have this condition if you have a job that involves repetitive activities that put high stress on your thumb joint.

Signs and symptoms of basal joint arthritis 

The most common signs of basal joint arthritis usually involve thumb pain and stiffness. You may also experience the following symptoms:

  • Pain applying mild force when turning a key in a lock or snapping your fingers
  • Decreased range of motion and strength in your thumb
  • Difficulty pinching or grasping an object firmly
  • Visible swelling at the base of your thumb
  • Misaligned thumb joint
  • Enlarged thumb caused by bone spurs at the base of your thumb

Non-surgical treatment

The first line of treatment for basal joint arthritis involves one or more non-surgical options. Conservative self-help strategies include using heat or ice at the site. You may also benefit from working with a physical therapist to learn new ways to do common tasks or how to use specialized tools to compensate for limited hand strength. A splint that holds your joint in the proper position may also give you relief.  

Over-the-counter acetaminophen can help reduce pain, while nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin, can address both pain and swelling. Prescription medications may help more severe pain.

If oral medications don’t help, you may benefit from corticosteroid injections. These injections at the basal joint help ease your pain by reducing inflammation. You may need one or more injections, depending on your treatment plan.

Surgical treatments

When conservative options don’t help, your orthopedic surgeon may recommend one of several outpatient surgical treatments for basal joint arthritis. Complete recovery can take from eight weeks to one year and may require wearing a cast, splint, and/or physical therapy.

Some surgical options involve removing the source of thumb pain. A trapeziectomy removes the trapezium, one of the bones in your wrist at the base of your thumb joint. This allows the thumb more room to move. Joint replacement, or ligament reconstruction and tendon interposition (LRTI) surgery, removes all or part of the trapezium bone and replaces it with a tendon. 

Other surgical treatments modify the affected bones. Joint fusion, or arthrodesis, permanently joins the two bones in the basal joint. This prevents the painful friction that occurs when two degenerating bones rub against each other. Osteotomy involves repositioning the basal joint to correct deformities caused by the condition. 

Find out more about getting relief from symptoms caused by basal joint arthritis. Schedule an appointment at Arizona Center for Hand to Shoulder Surgery online or by calling one of our three offices in Phoenix or Mesa.

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