Arthritis or osteoarthritis of the base of the thumb is a very common condition particularly in people over the age of 50 years.
Approximately 40% of post-menopausal females have radiographic changes at the base of the thumb, 10% seek medical treatment and 1% are severely afflicted.
Base of thumb arthritis is more common in females than males, and usually starts over 50 years of age, usually as a result of a previous fracture.
There are two types of arthritis; primary and secondary.
Primary is the most common cause and is due to ‘wear and tear’. Abnormal loads across the joint cause the articular cartilage (slippy ends of bones) to wear away, leaving bone on bone ends rubbing together.
Secondary arthritis occurs often after a fracture into the joint causing sharp bone surfaces to rub and wear the joint away.
Pain at the base of the thumb is the most common symptom. Provoking activities include the unscrewing of jars, and pinch grip and turning a key using the thumb often cause pain.
Other symptoms might include:
Your consultant will discuss your symptoms with you and examine your hand for:
In some cases, trigger finger doesn't need treatment and will get better by itself. However, if it doesn’t improve, treatment is required otherwise the finger or thumb may become permanently bent.
Non-surgical treatment: Resting the hand and using painkillers. Using a splint on the affected finger to rest it. A Steroid injection into the sheath may lubricate and also damp down the inflammation. Steroid injections can be repeated a few times. Further attempts may thin the overlying skin and surgery would be advised after a few failed injections.
Surgery: If non-operative techniques have been unsuccessful in providing long-lasting benefits, some patients may elect to undergo surgery.
The aim of surgery is to prevent the two ends of the bone from rubbing against each other. Your consultant will discuss the most suitable treatment for you. The main options are:
Surgery is performed under general anaesthetic or regional anaesthesia (only the arm is made numb). Each of the aforementioned surgeries take between 30 and 40 minutes.
This depends on the type of treatment you’ve had, but can take from between 8 and 12 weeks depending on whether you’ve had surgery. Your consultant will be able to advise you on this.
When can I return to normal activities?