Basal Joint Arthritis

By Ann Morley, OTR/L, CLT – Occupational Therapist and Certified Lymphedema Therapist at Southwest Health

Arthritis is a disease that causes inflammation and stiffness in the joints. Basal joint arthritis, sometimes referred to as thumb arthritis, is a common form and affects the joint at the base of the thumb (the basal joint).  Basal joint arthritis is most common in women over 40, but anyone can get it, and it often affects both hands.

The basal joint is what allows the thumb to move around and perform small motor tasks.  When arthritis occurs in the basal joint, it slowly destroys the joint.

The ends of the bones are covered with cartilage. This covering acts like a cushion, allowing the bones to move smoothly.  When the cartilage becomes damaged and worn down over time, the bones start to rub and grind against each other.  This causes the joint to become inflamed and painful.  With time, the small bone at the base of the thumb may collapse, and when that happens, you are no longer able to straighten your thumb.

Causes: Basal joint arthritis occurs as a result of wear and tear on the joint.  It is more likely to occur 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 lifting objects, unscrewing a jar lid, or turning a door handle or key; and you may also find yourself dropping things. The joint may swell, and with time the thumb may become stiff or deformed.  Your primary care doctor can usually diagnose basal joint arthritis from the way your thumb looks and moves.  If basal joint arthritis is suspected, your doctor may order x-rays to determine how much of the joint is destroyed and what your next step in treatment should be.

Nonsurgical Treatment: If arthritis is diagnosed early, it can often respond to treatment without surgery.  Your doctor may recommend occupational therapy for exercises and splint fitting.  If your symptoms do not improve, your doctor could also prescribe injections of an anti-inflammatory medication.

Surgical Treatment:   If non-surgical treatment doesn’t relieve the pain and stiffness or if your arthritis has destroyed the joint, your doctor may recommend surgery.  In surgery, the diseased joint is removed and the joint is rebuilt, usually with a piece of tendon (graft) taken from your arm or wrist.  Your arm is anesthetized so you don’t feel anything during surgery, and you are typically able to return home the day of surgery.

Recovery:  First your hand will be wrapped in dressing.  You will then have a cast or splint on your hand for approximately 3-6 weeks.  This keeps the thumb stable while it heals.  Your doctor will refer you to see an Occupational Therapist, who will provide you with exercises to help achieve return of motion and strength to your thumb.  Once the joint is healed, you should have little or no pain, as long as you do not overuse your thumb.  You should be able to return to many of your normal activities after a healing period of approximately 8-10 weeks.

Living with arthritis can be painful and frustrating, which is why we encourage you to seek treatment as soon as your symptoms begin.  Seeking treatment early can also help prevent the need for surgery.  If you are experiencing joint pain, the first step is to make an appointment with a primary care doctor by calling 608-348-4330.