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| HAND & WRIST PROBLEMS |
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| Arthritis of the Base of the Thumb |
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| What is arthritis of the base of the thumb? |
| Any condition that irritates or destroys a joint is called
arthritis. In a normal joint, cartilage covers the ends
of the bones and allows them to move smoothly and
painlessly against one another. With osteoarthritis
(also called degenerative arthritis), the cartilage
layer wears out and the bones rub against each
other. As the cartilage layer continues to wear out,
symptoms of arthritis develop and the joint is
eventually destroyed. |
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| In the hand, the second most common joint to
develop osteoarthritis is the joint at the base of the
thumb, or basilar joint. The basilar joint of the thumb
is formed by a small wrist bone and the first bone of
the three bones in the thumb. The shape of these
bones gives the thumb a wide range of movement –
up and down, across the palm, and the ability to
pinch with each finger. |
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| Who gets arthritis at the base of the thumb? |
| Arthritis in the basilar joint of the thumb is more
common in women than in men. It usually starts after
age 40. Past injuries to this joint such as fractures,
sprains, etc., may increase the chances of
developing this type of arthritis. |
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| Signs and symptoms of arthritis at the base of the
thumb. |
| The first symptom of basilar joint arthritis is pain with
activities that involve gripping an object with the
thumb and fingers (pinching). These activities could
include opening jars, turning door knobs, opening
car doors, and turning keys. Heavy use of the thumb
may also cause pain in the basilar joint, as can
changes in weather, such as a change in humidity
or temperature. As the disease worsens, less activity
is needed to produce pain. Pinching strength
decreases and swelling may develop when using
the thumb. As the arthritis continues to worsen, the
basilar joint begins to look bigger and “out-of-joint.”
At this point, movement of the thumb becomes
limited. |
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| How hand surgeons diagnose arthritis at the base of
the thumb. |
| Close inspection will sometimes show a lump at the
base of the thumb that can be swelling in the joint or
displacement of the thumb’s first bone. Also, forcing
the thumb firmly against the wrist bone while moving
the joint will usually produce pain and may produce
a gritty feeling. The pain and gritty feeling means
that the bones are rubbing against each other. Early
on, movement of the thumb is normal. Later,
movement becomes more difficult, especially when
sticking the thumb out to the side. In worse cases, as
the joint wears away, the thumb’s first bone collapses
into the palm when gripping smaller objects. The
collapse of the first bone then causes the second
joint to overextend when gripping larger objects. |
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| Treatment for arthritis at the base of the thumb. |
| The pain of early basal joint arthritis will usually
respond to non-surgical treatment: limiting
movement of the thumb (placing a splint on the
thumb) and using medicine (oral or local injection)
to decrease swelling and pain. Patients with more
severe cases may require surgery. Your doctor can
advise you on the best treatment for your situation. |
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| Copyright © American Society for Surgery of the
Hand 2001 |
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