What is Basal Joint Arthritis?
First of all, what is this basal joint? It is the joint at the base of the thumb which allows you to rotate, pivot and pinch to grip on to things in your hand.
Basal joint arthritis is the arthritis of the thumb. For this reason, it is also known as thumb arthritis.
A joint is where 2 bones meet. These ends of the bones are covered with a smooth cartilage to allow the 2 bones to move over each other easily. Without this, the bones will rub against each other with friction ultimately damaging the bones and therefore the joint.
As you know, there are several types of arthritis, but the one that mostly affects the basal joint of the thumb is osteoarthritis (wear and tear of the basal joint).
Am I at Risk of Developing Basal Joint Arthritis?
Basal joint arthritis is more common among females compared to women and the commonest age of incidence is above 40 years.
A past history of fractures or injuries to the thumb also predisposes you to this condition.
What are the Symptoms?
It is a very painful condition causing a burning and aching sensation sometimes joint muscle pain. Most people find it difficult gripping certainly something like opening a lid of a jar bottle which takes two hands and a fairly forceful grip. People with thumb arthritis find it difficult to do this. Other activities that they would find it difficult are opening a door knob and turning the car key.
People are often aware that they have the arthritis as there may be a visible swelling and tenderness at the base of the thumb. There may also be a visible lump over the joint which is hard in consistency suggesting a bony prominence.
In addition to these, they may also complain of limited movement of the thumb.
When Should I Seek Treatment?
If your hand is bothering you to the point that you cannot do the things you like to do, then it is about time that you seek for a consultation.
The treatment is started only after confirming the diagnosis of Basal joint arthritis. The reason behind this is that there are a few other conditions of the hand that may present in a similar way.
How is it Treated?
The treatment options available for basal joint arthritis vary from the use of anti-inflammatory drugs all the way up to surgery.
Treatment options can be classified into non-surgical and surgical.
Non-surgical Treatment
During the early stages or if the pain is not so severe, the arthritis will respond to non-surgical treatment.
- Place ice packs over the joint for about 5 – 15 minutes several times a day.
- Non-steroidal anti-inflammatory drugs (NSAIDS)such as aspirin and Ibuprofen will help to reduce the joint inflammation and swelling thus the pain.
- If NSAIDs do not work anymore, consider the use of splints. It is recommended to use a soft splint during the day and a rigid splint at night while you are sleeping. This provides the thumb some rest and help to reduce the inflammation of the hand.
- If there is no response for splinting as well, the next step would be a cortisone injection. Before this procedure, a local anaesthetic will be given and then the cortisone injection is administered to the joint. It is a very effective treatment used to reduce the inflammation in the joint.
Depending on the frequency of the flares, surgery needs to be considered. For instance, if you get more frequent flares of the arthritis, surgery is usually advised. This basically means that the cortisone injections are not controlling the disease well enough for a long enough period of time.
Surgical treatment
Surgery is the last option available in the treatment of thumb arthritis. Surgery includes removal of the arthritis joint and replacing it with a graft. Sometimes, the space is left alone to be filled with blood. All these will depend on what the surgeon sees during surgery. Following surgery, it will take approximately 6 months to 1 year to recover completely and regain full function.
Your doctor will discuss with you and decide on the best treatment for you.
Conclusion
Basal joint arthritis, also known as thumb arthritis is the inflammation and swelling of the basal joint in your thumb. Women over 40 years of age and people with a past history of fracture or injury to the thumb are more likely to develop thumb arthritis. It is a very painful condition associated with swelling, limited movements of the thumb and difficulty in gripping objects. The treatment for thumb arthritis will vary from the use of non-steroidal anti-inflammatory drugs to surgery. Surgery will be considered in those who tend to have more frequent flares of the disease.