Osteoarthritis of the thumb joint Author: Bradley Vance, MPT, BSc

Duration: 2:33

OA or osteoarthritis, is a common chronic condition that can involve one or more joints in the wrist, thumb and fingers. It can occur with aging and involves a loss of articular cartilage through mechanical loading and inflammation, and subsequently a loss of joint space between the bones. This can cause severe pain and swelling, ultimately impacting strength and function.

Additionally, we see structural changes in the bone itself, with a thickening of the subchondral bone and formation of osteophytes that are small bony growths. This is bone remodelling and we call this condition osteoarthritis, or OA for short.

A common site of OA development is between the bones that form the joint at the base of the thumb, the trapezium, and the first metacarpal bone. This joint is called the first carpo metacarpal joint, or the CMC joint, for short.

As the condition develops, you might begin to feel pain and stiffness in the base of the thumb, particularly with certain motions such as pinching or squeezing. There can be some stiffness when waking up in the morning, but the major symptom is pain with activity, the pain and stiffness can lead to difficulty with everyday tasks such as opening jars or turning a key in a lock. You might also begin to notice some local swelling or bony changes at the base of the thumb. Physiotherapists can help with managing symptoms in several ways. Not only does OA affect the cartilage and bone, but this can, in turn, affect all the other structures involved in the joint complex, including the tendons, ligaments and muscles.

A physiotherapist might suggest a splint to be worn to provide some external stability to help reduce pain. These splints are usually only worn during the night, during flare ups or during repeated activities involving the thumb. Your physio might also instruct you in some gentle range of motion and stretching exercises to help improve your thumb mobility, eventually incorporating specific strengthening exercises to help keep the muscles around the joint from becoming weaker.

A common misconception with arthritis is that exercise will further damage the joint. In fact, exercise and movement are often some of the best things that you can do for joint health, and a physiotherapist can work with you to ensure that you are moving and loading the joint in a manner that is safe and beneficial. If you're feeling pain or noticing stiffness around the base of the thumb, it would be a good idea to book an appointment with your physiotherapist to confirm a diagnosis and begin a rehabilitation program to maintain or restore function and help reduce pain.

Presenter: Mr. Bradley Vance, Physiotherapist, Surrey, BC

Local Practitioners: Physiotherapist