Dr. Bertrand Perey, MD, FSRC, Orthopaedic Surgeon

Duration: 3:17

Pain and inflammation and arthritis are common symptoms at the base of the thumb. These symptoms are associated with age and it's a type of osteoarthritis that is worse with activity, such as gardening or anything that involves gripping, including racquet sports and golf. As well as things around the house, like opening jars or prolonged pinching and finer tasks. The joint at the base of the thumb is very mobile and the thumb is a critical part for all of your hand functions, and therefore becomes symptomatic. In addition to pain, and pain with use, the area gets sore and swollen and tender to touch. You may notice a redness or a warmth in the area, particularly with overuse. As well, the base of the thumb can become more prominent. You may notice some clicking.

The treatment initially involves using a splint or a brace around the base of your thumb and wrist and sometimes across the wrist. The splints to braces are made of various materials depending on comfort and fit and an occupational therapist, or physiotherapist, or hand therapist, can fit you, or make a custom splint for you. Some patients use different splints for different activities. You'll notice an overall improvement in your function, since the splint immobilizes the painful joint. With the splint you may be able to get back to many of your regular activities. The next way to treat this is with oral or topical anti-inflammatories. Ibuprofen is commonly used, or sometimes a prescription anti-inflammatory is required. Tylenol can also be added as it works differently in your body to help with the pain. Keep in mind that the medications have side effects and you should talk to your doctor or your pharmacist about them.

Cortisone, or corticosteroid injections, are relatively safe and very effective for the arthritis at the base of your thumb. Many patients get so much relief, that they'll have additional injections in the future. They can help keep symptoms under control and to keep activity levels high. You may have more than one injection. The splinting, medications, and injections are all very helpful for many, but the arthritis could progress beyond the medical care, in which case surgery could be considered. Surgery for this joint involves taking out, or excising a part of the arthritis, and rebuilding the ligaments. The procedure is commonly done and can be very effective. It is usually done on a day care basis and for most patients a splint is applied for up to 6 weeks after surgery. Pain in the thumb takes approximately 6-12 months to completely improve and for the majority of patients you are asymptomatic by one year.

Presenter: Dr. Bertrand Perey, Orthopaedic Surgeon, New Westminster, BC

Local Practitioners: Orthopaedic Surgeon