Osteoarthritis of the thumb
Thumb osteoarthritis: triggers, causes, symptoms, treatment
Pain and reduced strength when gripping as well as restricted thumb mobility – this is how osteoarthritis of the first carpometacarpal joint manifests during everyday activities. But there are many ways of slowing down the damage, of reducing pain, and preserving mobility and well as strength in the hand. Find out everything you need to know about osteoarthritis of the first carpometacarpal joint in this article.
How does osteoarthritis of the first carpometacarpal joint develop?
In most cases, osteoarthritis of the first carpometacarpal joint affects the thumb – or more precisely, the carpometacarpal joint of the thumb. This joint is formed by the first metacarpal bone of the thumb and a carpal bone on the side of the thumb, the trapezium bone. The pain typical for osteoarthritis of the thumb therefore usually occurs close to the wrist at the ball of the thumb. When they are healthy, the joint surfaces of both bones are covered with smooth cartilage which, in turn, is protected with a thin cartilaginous membrane. The narrow gap between the joint surfaces contains synovial fluid which provides the cartilage with nutrients and acts as a lubricant.
When strain with great physical effort keeps recurring (for example, constant wringing out of cloths or during assembly work), this membrane can become damaged, meaning the cartilage surfaces touch. Continuing excessive strain can then result in tearing and the cartilage layer roughening. The rough surfaces accelerate the abrasion and wear of the cartilagetissue. Often, the membrane of the joint capsule also becomes inflamed, leading to overheating, swelling, and joint effusion.
Pain and loss of strength are the result. Abduction of the thumb may not be possible at all or only with great pain. Once the cartilage has been damaged, wear can only be decelerated but not reversed.
Causes of osteoarthritis of the carpometacarpal joint of the thumb
Genetic and hormonal influences often play a part because osteoarthritis of the first carpometacarpal joint frequently occurs in a familial setting and mainly affects women from the age of 60.
Osteoarthritis of the thumb can also develop as a result of injuries where the joint surfaces were damaged, such as a fractured wrist.
Osteoarthritis of the first carpometacarpal joint – treatment and outlook
Healing in the sense of restoring the smooth and healthy cartilage area is not possible. But there are many ways of treating osteoarthritis of the first carpometacarpal joint, with non-surgical treatment ideally being the focus, depending on the degree of the osteoarthritis.
If the wear has not yet progressed much, immobilization takes place to relieve the joint and reduce pain – for example, by using an orthosis specifically designed for osteoarthritis of the first carpometacarpal joint. In addition, pain-alleviating and anti-inflammatory medication is used. Furthermore, to preserve the function of the thumb and hand, physiotherapy or occupational therapy is usually prescribed.
The treatment focuses on preserving the strength and mobility of the hand and on reducing pain. The treatment goal is to enable patients to use their hand as normal during everyday activities and to prevent pain-related misalignment and muscle atrophy.
In general, further damage to the joint cartilage cannot be stopped completely with non-surgical measures.
Instead, those affected learn techniques to activate the thumb with as little pain as possible and to prevent permanent loss of function in the hand. Furthermore, for pain alleviation as well as reduction of inflammation and swelling, cryotherapy and creams can be beneficial or ultrasound as well as electrotherapy.
Osteoarthritis of the thumb: what do you do in this situation?
Low-impact instructor-led exercises, a training program for home, and gentle mobilization treatment support the preservation of hand function.
Excessive resting of the hand is not recommended because this would lead to further limitations.
Use of orthoses in cases of osteoarthritis of the first carpometacarpal joint – an important treatment component
One of the most important treatment principles in cases of osteoarthritis of the first carpometacarpal joint is relief of the damaged cartilage. Making the most of the pain-free range of motion is also crucial. That is why an orthosis like the RhizoLoc is an important component when treating osteoarthritis of the thumb, during conservative care as well as after surgery. As part of non-surgical treatment, the RhizoLoc stabilizes the carpometacarpal joint of the thumb and the metacarpophalangeal joint of the thumb in a neutral central position, while the fingers remain free. The extent of the movement restriction can be individually adjusted using a malleable aluminum frame and a Velcro tab.
The thumb orthosis reduces pain and protects from undesirable movements of and strain on the affected joint. To check on progress, to apply creams, or to carry out physiotherapy, the RhizoLoc can quickly and easily be taken off and put on again with the free hand.
After surgery, such as arthroscopy or arthroplasty, the RhizoLoc – if applicable, after the plaster cast has been removed – is used to protect and relieve the joint that was operated on, thus supporting quick healing without complications. The active mobility of the fingers stimulates circulation and lymphatic drainage which, in turn, promotes healing and reduces the risk of accumulation of fluid in the tissue (edema).