Baltimore Sun (MD)
BALTIMORE _ We've all heard of arthritis in the knees and even the hips. But many people may not know the thumb is prone to the joint disease as well. Neil Zimmerman, hand surgeon at the Curtis National Hand Center at MedStar Union Memorial Hospital in Baltimore, said the most common type of thumb arthritis happens gradually over time.
Q: What is thumb arthritis and what causes it?
A: The most common type of arthritis that involves the thumb is osteoarthritis, also known as wear-and-tear arthritis, which is most commonly located in the joint at the base of the thumb where it joins the palm. This type of arthritis is usually a gradual type of wearing out of the gliding surfaces of the thumb joint that occurs in most people over their lifetime, although it can arise in this area following a bone fracture or ligament injury of the area. Rheumatoid arthritis or other types of widespread arthritis can also severely involve the thumb.
Q: What are the symptoms of thumb arthritis?
A: Aching pain at the base of their thumb with pinching and gripping activities is frequently the first sign of this problem. The joint at the base of the thumb carries a magnified load of whatever forces are applied to the tip of the person's thumb causing the joint surfaces to wear out and lose their cushioning properties. People usually first become aware of thumb arthritis with activities such as writing, applying makeup, and when pressure is applied to the heel of their hand.
Q: What kinds of lifestyle problems can thumb arthritis cause?
A: Writing, lifting, cooking, exercise, and using tools can become difficult. Also, sports such as yoga and golf can be compromised by pain at the base of the thumb. People also often notice pain at the base of their thumbs when using their hands to help them arise from a chair.
Q: How is thumb arthritis treated?
A: Thumb arthritis is frequently successfully controlled by wearing a small brace to provide support for the base of the thumb. Oral medications or injections may be needed and are usually effective at easing discomfort at the base of the thumb. Occasionally surgical reconstruction is necessary, and is quite successful if required. The surgery is a brief outpatient procedure that can resolve pain at the base of the thumb and restore normal usage.
Q: What are some of the worst cases of thumb arthritis have you seen?
A: The base of the thumb is usually the first area affected by arthritis but the arthritis can also involve the next joint and even the joint near the thumb's nail. Severe and untreated arthritis can cause a person's thumbs to curl into their palm and the knuckle to become double-jointed, severely compromising a person's ability to hold or pinch objects with their hand. These severe deformities are also usually readily amenable to surgical reconstruction.
Q: Is thumb arthritis curable or something that needs to be treated over a lifetime?
A: Most frequently, thumb arthritis is a mild issue that intermittently flares up and resolves with splints, medications or injections. As the years progress, many people generally function very well and maintain their activity level. Surgery is very helpful in returning or maintaining a person's activity level if the arthritis has progressed to the point that it interferes with a person's ability to care for themselves or to participate in their preferred leisure-time activities.
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