Basal joint arthritis is arthritis of the thumb. The basal joint is also known as thumb CMC (carpometacarpal) joint. This joint receives an enormous amount of stress especially with pinching motions. The amount of pressure taken in this joint when grasping, using a pinch between the thumb and index finger, is approximately 6 to 9 pounds of pressure for every 1 pound of pinch. It's no wonder that this joint wears out and has so many arthritic problems.
Arthritis in the basal joints can be one of many types of arthritis. The most common types of arthritis affecting this joint are osteoarthritis, rheumatoid arthritis, and traumatic arthritis. Traumatic arthritis generally happens due to injury of the joint. Osteoarthritis is a degenerative arthritis. Rheumatoid arthritis is an autoimmune disease.
Your Physician can do an array of tests to diagnose basal joints arthritis. These tests may include ex rays, bone scans, MRI, and a physical examination including manipulation of the joint.
Symptoms of basal joints arthritis can include:
o Pain at base the of the thumb with use
o Aching joints at the base of the thumb that continues to be bothersome even after discontinuing use
o Deformity in the joint at the base of the thumb
o Tenderness of the base of the thumb
o Swelling in the joint at the base of the thumb
o Decreased strength in the basal joint
o Decreased range of motion
o Difficulty in doing tasks such as turning keys, doorknobs, jar lids, buttoning buttons and zipping zippers
o Severe pain when gripping
o Severe pain when pinching the thumb and fingers together
o Decreased ability to grip
o An unstable feeling in the basal joint
o An out of joint appearance at the base of the thumb
o An enlarged, bony appearing joint at the base of the thumb
o Limited joint mobility
Exact cause of basal joints arthritis is unknown. Repetitive use and factors including injury, stress, muscle weakness, the aging process, heredity, and obesity may be contributing factors. Cartilage normally cushions the basal joint. When basal joint arthritis is involved cartilage cushioning degenerates and the bones rub together. This is what causes damage due to joint friction. Bone spurs of pure as the body attempts to repair the damage.
Increased risk factors include:
o Age (these joints arthritis generally happens after the age of 40).
o Gender (basal joints arthritis is more frequent in females).
o Past injuries to the basal joint including fractures, sprains, and jamming the thumb.
o Disease such as rheumatoid arthritis.
o Excessive use of the basal joints.
o The family history of basal joint arthritis.
Treatment for basal joint arthritis can include medication for pain and swelling, corticosteroid injections, splints, and in some cases surgery. The main focus of treatment is pain reduction.
Arthroscopic surgery may be required to reduce pain. Surgery can only be performed during early and middle stages of basal joints arthritis. Advanced stages of basal joints arthritis cannot be repaired with arthroscopic surgery. This is why it is important to discuss treatment options with your doctor during early stages of the condition. Other surgical treatments available are; joint fusion, Osteotomy (bone cutting), Trapeziectomy (removal of the trapezium bone) and joint replacement.
Limiting the use of the joint is one of the best ways to decrease pain. One way this can be done is by wearing splints that immobilize the basal joint and facilitate proper positioning.
Non-steroidal anti-inflammatory drugs (NSAIDs), including OTC medications such as ibuprofen and naproxen sodium, can be used to treat joint pain and swelling. Tylenol can also be used for pain relief. When these OTC medications are non-effective your Physician can prescribe stronger NSAIDs.
Often a combination of splinting and NSAIDs will greatly decrease pain.
Corticosteroid injections can be used for pain relief. Corticosteroids work by reducing inflammation in the joint. Care must be taken when using corticosteroids.
Range of motion exercises can also improve joint pain and mobility. These are done by manipulating the joint through all natural movements. This should be done carefully multiple times daily.
Applying heat or cold can also assist with pain. Many people find ice packs work great in alleviating pain and swelling in the basal joint. Other people have difficulty using ice as it increases other types of arthritic pain. Application of heat works better in these cases. Using a heat pack or a heating pad for 10 to 15 minutes of the time several times throughout the day can decrease stiffness and pain in the joint.
Decreasing use by modifying household chores and finding ways to use other joints when possible to allow this joint time to heal is also an effective way of decreasing pain. Any way that you can decrease use of the basal joint and still keep your independence will be helpful. Simple adjustments in the house such as finding larger handled flatware, adding a key chain or something large to grasp to zipper pulls so that you can manipulate your own zippers, specialized door handles, specialized faucets, and many other adjustments that can make throughout your home can decrease the aggravation you put on the basal joint.