Thumb CMC (CarpoMetaCarpal) Arthritis
/ Basal Joint Arthritis

What is Thumb Carpometacarpal (CMC) Arthritis?
  • Osteoarthritis is the wear-and-tear of the nice, smooth articular surface that coats the end of bones and allows the two bones of a joint to slide easily upon each other with movement. 
  • When the cartilage breaks down, it becomes becomes pocked, bone spurs may develop, and the joint space between the bones is lost. 
  • Pain occurs when the bones start rubbing against each other. 
  • The joints can also change position, become unstable, or become misshapen.  A common location for this to occur is at the base of the thumb, known as CMC arthritis or basal joint arthritis.
  • Common Symptoms
    • Pain at the base of your thumb, particularly when gripping, grasping or pinching an object
    • Swelling, stiffness and tenderness at the base of the thumb
    • Decreased strength when pinching or grasping objects
    • Decreased range of motion
    • An enlarged or bony appearance of the joint at the base of your thumb
    • The thumb may begin to "collapse" towards the palm of the hand.

Common Treatments Include:
  • Use of orthotics, splints or braces to position the thumb joint in proper alignment and to support the joints during activity.
  • Implementing Ergonomic Improvements & Activity Modification
    • Use of gadgets and devices (adaptive equipment) to make tasks easier.
    • Using modified techniques to place less stress on the joints (joint protection). 
    • Modifying the flow and pace of how activities are performed in order to minimize muscle fatigue, joint stress, and pain (energy conservation).
  • Use of Heat and cold 
    • Use cold packs for acute pain or swelling.
    • Use heat packs to control more chronic pain or relax the muscles.
  • Wearing compression or Isotoner gloves at night may help control swelling and provide a comforting, neutral warmth.
  • Perform gentle ROM exercises to keep joints as flexible as possible.
  • Use of topical pain relieving creams if helpful and as needed.
  • Modalities such as ultrasound, electrical stimulation and iontophoresis may be helpful to reduce pain and inflammation.
  • Therapeutic taping may be helpful to reduce pain and provide gentle support.
  • A short course of anti-inflammatory medications, such as NSAIDs, may be helpful in the inflammatory stage of arthritis onset as prescribed by an MD or an over-the-counter (Advil, Aleve) if not contraindicated by other medical conditions.
  • A Cortisone injection into the painful area may temporarily reduce inflammation and pain.
  • If conservative treatment methods do not alleviate the symptoms, surgical options may be considered.

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