Thumb Osteoarthritis

What is osteoarthritis of the thumb?

Osteoarthritis (OA) is a common inflammatory condition that affects joints causing pain and loss of function.

Your thumb joints, like other joints, are constantly undergoing normal wear and repair process from the everyday use and stresses that are placed upon them. The majority of the time these process will go on unnoticed and you will not experience any symptoms.  This is because there is a good balance between the wear and repair process. Sometimes if we do more with our bodies than usual, or if there is an injury, this balance may be disturbed and you may start to experience some symptoms of pain, swelling and heat in the joint. This is known as a flare up and this may last for up to 24 weeks.

What are the symptoms?

The severity of osteoarthritis symptoms can vary greatly from person to person and with time. You may experience some of these symptoms:

  • Pain and stiffness felt in and around the thumb joint, typically felt after periods of rest, such as first  thing in the morning and tends to improve within 30 minutes.
  • Swelling around the base of the thumb
  • Reduced grip strength
  • Increased temperature of the area
  • Typically symptoms present gradually over several months or years, but at times may flare up, where the symptoms suddenly increase for up to several weeks then settle again.
  • You may find that tasks which require loading the thumb such as lifting, gripping, twisting activities harder to do
  • Grinding sensation when moving the thumb joint
  • Altered shape. Over the years you may notice that your thumb joint appears broader
  • Instability - at times you may feel that the thumb gives way in the later stages of the condition. The thumb joint may collapse inwards known as a subluxed position

What are the causes?

People often think that OA is mainly related to age, but this is not correct and there are many other factors that can contribute to OA, such as:

  • Aged over 50
  • Previous injury to the thumb joint
  • Previous surgery to the thumb
  • Gender – It is more common in women than men
  • Smoking
  • Having a history of gout or Rheumatoid arthritis in the joint
  • Having a family history

What can I do to help myself?

Osteoarthritis is a long term condition and can be managed well with some simple lifestyle changes.

  • Use pain relief. They will reduce your pain, allowing you to remain active. National guidelines recommend trying paracetamol and an Anti-Inflammatory gel to begin with. If you are not sure you can use these or they do not seem to be working speak to your GP or pharmacy.
  • Reduce or modify any specific activities that aggrevate your symptoms but do not stop using the hand and thumb completely.
  • Pace yourself. Try to spread your activities evenly over the day and week.
  • Apply an ice pack to the affected area. This is especially useful if you are experiencing a flare up and the thumb seems warm or swollen. Ensure you wrap the ice in a towel and check the skin regularly to check for ice burns.
  • Do some regular mobility and strengthening exercises see below
  • Wear a splint, for short periods,  to support the thumb. It is important not to rely on splints all the time as the surrounding muscles will become weaker.
  • Consider gadgets and devices to help you with daily taks, such as jar twisters, wide grip cutlery, pen grips, key turners and plug pulls.
  • Stop smoking
  • If you find symptoms persist following this advice you could consider a self-referral to see a physiotherapist please see below

What will physiotherapy do?

A physiotherapist with take a thorough history of your symptoms and will conduct a physical examination of the area to confirm the diagnosis.

The main aim of physiotherapy is to restore strength and function to the hand and thumb. Treatment will be based on active rehabilitation, focusing on strength and flexibility.

Your physiotherapist will create an individual exercise programme to address your individual needs. We have included some gentle exercises for you to start trying if you wish to, please see below.

Corticosteroid injections can be helpful for pain management but will not resolve the underlying cause of the problem. They should only be used after everything else has been tried. This can be discussed with your GP or physiotherapist. Due to the current coronavirus pandemic we will not be offering injections until further notice.

Acupuncture, electrotherapy and massage have not been shown to be helpful for this condition and therefore are not offered.

 

Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if:

  • the pain is severe and started after an injury or accident, like a fall
  • if you have cut yourself and can no longer move your fingers or wrist normally
  • you heard a snap, grinding or popping noise at the time of an injury
  • you are unable to move or hold things
  • your hand or wrist has changed shape or colour
  • you have a very high temperature, feel hot and shivery, and have redness or heat around the hand, wrist or fingers – this can be a sign of infection
  • you have any severe tingling or loss of sensation in your hand and it wont go away

Immediate medical advice is available by contacting NHS 111

Exercises & Resources area

Exercises & Resources

If you already have a diagnosis from a medical professional you may find some of the following links more helpful:

5 star service. An outstanding service by all staff. They have identified my symptoms with great professionalism & empathy. Best health care and results I have ever had.

Excellent, supportive and professional approach. Could not achieve these results on my own! Thank you.

Everyone was so friendly and helpful. Wonderful experience.

Having formerly been a rugby player needed physiotherapy on a number of occasions I have never has as comprehensive a diagnosis and treatment as I have had from Alison Starkey. She was excellent.

Shafeeq Younus was very knowledgeable and courteous. Made me feel so much better mentally. Nothing could be improved.

Very helpful. Exercises really seemed to work for me.

Yohann & Diane are brilliant. Yohann was the only one who realised I had, had a mini stroke, if it hadn't been for him I don't know where I would be today. Diane was brilliant today, she really helped me and calmed me down.

Bart (Klimek) was great, feel like the exercises he gives are helping loads and I'm getting sorted.

Excellent service. Good follow up each time with the care given. All instructions for therapy were very clear.

Within days of attending I was doing exercises, more movement and less pain and everything was explained to me in great detail.

If your pain persists, or you are not sure what to do you can self-refer to see a local physiotherapist who can help you with your problem

Refer