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Basal Thumb Arthritis

What is Basal Thumb Arthritis?

Basilar thumb arthritis is a type of osteoarthritis that affects the joint at the base of the thumb, where the trapezium bone meets the thumbs first metacarpal, also known as the TMC or Trapezio-MetaCarpal joint. As a result of the arthritis, the cartilage that covers the ends of each bone at the point of friction wears away, causing the bones to rub against one another with no buffer, which leads to a great deal of pain.


What causes Basal Thumb Arthritis?

The particular joint affected by basal thumb arthritis is one that is subjected to a great deal of wear and tear over the course of your life as it is very mobile as a saddle joint. So even if you do not suffer from osteoarthritis of other joints, it is possible to have it affect only the TMC joint. While general wear and tear of the joint is the immediate cause of the arthritis, the factors that lead to an individual having a likelihood of arthritic development are unknown. It is suspected that a variety of factors play a role such as weight, heredity, possible prior injury, or employment that requires constant heavy use of the joint.


What are symptoms of Basal Thumb Arthritis?

Symptoms of basal thumb arthritis include pain and swelling of the TMC joint, decreased range of motion, weakening of the pinch strength of the hand, and sometimes a bone protuberance at the base of the thumb. Depending on the severity of the arthritic development, the pain and swelling may vary in intensity, but can often be debilitating.


How to diagnose Basal Thumb Arthritis.

Physical examination and X-rays are the best way to determine if you have basal thumb arthritis, but in some cases more complex imaging such as CT scans or MRI scans may be advisable to determine the severity of the arthritis.


Treatment Options

Non-surgical treatment of Basal Thumb Arthritis.

The main concern in treatment of this type of arthritis is to reduce pain, minimize the disability and improve joint mobility. This may be achieved by splinting the joint, either full-time or just at night, depending on the severity of the pain. Over-the-counter NSAIDs can also aid in reduction of the inflammation and reduction of pain. Cortico-steroids may also be beneficial in pain management. It may also be beneficial for you to modify the activity you perform that puts strain on the joint, so as to avoid increasing the pain and inflammation.

Surgical treatment of Basal Thumb Arthritis.

As in most conditions, surgery is always a last resort, but if you are experiencing pain while at rest, or while doing daily activities, and of course if conservative, non-surgical treatment proves ineffective, surgery is the only option. While there are several surgical procedures that may be performed for this condition, the most common is a Trapezial resection arthroplasty. In this surgery, the trapezium bone is removed entirely and replaced with a cushion made from your body’s own tendon tissue, so that it will most likely not be rejected by your immune system. In some cases, it is necessary for the doctor to hold the bones in place with a steel pin while they heal, but this is not universal. You may also undergo a joint fusion, in which the affected bones are fused together, which greatly reduces the swelling and pain, but also reduces the flexibility of the joint, making some tasks more difficult or even impossible.


How can Dr. Knight help you with Basal Thumb Arthritis?

Basal thumb arthritis can be extremely painful, and Dr. Knight’s primary concern is to relieve you of this pain, as well as the accompanying inflammation, so that you can return to your life and work and continue to go about your daily routine with little or no change in behavior.


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